Medical homicide as psychiatric treatment.

All or nothing: medical homicide as psychiatric treatment

Gordon Friesen

By Gordon Friesen
President, Euthanasia Prevention Coalition

When medical homicide is debated, the question always revolves around a balance between the (alleged) needs of that small number, who wish to die, and those of larger society, to protect others from the dangers.

In Canada it was judicially decided (wrongly in my opinion) that an 'absolute' (or 'categorical') ban was not warranted ('Carter vs Canada').

Pro-death cultists are now attempting to replicate that reasoning in the case of medical homicide for mental disorders alone. But this case will be much more difficult to make. For two things have changed in the meantime:

1) Mental illness presents a completely different context from earlier assumptions surrounding end-of-life euthanasia.

And,

2) We now possess a decade of experience, of deep social harms which were largely unsuspected when 'Carter' was first decided.

As for the first point, psychiatric homicide runs afoul of the 'irremediable condition' requirement of Canadian euthanasia. For no one can determine when psychiatric disorders are incurable. Moreover, it also contravenes the basic understanding that euthanasia will (always) be the result of a fully voluntary, informed, and capable decision.

Death-cult apologists do not entirely contest these points. However, in keeping with their all-or-nothing "no categorical exclusion" playbook, they would like to state this question more narrowly: as whether any person, with any mental disorder, in any circumstance, might ever display proper decisional capacity (or irremediable condition).

Unfortunately, however, to frame the conversation in this way, involves pretending their adversaries actually believe otherwise. In the recent debate with Maid-in-Canada, for example, such was their immediate response to our central messaging, to the effect that the symptoms of mental illness often make that sort of choice impossible:

“He (Friesen) tries to soften this by saying that mental illness often makes that sort of choice impossible, but his position seems clear: he seems to believe it is self-evident that people with mental illnesses cannot make these kinds of serious decisions.”

And so it is that the authors create a completely fanciful portrait, of my thinking, which they may then reject as "categorically false.”

Sadly, MIC continue with this charade, also, in portraying the meaning of third party references. They notably use one (and only one) phrase, without context, to dismiss the very real capacity concerns shown by the Canadian Association of Suicide Prevention:

“MAiD and suicide can, at least in principle, be distinguished”.

This snippet, they say, shows that CASP does not support my (supposed) denial of all decisional capacity among the mentally ill. However, let us explore the full thought of CASP on this crucial ‘overlap’ of medical homicide and common suicidality:

"there may be little to no overlap between MAiD and what we traditionally understand as suicide in those people seeking MAiD at the end of life. In contrast, the risk of overlap increases precipitously for those seeking MAiD for chronic, non-life threatening conditions and, in particular, for mental disorders."

Although we may disagree with the implied trivialization of medical homicide at the end of life, we strongly agree with the conclusion ultimately reached: that the serious (and generally admitted) capacity problem, of differentiating "rational" desires from common suicidality, creates a much larger potential, for social harm, when the subject is medical homicide for mental illness, than if that problem is considered in the original end-of-life context, or even that of "grievous and irremediable (physical) condition". Hence the rationale for a complete prohibition (in this more limited circumstance) becomes that much stronger also.

Practically speaking, this means that Bill C-218, for mental illness alone, stands a far greater chance of surviving constitutional challenge, than did previous law prohibiting all forms of consensual homicide.

But if that were not enough, let us consider the following, from the same source:

“Regarding the capacity for a patient to consent to MAiD, the very nature of mental disorders may impair the decision-making capacity of the patient. Those suffering from a mental disorder are routinely encouraged to avoid making major decisions while in the midst of their suffering. The decision of ending one’s life prematurely is enormous and grave and must not be made while in the throes of mental illness.”

There is not much ambiguity in the meaning of that paragraph.

The capacity/suicidality problem clearly constitutes an extremely serious motive for prohibiting the use of homicide as a treatment for mental illness.

No medical homicide for mental illness. Support Bill C-218