Euthanasia: No Evidence Base for Futility and Irremediability in Psychiatric Disorders

This commentary was published by The Psychiatric Times on April 6, 2026.

By Dr's Mark Komrad and Catherine Ferrier

Dr Mark Komrad

As Canada approaches the planned implementation of their medical euthanasia program—or medical aid in dying (MAID)—for patients with sole psychiatric illnesses in March 2027, the Canadian Parliament is again studying the advisability of this decision. Here, we make an argument as to why these practices should remain closed to individuals with psychiatric disorders.

Unlike many other kinds of illnesses, futility or irremediability cannot be reliably resolved by clinicians in cases of psychiatric disorders, especially for any one particular individual. As Sonu Gaind, MD, past president of the Canadian Psychiatric Association and chair of the Toronto Expert Advisory Group on MAID for mental illness, wrote, “An extensive review of the literature shows that we cannot predict irremediability when it comes to mental illness. . . There is a big difference between being able to predict the declining course of a well-known medical ailment with understood biology, even if not with 100% certainty, versus making unpredictable assessments about the course of mental illnesses.”1 Some reasons for this follow.

Diagnosis and Prognosis of Mental Disorders Are Unreliable

Prognosis, the ability to predict the course of any illness—with or without treatment—depends on accurate identification of what the illness is, so that we can mine scientific evidence about the course of that illness. Because psychiatric conditions are based on patient’s history and clinical observation of the individual (rather than other kinds of validations, like blood tests, imaging studies, etc) the reliability of psychiatric diagnosis is limited. Studies have shown that clinicians agree on a patient’s formal psychiatric diagnosis between 66% to 75% of the time.2 Also, over time, psychiatric diagnoses are liable to be changed, much more than diagnoses of somatic illnesses. So, the unreliability and instability of psychiatric diagnoses mean that predicting the course of a patient’s condition, the prospect of its remission, and its response to any or all treatment, are too elusive to declare any one case “untreatable” or “futile.” The level of uncertainty in the science of psychiatric prognosis is very high.3

Inability to Know Which Suicides to Prevent and Which to Provide

Because of these unpredictable aspects, allowing MAID for some psychiatric patients, but not for all, poses a profound and irresolvable clinical conundrum—how to distinguish those patients for whom suicide should be prevented from those for whom it should be provided. The chairs of all 17 academic departments of psychiatry in Canada expressed profound concern about allowing MAID for mental disorders for this reason.4 Imagine a likely scenario if MAID were legalized for psychiatric disorders: a psychiatric inpatient ward where some patients are being treated for suicidal thinking or behavior, perhaps involuntarily, but others on the same ward might be deemed eligible to receive MAID. Besides the moral injury to the clinicians, how confusing it would be for the patients in that milieu! Now scale up this conundrum to the general population where, nationally, some suicides for mental disorders are not prevented, but provided. That will impact the taboo against suicide—a vital component of suicide prevention in general. A taboo (“it is not good to commit suicide”) is different than stigma (“you should be ashamed if you try it”). Indeed, because of MAID’s dampening taboo, there is growing evidence that the rates of “ordinary suicide” in jurisdictions that have MAID (specifically Oregon, Switzerland Netherlands, Belgium5 and Australia6) have risen much faster after it was legalized than before, strongly suggesting the emergence of “suicide contagion”—a well-known public health phenomenon. The mixed messages of the provided vs the prevented suicides are profoundly impactful, particularly on those with mental illness, who already struggle with impairment in rational reflection about suicide as an option.

