Health committee  Thank you for the question. I'll start. Contrary to that sort of feeling, we're not seeing increases in youth addiction. In fact, kids are using less substances over time. It has been going down. When you do a survey of kids, the number of kids who use certain substances goes down by about 2% to 3% per year.

Health committee  We have lots of dedicated and hard-working people, and I think it would be fair to say that we need more. I work in a tertiary hospital where there are a certain number of hospital beds, but there's a group of children who aren't sick enough to require full hospitalization. They are really struggling, such that it's hard to get their day-to-day work done.

Health committee  I thank the chair and the members of the committee for the honour of the invitation and this opportunity. As an introduction, I'm a clinical assistant professor and subspecialist child and adolescent psychiatrist. I've been in practice for 14 years. I was a medical director for a major psychiatric emergency unit at B.C.

Medical Assistance in Dying committee  I think the report was excellent. I read it and I find that I agreed with most of it. I found it was a pretty good summary of the expertise we currently have on the issue.

Medical Assistance in Dying committee  There are so many factors that go into a nation's global rate. Whenever we look at a large population rate like the Canadian average, we're including a number of people with a number of different experiences. I'm always careful to not make a positive claim where one doesn't exist.

Medical Assistance in Dying committee  Yes. I have done these analyses. I've actually submitted the evidence to the committee. There is no evidence to support the notion that suicide rates have increased in countries that have adopted MAID, nor in states that have adopted MAID. I have submitted that evidence to the committee.

Medical Assistance in Dying committee  Thank you for the question. I provided that evidence in my brief to the committee. There has been no significant change to suicide rates since the implementation of MAID, despite many proclamations that it would increase, by supposed experts, prior to the passing of MAID. It reminds me a lot of what happened during the initial phases of COVID, when a number of experts stepped forward and said that suicide rates would increase then as well.

Medical Assistance in Dying committee  I'd simply answer yes, and unequivocally yes. This is the core part of psychiatric training. I understand the need for good scientific analysis, but there are many reasons why the science in this area is difficult to conduct. All the best science we have points towards a very clear difference between the type of suffering that happens in MAID requests and the general suicidal patient who presents to a hospital or to a psychiatric clinic.

Medical Assistance in Dying committee  In a previous meeting, Dr. Derryck Smith emphasized the importance of not focusing so much on a diagnosis but on the patient. The patient's experience could very much be untreatable and incurable, and many of the treatments we offer them may or may not work. Our ability to cure everybody is not 100%.

Medical Assistance in Dying committee  Just to follow up on that point, I think neurostimulation and older medications are all things that.... I've practised ECT and I've seen some pretty incredible responses. That being said, ECT is a daunting prospect for a patient. It has a number of benefits and side effects. So do monoamine oxidase inhibitors.

Medical Assistance in Dying committee  Absolutely. I think it's a big problem. When we test the limits of psychiatric science, we have to do that on the positive and negative. If we can't say 100% for certain what's going to happen, we also can't say that treatments will be 100% effective. This is why we put the patient at the core of our decision-making.

Medical Assistance in Dying committee  I am here.

Medical Assistance in Dying committee  Thank you for the opportunity to provide my perspective. I'm a physician with 14 years of tertiary experience in emergency psychiatry involving suicidality, and I'm a researcher, teacher and expert in suicide and suicidology. It's really important to note that what most people think of as suicide is far different from most experiences of MAID.