Good evening.
Thank you very much for inviting me to appear before you.
I am chief of psychiatry at an Ontario hospital, a medical ethicist, editor-in-chief of the Journal of Ethics in Mental Health and president of both the Ontario and the global associations of tertiary care ACT teams. They are the teams that take care of the very sickest mentally ill patients.
For the last 23 years, I have treated patients that other psychiatrists told me could not get better, yet they get better. Suffering can always be reduced. With dozens of validated psychotherapy modalities, hundreds of medication combinations and myriad psychosocial interventions, there is absolutely no such thing as “everything has been tried”, despite what some patients say and despite what some psychiatrists who lack skill, knowledge or perseverance say. Death is being falsely presented as the only option.
You seek my evidence because I have particularly relevant experience and knowledge. How do you know who is right when my statements conflict with others? Tragically, ableism and stigmatization are never defeated because of clear logical points made about social fairness. Ideology pays lip service to reason while amplifying misinformation.
I presented on this same issue at a Senate hearing in 2021. My rage has since given way to profound sadness because the same misrepresentations keep being repeated by the same players. The issues have not changed in five years. The facts, however, have been made clearer. People are getting MAID for psychiatric reasons under the guise of flimsy medical excuses. Prolific MAID providers are happy to assist with suicides while people are on wait-lists for effective treatment. MAID is being offered to veterans, disabled people and people with very treatable illnesses. Irremediability is clearly known to be impossible to predict for mental illnesses. Patients will doctor-shop until dead.
Orwellian doublethink has been rampant. MAID activists say MAID is not suicide, that “irremediable” means you can't get better right this minute, that suffering is best relieved by death and that the health care system cares about you so much it will help you kill yourself. People need lifeguards, not someone to push them under.
Only one in three adults and only one in five children in Canada have access to the mental health care they need. The general public is not aware of this appalling and intentional lack of services. The Mental Health Commission tells us we could save billions by paying for upstream services that we know work. Instead, we let people get sick downstream, and it costs us billions more than necessary.
Why don't we provide care that we know works and is extremely cost-effective? Why are any of you supporting suicide instead of the care that prevents suicide?
The answer is stigma, ableism, false economic claims and a distorted view of autonomy. Please stop pretending that autonomy is some detached, rational enterprise. Very sick people are actually driven by fear, desperation and hopelessness borne of the illnesses we undertreat and don't treat. If you have to help someone kill themselves, then they are not acting autonomously. I am tired of the farcical news stories citing people who have been trying to kill themselves for decades and are demanding that a doctor help them.
There is a laughable conceptual distinction put forward by MAID activists that MAID is well thought out and true suicides are impulsive. Decades of suicide research put the lie to this. Eighty per cent of suicide attempters thoughtfully plan their suicides. MAID is suicide par excellence, like having a wedding planner to make it all as easy as possible, even with same-day service.
The Harvard school of public health showed that 90% of people who attempt suicide do not go on to complete suicide following treatment. With the right treatment, suicidal thinking disappears. The rates of suicide in jurisdictions that have MAID—specifically Oregon, Switzerland, the Netherlands, Belgium and Australia—rose much faster after it was legalized than before. Suicide contagion is a well-proven reality. Don’t pretend it won’t happen in Canada.
Seventy-two per cent of Canadians oppose MAID for mental illness. Over 90% of psychiatrists are opposed. You should listen, but mostly, you should stop and try to imagine what it is like to be given up on. If you have never tasted raw, hopeless despair, then stand boldly behind the claim that we should all be entitled to suicide facilitation, but if you have known suffering, the suffering of those you are inviting to death, then you can’t pretend that this planned social travesty is anything but accursed ignorance.