Enormous and Nonspecific Variety of Treatments for Mental Disorders

The breadth of treatments for psychiatric illnesses is wider than for somatic treatments. There is much less specificity for any one medication, therapy, or procedure for a mental disorder. Treatments for psychiatric disorders are much less precise than for somatic disorders.7 For example, a medication that might be effective for schizophrenia will also be effective for bipolar disorder, anxiety, posttraumatic stress disorder, insomnia, eating disorder, and others. Psychiatric treatments come in many modalities from over 100 pharmaceuticals of different actions to several hundred bona fide methods of talk therapy and physical treatments,8 like electroconvulsive therapy, transcranial magnetic stimulation, and many others. The response of several patients with a similar psychiatric condition can be highly variable,9 more so than for nonpsychiatric conditions, requiring a much more robust trial-and-error approach. Patients typically require more than one kind of treatment for optimal benefit. There is not widespread availability for so many of these various treatments, particularly some cutting-edge treatments like psilocybin, clozapine, ketamine, and dialectical behavior therapy. Some are available only in academic centers and some are wielded primarily by subspecialists in a certain condition, who may be difficult to access, as they are scarce, with long waiting lists to see them. Waiting lists for such specialists in Canada can be far longer than the 90-day wait for Track 2 MAID.10 Off-label treatments are especially common in psychiatry, even when there is a good evidence base, so they may be difficult to get approved.11 Therefore, not every treatment is available to every psychiatrist, and indeed, not every psychiatrist is even aware of the full scope of treatment options, or is trained in them.12

The Challenge of Evaluating Capacity to Consent to MAID

Capacity to consent to treatment is more elusive in the setting of mental illness. The most respected bioethics textbook in the world, Principles of Biomedical Ethics, written by Beauchamp and Childress, defines autonomy as: “Self-rule that is free from both controlling interference by others and from inner limitations.”13 Mental illnesses and their associated cognitive and emotional distortions are the quintessential inner limitations. The state-of-the-art of capacity assessment is a highly complex one, which was developed for far less serious existential issues than to make the decision to end one’s life. It was developed for capacity to stand trial, write a will, consent to surgery, etc. Even at that level, capacity assessment requires specialized training that even most psychiatrists do not have. It is a skill that is provided mostly by certain psychiatric subspecialists—forensic psychiatrists and consultation-liaison psychiatrists who work on medical and surgical wards. Even in the Netherlands, a country that has had 2 decades to develop experience with psychiatric MAID, one study showed that 92% of psychiatric patients receiving euthanasia had inadequate capacity assessment,14 because there were no agreed upon standards for such an assessment for approving a suicidal wish in that cohort where suicidal feelings are particularly endemic.

Those With Mental Illness Are More Marginalized and More Vulnerable

Family physician Ramona Coelho has written: “When feeling like a burden, or when loneliness, depression, or fear of prolonged suffering are the factors driving the decision, the choices for MAID are not made in true freedom but are borne of anguish and desperation... Suffering can distort autonomy.”15 Mental illness can indeed cause severe suffering. One might even consider it the “most human” form of suffering. That marginalization makes individuals more vulnerable to requesting MAID, which has been widely documented in Canada. Those with chronic and severe mental illnesses are among the most marginalized citizens of all. They are overrepresented in the lowest socioeconomic quintile of the population.16 They are more likely to be underresourced, disabled, unhoused, and stigmatized than people with other medical conditions. Franklin Roosevelt famously said, “necessitous men are not free men.” Those with mental illness are disproportionally necessitous.

MAID Inverts the Fundamental Ethos of Mental Health Professions

It is already challenging for physicians to get out the way of death, and to refer patients for palliative care. Further, to administer the means to actively produce death is anathema to medical ethics, but particularly for psychiatrists, whose daily work and fundamental ethos is to prevent suicide. This is why the American Psychiatric Association is opposed to any intervention to produce death for those with mental illness.17 Mental health professionals typically have longer and more frequent encounters with individual patients than other physicians and health care professionals. Helping individuals deal with despair, demoralization, suffering, and hopelessness is a core mission in the mental health professions. Psychiatric clinicians address symptoms, but also build coping mechanisms, mobilize support systems, and even help people make meaning of unresolved suffering. Mental health experts are skilled at accompanying patients in their afflictions and have specific training and experience on how to avoid absorbing a patient’s hopelessness and nihilism, a skill set which is independent of any psychiatric diagnosis. To create a facilitated path to suicide by opening MAID in the setting of mental health treatment is a profound, indeed revolutionary, and perilous inversion of that professional ethos for individual patients, and for public mental health.

Dr Komrad is a psychiatrist on the teaching staff of Johns Hopkins Hospital in Baltimore, Maryland. He is also a clinical assistant professor of psychiatry at the University of Maryland in Baltimore and on the teaching faculty of psychiatry at Tulane University and Louisiana State University in New Orleans, Louisiana. He is also a founding member of the international physicians’ organization Doctors Say No.

