People who experience mental illness do not need our help to die—they need our support to live

On March 17, 2024, individuals in Canada whose sole underlying medical condition is a mental illness will become eligible for medical assistance in dying (MAID) unless the federal government decides not to go forward as planned. As a parent, a medical professional, and an advocate for human rights, we must put a stop to this inhumane policy. By legalizing MAID for mental illness, Canada will further deviate from the practice of preventing suicide—for everyone. Moira Wilson is the president of Inclusion Canada. Photograph courtesy of Inclusion Canada “Assisted suicide” may be an unsettling term, but I use it intentionally. It’s time that we reckon with the discomfort of reality. People with disabilities are now legally dying by suicide in Canada with assistance from MAID providers, and this will become far more common with the availability of MAID for mental illness. Medical assistance in dying was—for the first five years—an option made available to people with a “grievous and irremediable medical condition” and a “reasonably foreseeable natural death.” Then, in 2021, Canada began to allow all eligible people labelled with a grievous and irremediable illness, disease, or disability to die by MAID. The caveat was—and is—that people with a mental illness were to be “excluded” from MAID as a solution to suffering associated with their mental illness. They are therefore, at present, “included” under the Criminal Code’s protection from suicide promotion and facilitation—which is a protection most Canadians enjoy. People with a mental illness currently remain eligible for MAID if they have a co-occurring illness, disease, or disability. This mental illness “exclusion” will expire this March. Research shows that recovery from mental illness is very difficult to predict. While mental illness can be treatment resistant, it is impossible to predict the likelihood of improvement for a given person at a given time. As the parent of a son with an intellectual disability, I have some experience with doctors predicting quality of life. This is a near-universal experience for parents of people with disabilities. The nature of these early-diagnosis conversations can change your life-course, and give or take away hope. I am thankful that my son’s doctor told us to never put limits on him, but others in my community were told that their child simply would not thrive. They later defied these predictions. I have little faith in a medical professional’s ability to predict without bias what is scientifically known to be unpredictable. As a medical professional myself, I am disappointed with Canada’s choice to pivot away from suicide-prevention—which was a key reason for legalizing MAID in 2016. I’ve come face-to-face with suicide at various points throughout my career, including leading reviews of deaths that occurred by suicide in my community of Saint John, N.B. Because of this, I want to be clear not to overlook the “grievousness” of mental illness. Mental anguish paired with social stigma can be a lot for one person to hold. Many people expend precious energy into keeping themselves alive every single day. This is exactly why, when a person wants to die, they don’t need to hear that their suffering warrants death. They don’t need their suicidal ideation affirmed. People who experience mental illness do not need help to die. They need support to live, to be heard, to be invested in, to have the conditions of their life improved upon, and to be unconditionally valued. Even if—especially if—they may be “difficult” to work with. Social determinants shape a person’s likelihood of acquiring a mental illness, their likelihood of accessing adequate and appropriate treatment for their mental illness, and the likelihood that their treatment will be successful. Four out of five people with a mental health disability have at least one other type of disability, and over 40 per cent of people with an intellectual disability have a co-occurring mental health condition. Yet, our elected officials are pursuing MAID for mental illness of their own accord and on their own rushed timeline. At the recommendation of the Senate, elected officials made the hasty decision to go down the path of legalizing assisted suicide for people with a mental illness at a pre-determined date. They made this decision over the course of less than a month in 2021. If no further action is taken, this predetermined course of action will come into effect in March, with no new safeguards being added to the law. That leaves us, Canadians, in the unfortunate position of needing to ask elected officials to admit they made a mistake. Join me in encouraging them to do so. Moira Wilson is the president of Inclusion Canada, a national federation working to advance the human rights of people with an intellectual disability. She is the parent of an adult son with a disability, and is also a pharmacist who has worked in a leadership position at a major regional hospital in New Brunswick.

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People who experience mental illness do not need our help to die—they need our support to live

Social determinants shape a person’s likelihood of acquiring a mental illness, accessing treatment, and the chance that treatment it will be successful.

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