Honourable senators and members of the committee, I've spent my life working in suicide prevention. I was president of the Canadian Association for Suicide Prevention and the international association. I am founder of the Quebec association for suicide prevention. I also work with the World Health Organization in training, research and policies.
I believe MAID should be available when suffering is not remediable by other means. However, in the case of mental illness, this is not possible to determine. I believe suicides are preventable, even in seemingly hopeless situations. I agree with the position of the International Association for Suicide Prevention that the overlap between MAID requests and suicide makes it impossible to distinguish between them and that MAID for mental illness will undermine suicide prevention by communicating that death is a viable alternative to treatment.
I don't think I have to say much about irremediability. Other people have talked about its impossibility to be determined with mental illness. No one can accurately predict whether a patient who failed to respond to multiple past treatments will respond to the next treatment or not. Mental health diagnoses change. They are, unfortunately, unreliable. With common diagnoses like schizophrenia, if you ask two psychiatrists to independently make a diagnosis, in about one out of seven patients they will make different diagnoses. That means many people will get the wrong treatment unless or until their diagnosis is corrected. Over the course of 34 years, 86% of mental health patients have at least two diagnoses. According to research, virtually no one gets and keeps one pure diagnosis type.
We have an obligation to provide access to mental health treatment before providing access to MAID. In 2025, the Canadian Institute for Health Information found that 41% of adults with a mental illness said that their needs were met not at all or only partially, while 52% of young adults reported being able to obtain not any or only limited help for their mental illness. One out of three Canadians said they did not have access to mental health services because they were unable to pay the cost.
Some believe that requests for MAID are more reasonable or rational and that this can be distinguished from suicide. However, there is no discernible difference between the reasoning in MAID requests for mental illness and justifications given for suicide. Both people feel that their suffering is interminable and intolerable. Moreover, most important human decisions are emotional and not rational or reasoned. What are the most important decisions we make? They are who we marry, our career choice and even what type of car we buy. We cannot expect that while we are suffering from a mental illness, which can cloud one's thinking, things should be any different from other important decisions we make.
I held the Bora Laskin Canadian national fellowship in human rights research to study euthanasia in the Netherlands, where MAID for mental illness was legalized in 2002. Each year, only one or two requests were approved. However, recently, after news stories about people with depression who received euthanasia, requests skyrocketed in 2023, with 138 deaths. In 2024, it went up 60% more, with over 7,000 requests and 219 deaths. Most of the people who died and who requested it were depressed women living alone under the age of 24.
Alarmed psychiatrists petitioned the government to stop this practice. They said, “Introducing euthanasia as a sanctioned outcome reframes suicidality from a symptom requiring containment into a potential treatment endpoint, an acceptable 'treatment plan.'” I don’t want this to happen in Canada.