Dr Ferrier is a family physician working in the Division of Geriatric Medicine of the McGill University Health Centre. She is an assistant professor in the Department of Family Medicine at McGill University in Montreal, Quebec, Canada, and is the president of the Physicians’ Alliance Against Euthanasia.

References are attained by linking to the original article (Article Link).

Meghan Schader: Please Do Not Use the R Word: Part 2

Meagan Schrader

By Meghan Schrader

As I’ve written, some people have begun incorporating the words “retard” and “retarded” (known in disability circles as the R word) into their political identities; people are using the R word as a way to signal their frustrations with political correctness. Hence, public usage of the R word has increased significantly.

I want to help other euthanasia opponents understand why it’s important to resist this fad.

So I’m offering a more detailed account of a few of my experiences of being called the R word; I think they might help euthanasia opponents understand why participating in the R word craze trivializes the word’s connection to disabled people’s experiences of abuse, even if the people using the term as a badge of honor don’t mean it that way.

One day at church when I was eleven, another girl randomly walked up to me and said, “Meghan, you’re a retard and everyone hates you.” “That’s not a very Christian thing to say,” I answered. “I’m not Christian, I’m Episcopalian,” she said. (LOL).

This girl was not alone in using that term. During one Sunday School class when the teacher finally told an aggressive bully to stop calling me the R word, he said, “She’s like an animal, she has no feelings anyway.” This abusive behavior spread among other children in the class, until pretty much everyone was calling me the R word and saying that they hated me. The problem became so severe that my parents pulled me out of Sunday School.

In sixth grade there was one bully who not only called me the R word, but also taunted me with comments like, “Did your mother drink when she was pregnant with you?” “Did your parents lose a bet with God or something?” “I’m going to throw acid on you in science class.” Then he stole metal pellets from the science classroom and threw them at my head. After that, the principal ordered us to attend a peer mediation session with two peer mediators and a police officer. The bully had no compunction. He proudly admitted that he had, in fact, called me the R word, threatened my life, etc. “Yeah I hate her; everyone in the school hates her,” he said.

These are only a few examples; I could go on and on about all of the times that bullies did vicious things while calling me the R word.

In short, when you use the R word to prove how bravely politically incorrect you are, you are ignoring the term’s link to dehumanization and prejudice.

So, please: Don’t use the R word.

Meghan is a disability instructor and a member of the EPC-USA board.

• Previous article by Meghan Schrader on this topic: (Read).
  

Euthanasia can allow structural coercive forces to push people toward death.

The following presentation was made by Dr Ramona Coelho to the Special Joint Committee on Medical Assistance in Dying on April 14, 2026. (Link to the meeting)

Dr Ramona Coelho

I am a family physician, Senior Fellow at the Macdonald-Laurier Institute, and an adjunct research professor at Western University.

I served on Ontario’s MAiD Death Review Committee and have published extensively on MAiD, and I speak in an individual capacity.

For twenty years, I have cared for patients with complex disabilities, mental illness, chronic pain, and social vulnerability, many facing financial instability.

Suffering is complex, shaped by psychological distress, trauma, poverty, isolation, and lack of support. Addressing it requires careful assessment, time, and care.

Community life plays a large role in mitigating suffering.

Yet in Canada, some individuals receive MAiD where suffering is driven by these unmet needs.

In my practice, I observed troubling patterns in how MAiD is introduced and assessed.

Some patients were referred immediately after a new diagnosis, others were approached repeatedly during vulnerable hospitalizations, and some were assessed and approved quickly without meaningful exploration of suffering or supports.

Ontario MAiD Death Review Committee reports contain anonymized cases, which you should all have. Across these cases, there were individuals with untreated mental illness, suicidality, addiction, isolation, and unmet social needs, demonstrating premature eligibility, inadequate safeguards, and a failure to address suffering before ending lives.

In particular, Track 2 cases reflect social vulnerability and untreated mental illness. Statistics showed nearly 30 percent of recipients lived in poverty. More were women. Many listed a lawyer, physician, or friend, not family, as next of kin, indicating social isolation. Less than half received mental health or disability supports. Fewer than 10 percent were offered housing or income support.

Although framed as choice, MAiD can allow structural coercive forces to push people toward death.

