By Alex Schadenberg, Executive Director - Euthanasia Prevention Coalition
Doctor K Suno Gaind, who is a President of the Canadian Psychiatric Association and an associate professor at the University of Toronto wrote an article that was published in the Globe and Mail on Friday May 27, 2016; where he states that there are no known standards for approving euthanasia for psychiatric reasons.
Dr Gaind questions how euthanasia fits with - Do No Harm - ethic:
Do no harm. How do we square this guiding tenet with medically assisted death? Which is the greater harm – helping a person to end his life, or allowing continued suffering when he seeks death?
When it comes to mental illness, it is even more complicated. The 2015 Supreme Court decision emphasized the need to protect the vulnerable from seeking suicide at a time of weakness. Less clear is how we actually do that.
Mental illness can affect how a person thinks. Depression fuels negative self-thoughts, self-blame, hopelessness and struggling with one’s place in the world. Negative events are dwelt upon and positive ones discounted, with emotional resilience lowered until mundane stresses seem overwhelming.
This is not to deny the real pain and suffering of mental illness, nor to imply that it invariably compromises clarity of thought. However, in severe cases, teasing apart how illness-based cognitive distortions can influence decision making is a formidable challenge. Heart disease might produce suffering but not necessarily alter thought processes; with depression, people often say they no longer feel or think like themselves.
This predicament could be moot if suffering continued indefinitely. The value of suicide prevention is not to stay alive with intolerable suffering, but to avoid ending life during a vulnerable period. Unfortunately, cognitive distortions can lead some to decline treatment and seek death, despite the prospect of a healthy future.
Dr Gaind explains how difficult it is to assess irremediable suffering of psychiatric patients.