Medical Assistance in Dying committee  Thank you very much. My name is Sonu Gaind. I'm a full professor, psychiatrist and governor at the University of Toronto, the chief of psychiatry at Sunnybrook, and a past president of the Canadian and Ontario Psychiatric Associations. My expertise is in psycho-oncology. I work with cancer patients and their families.

Medical Assistance in Dying committee  I hope I'm not losing time.

Medical Assistance in Dying committee  I can't slow down. I won't be able to finish my comments.

Medical Assistance in Dying committee  I'm sorry, but I have prepared material I'd like to finish.

Medical Assistance in Dying committee  Thank you. Saying something false repeatedly doesn't make it true, and evidence shows they can't make the distinctions they claim. The CAMAP curriculum dangerously doesn't teach assessors how to distinguish suicidality from psychiatric MAID requests, but convinces them that they can, leading to remarkable statements like Dr.

Medical Assistance in Dying committee  I'd be happy to, and I will reiterate that I think it's wholly inadequate. I'll be stronger in saying that. I think we could have gotten a better use out of our $3.3 million that went for that. However, pejorative comments aside, it's something where, when I look at that, I am looking to see if this helps the assessors in any either evidenced or reasonable way to tease apart things like irremediability.

Medical Assistance in Dying committee  I've heard that echoed by many people, actually, and it is simply not true. Our suicide assessments that we're trained to provide through residency are not about distinguishing suicidality from whether somebody wants to die through MAID. It's a completely different thing. The CAMAP guidance focuses very heavily on whether it's impulsive or not, completely bypassing and missing the fact that many suicides are actually planned out, well thought out over a period of time.

Medical Assistance in Dying committee  I don't agree it's a fair characterization. I am actually shocked that she said that. She should know better than most that many people have wanted to be involved and have not had the opportunity to be. That includes for many things that I can give further details on, but I know that the time for your question is limited, but I do not agree with that.

Medical Assistance in Dying committee  If I have to answer that, publicly, it's maybe 25 years, something like that. It's 20 to 25 years.

Medical Assistance in Dying committee  I've met patients in the course of my practice who have not gotten better, but I've met more who I never thought would get better and did.

Medical Assistance in Dying committee  Absolutely. It's about trying to help somebody re-engage meaning and purpose of life. We are able to do that. The point I was making in my preceding comments is that I could not have predicted which of those people would or would not get better. The vast majority did get better, and if I had thought they would have—

Medical Assistance in Dying committee  It's not about being medically difficult to care for. It's about being impossible to properly predict that they won't get better. That means that you would be providing death under false pretenses. That's my problem with this. In terms of your question, I'll answer with two things about the people who don't get better.

Medical Assistance in Dying committee  Regarding the things that you're quoting, first, I'll point out that it's not in the health practice standard. They actually removed the suggestion that there be a specialist involved, so that is no longer there. Dr. Gupta was one of the six people who also wrote that. In the same expert panel report, they say, literally, that they are unable to provide guidance on the lengths, number, or types of treatments required before providing MAID for psychiatric illness.

Medical Assistance in Dying committee  No, it would not provide the safeguard you're thinking it would.

Medical Assistance in Dying committee  There are a few things. One is, keep in mind that I know of no other thing we do in medicine that requires a carve-out from the Criminal Code to avoid prosecution for homicide. What we're talking about is helping people die when they're not dying—that's the bottom line of what we're talking about.