With mental illness, it is not possible to reliably determine that someone will not recover. At the same time, many Canadians wait prolonged periods for specialized psychiatric care, extending suffering and delaying recovery.

Suicidality, lack of insight, and impaired judgment are symptoms of many psychiatric conditions. They fluctuate, and recovery often occurs with time and social support, with or without treatment.

Given the lack of evidence to guide MAiD assessments for mental illness, bias and discrimination will inevitably determine who receives MAiD and who receives suicide prevention.

I invite you to read my article: Discrimination-driven deaths – Analysing Ontario Coroner Reports on Euthanasia and Assisted Suicide.

In response to claims that MAiD professionals consistently follow guidelines and that CAMAP guidance is sufficient, review the Ontario MAiD Death Review Committee cases and read my article. They illustrate gaps between guidance and practice. Also consider the risks of expanding MAiD on suicide contagion; MAiD presents death as a solution to suffering and provides the means to achieve it, with clinician support.

One witness cited a documentary on MAiD for mental illness, noting that the individuals later died by suicide, and suggested that delaying MAiD contributed to these deaths.

But why might this have occurred? Repeated exposure to messaging that frames death as the best or “dignified” response to suffering can increase resolve to end one’s life and worsen suicidality.

Suicide prevention research shows that normalizing death as a response to life suffering, combined with access to lethal means, increases suicide risk.

Further, The CPA’s consensus statement on MAiD for mental illness reflects opinion, not evidence-based medicine.

It should not reassure us that we are ready for this, nor guide life-and-death decisions.

In contrast, the International Association for Suicide Prevention states that MAiD should not be provided solely for mental illness and that suicide prevention principles must continue to apply to those near death or living with disability.

The UN Committee on the Rights of Persons with Disabilities has advised repealing Track 2 MAiD, including expansion to mental illness.

There are good reasons why Quebec, Alberta, and other provinces are not moving forward with MAiD for mental illness.

We cannot continue to delay.

A government committed to protecting all Canadians must stop MAiD for mental illness.

People do not want to die they want their suffering to be relieved.

Dr Peter Blusanovic

This speech was delivered by Dr. Peter Blusanovics at the Euthanasia Prevention Coalition Parliamentary Press conference on April 13, 2026.

My name is Dr. Peter Blusanovics, I am a Montreal family physician who has been practicing for over 30 years. I have experienced helping patients in offices, in emergency rooms and in mental health institutions. and I have treated many with mental illnesses in these settings.

And that’s why I’m here today. I want to provide a voice for our most vulnerable, those who have and are suffering from mental health.

Bill C-218 needs to pass to put a stop to euthanasia for people with mental illness.

Basic needs are not currently being met in our health care system.

Without this bill, we are condoning a bypass towards suicide, and blatantly admitting defeat.

Mental illness needs to be properly identified and treated. These Individuals do not want to die they want their suffering to be relieved.

But there is currently lack of medical support, such as physicians, psychologist and social workers. There is lack of access to psychiatric support and long waiting lists before being assessed. There is lack of financial support: lack of housings , economic security and support from family and significant others.

I will say it again that I am here to provide a voice for our most vulnerable.

I know that offering medical aid in dying provides no solution.

Everyone deserves the right to be treated with dignity and with humanity.

We are supposed to be a mature and evolved society that needs to take care of its most vulnerable .

We need to realize that the lack of proper care in our health care systems is not a good enough excuse, to offer assisted suicide as a solution.

Je m’appelle Dr. Peter Blusanovics, je suis médecin de famille à Montréal où je travail depuis plus de 30 ans. J’ai eu l’occasion d’aider des patients en cabinet, aux urgences et dans des établissements de santé mentale, et j’ai soigné de nombreuses personnes atteintes de troubles mentaux dans ces contextes.

C’est pourquoi je suis ici aujourd’hui. Je souhaite faire entendre la voix de nos plus vulnérables, ceux qui souffrent ou ont souffert de troubles mentaux.

Le projet de loi C-218 doit être adopté pour mettre fin à l’euthanasie des personnes atteintes de troubles mentaux.

Les besoins fondamentaux ne sont actuellement pas satisfaits dans notre système de santé.

Sans ce projet de loi, nous tolérons un contournement menant au suicide et admettons ouvertement notre échec.

