Will our crumbling healthcare system lead to more people being offered the “relief” of assisted suicide?

Susan MartinukFor the past decade, activist groups have been spreading the news about the so-called ‘right to die’ and, according to the latest statistics, their efforts have been a success.

The province of Quebec is now the world leader, with more assisted deaths per capita (5.1 percent of all deaths) than any other jurisdiction. Across Canada, that number is 3.3 percent of all deaths – higher than Belgium (2.3 percent) and gaining on the Netherlands (4.8 percent).

Our lead on the world stage of death is a rather dubious distinction, but it becomes even more concerning against the backdrop of Canada’s low-performing healthcare system.

Case in point: A suicidal woman seeking help at a Vancouver hospital came head-to-head with bare-bones healthcare and a fatalistic clinician.

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Kathrin Mentler was depressed and didn’t feel “safe at home.” So, she went to Vancouver General Hospital (VGH), which offers mental health and crisis intervention services. She later told the media that her goal that day was “to keep myself safe.” She wanted “help to live” and was prepared to stay the night. Instead, she was told there were no beds and “the system is broken.”

When Mentler stated that she had previously attempted to overdose on medication, the clinician (not a psychiatrist) asked if she had considered medical assistance in dying (MAID) as it would be a more “comfortable” process. Rather than help Mentler overcome her suicidal thoughts, the clinician explained, in detail, the various steps in the MAID process.

She then told Mentler a story about a patient with mental health problems who had drowned. The twist to that tale? The clinician felt relieved that the patient was now free from his/her struggles.

By then, the message was clear – peace of mind is easily achievable … through death.

Mentler left VGH shortly after and woke up the next morning wanting to “scream and cry.” Instead, her friends encouraged her to go public with her story and she lodged an official complaint.

Proving that bureaucracy can always make a bad situation worse, the health authority that operates VGH first defended the doom and gloom conversation as part of a suicide risk assessment tool; when that didn’t play well, it shared its “deepest apologies for any distress caused.”

This story is of concern on several levels.

First, offering/providing MAID solely based on mental illness is not legal. It was scheduled to become legal in March, but the federal government delayed the legislation for one year to allow for the development of more guidelines. Whether or not sufficient safeguards can ever be achieved for mental illness is questionable, at best. But a 2022 Postmedia-Leger poll found that 45 percent of Canadians agreed with providing MAID to adults with mental illness.

Access to MAID will almost certainly soon include those who may not have an accurate assessment of themselves, their situation, or the world around them. This leaves them particularly vulnerable and increasingly susceptible to the distorted view that an easy death offers more dignity than a difficult life.

Fortunately, in the present situation, Mentler was able to see the discussion for what it was – inappropriate and unhelpful.

Second, this situation offers a look at the intersection of MAID and a healthcare system on life support. Mentler was told no beds were available – even though she wanted one to keep her safe through the night. They apparently offered to call a psychiatrist, but it isn’t clear that she ever saw one.

Canada’s healthcare system is characterized by an insufficient number of doctors or nurses, a severe shortage of beds, an even worse shortage of psychiatric beds, and long waitlists for care. Since 2018-19, more than 53,000 Canadians have died on a waitlist. Waits for psychiatric services range from 3.3 to 12 weeks – but that’s not good enough when a life is on the line.

These facts have been documented over and over again. How often do we have to describe the appalling state of healthcare before politicians accept the mantle of leadership and take action?

It is hoped that the above circumstances are an anomaly – the result of one incompetent or frustrated individual operating outside the typical standard of care. But the apparent intersection of MAID and “a broken system” deserves further consideration. After all, there are many people who want to live but desperately need medical care to survive. As the Canadian healthcare system continues to crumble, these individuals will most likely fall between the widening cracks.

Susan Martinuk is a Senior Fellow at the Frontier Centre for Public Policy and author of Patients at Risk: Exposing Canada’s Healthcare Crisis.

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