Les maladies mentales doivent être correctement identifiées et traitées. Ces personnes ne veulent pas mourir, elles veulent que leurs souffrances soient soulagées.

Mais il y a actuellement un manque de soutien médical, notamment de médecins, de psychologues et de travailleurs sociaux. L’accès au soutien psychiatrique est limité et les listes d’attente sont longues. Il y a un manque de soutien financier : manque de logements, de sécurité économique et de soutien de la part de la famille et des proches.

Je le répète : je suis ici pour donner une voix aux plus vulnérables d’entre nous.

Je sais que l’aide médicale à mourir n’apporte aucune solution.

Tout le monde a le droit d’être traité avec dignité et humanité.

Nous sommes censés être une société mature et évoluée qui se doit de prendre soin de ses membres les plus vulnérables. Nous devons prendre conscience que l'insuffisance des soins dans nos systèmes de santé ne constitue pas une excuse suffisante pour proposer le suicide assisté comme solution.

EPC Press Conference: Suicide and Euthanasia for Mental Illness

Welcome to the Euthanasia Prevention Coalition press conference.

Alex Schadenberg

My name is Alex Schadenberg. I am the Executive Director of the Euthanasia Prevention Coalition.

I want to express is our deepest sympathy to the many families who have lost loved ones to euthanasia. Canada is surpassing 100,000 deaths by euthanasia this month, a very sad milestone.

I remember Gaetan Barrette, then the Quebec Health Minister, stating in the Quebec National Assembly in 2014 that euthanasia would be for extraordinary cases, likely 100 per year. Euthanasia now represents 8% of all deaths in Quebec.

Suicide and Euthanasia for Mental Illness

Jocelyn Downie, a long-time euthanasia academic told Canada's Parliamentary Special Joint Committee on Medical Assistance in Dying, that is studying euthanasia for mental illness alone, that parliament must stick to the March 17, 2027 timeline and permit euthanasia based on mental illness alone. Downie threatened the committee by stating:

“What will happen, if there is an extension or an exclusion, is that people will die by suicide”

Downie is saying that the answer to suicidal ideation is suicide and people will die by suicide if they do not have access to euthanasia.

The threat that people who are denied euthanasia will die by suicide is a false pressure tactic.

The Supreme Court of Canada accepted the “suicide argument” in Carter when it struck down Canada's laws that protected people from being killed by euthanasia, but the Supreme Court was also wrong.

If the premise that people will die by suicide if euthanasia is not available to them is correct then the suicide rate should go down after euthanasia became an option for Canadians who are not terminally ill.

But Canada's suicide rate has increased.

According to the Government of Canada suicide mortality statistics, there were 3,978 recorded suicide deaths in 2016, the year that Canada legalized euthanasia. In 2021, there were 3,927 recorded suicide deaths in 2021 the year that the euthanasia law expanded to Canadians who are not terminally ill. In 2023, two years after extending euthanasia to people who are not terminally ill, there were 4,735 reported suicide deaths in Canada, representing a greater than 20% increase from 2021.

I am not arguing that Canada's increase in suicide deaths was directly related to Canada's expansion of euthanasia, but I am saying that if Jocelyn Downie was correct, the suicide rate should have decreased, whereas in fact it has significantly increased.

Canada has had a massive increase in deaths by euthanasia.

Health Canada released their Sixth Annual Report on Medical Assistance in Dying in Canada on November 28, 2025 (2024 deaths) which indicated a 6.9% increase from the Fifth Annual report (2023 deaths).

The 2024 report indicates that there were 16,499 reported (MAiD) euthanasia deaths which was up by 6.9% from 15,427 in 2023.

In 2025, we know that euthanasia increased by 7.3% in Ontario and 11% increase in Alberta. I predict that in 2025, the increase in Canadian euthanasia deaths was greater than 7% with the number of euthanasia deaths being approximately 17,700.

Clearly, there is no indication that the massive growth in Canadian euthanasia deaths has resulted in a lower rate of other suicides.

Suicide rates do not decrease in jurisdictions that have legalized euthanasia or assisted suicide.

In December 2020 I responded to a statement by Senator Stanley Kutcher who said:

in jurisdictions, such as Belgium and the Netherlands, where assisted death is legal, that the suicide rates have decreased. He then stated that there is no link between assisted death and the rate of suicide in jurisdictions where it is legal.

The problem with Senator Kutcher's statement was that he was absolutely wrong.

In the article I explain that there are no jurisdictions that have legalized euthanasia or assisted suicide, that over a long period of time, have experienced a decrease in suicide deaths.

In February 2022 bio-ethicist David Albert Jones published an article titled: In Europe, suicides rise after ‘right-to-die’ is legalised. Jones provided a comparison between European countries that have legalized assisted dying and those that had not legalized it and found that countries that had legalized assisted dying experienced an increase in suicide rates compared to countries that had not legalized assisted dying who generally had a lowering of their suicide rate.

In other words, Downie is using a false argument to scare monger Members of Parliament into approving euthanasia for mental illness alone. Downie uses court decisions to uphold her position but the Justices are not suicide prevention experts and in fact are wrong in their assumption that legalizing euthanasia will prevent suicide.

Minimally speaking, legalizing euthanasia does not lead to a decrease in suicide rates and the data suggests that legalizing euthanasia or assisted suicide has a suicide contagion effect leading, long term, to higher suicide rates.

Once again, if Downie is correct, based on the massive numbers of euthanasia deaths in Canada, the Canadian rate of other suicides should have gone down, but in fact they have gone up.

We mourn 100,000 euthanasia deaths in Canada, since legalization, and we challenge the federal government not to expand Canada’s euthanasia law but to launch a study by neutral researcher on the effect of Canada’s out of control euthanasia regime.

I would not be here today, living this beautiful life if I had been given an option to receive help to be killed.

The following is the speech by Stephanie Kollmar at the Euthanasia Prevention Coalition rally on parliament hill on April 13.

Stephanie Kollmar

Thank you for the opportunity to share my story and unite with so many who understand the pain of mental health struggles. 

I was 26 when my husband took his life. To make matters worse, it was suicide by cop. 

The four years of our marriage worsened year after year with partly his pride in refusing to accept help and consistent hospital visitations that resulted in no solution. In his young mind and prideful nature, he turned to the use of street drugs instead of psychiatric support as his self-medicating choice. This of course worsened his mental state, brought abuse into our home and finally, in hopes that he would seek help by my walking away, I left with the children. 

Unfortunately, he didn't see the hope I saw. He saw the end and called 911, and upon their arrival he charged directly at the police, running full speed in his underwear down our driveway, the same police station that visited my home so many nights, chose to shoot him multiple times. He died that night January 18, 2010, in Saint-Dorothée QC at 26 years old. 

My already broken nervous system went into shock. My daughters were 6 and 2. I had been a stay-at-home mom with a full focus to help him heal and my last initiative failed. In my own grief I was dissociated, numb, struggling with guilt, and uncertain how I was going to show up for my daughters. I was fortunate to have my parents and moved in with them. Being in their Christian home started to bring back a sense of peace and regulation, but I struggled immensely to be around other families at church and to connect at a deeper level. The last thing I wanted was to feel the amount of emotional pain that was surging through my body or have people pity me. 

I tried my best to put on a smile and keep conversation short and light, but I ended up leaving the church. I couldn't sustain pretending, isolation felt safer and I had a plan to end my life.  

Though he had left me with debt after the forced house sale from his death, I had a small amount of savings and had begun working three months after he passed. I had decided once the money was gone, I estimated about six months, I would end my life and my daughters would be better off without their broken-hearted struggling mom.

I would not be here today, living this beautiful life, if I had been given an option to receive help to be killed. 

That six-month duration from May 2010 to Nov 2010, though still painful, was enough time for me to process this secret decision and recognize, I needed my daughters and they needed me.  

One day at a time I started to dream of a future again, leading me into the corporate world to begin a career, and opening my eyes to see how the trauma had affected my nervous system.  I further struggled to have meaningful connections with those around me, I was rigid, guarded and very afraid of men. A couple years went by until I finally accepted I needed to start therapy - and ultimately fell in love with my healing journey. I discovered a lot about the mind, processing, unconscious beliefs, behavioural patterns, victim mentality, attachment styles, trauma, nervous system regulation and emotional intelligence.  Adding nervous system practices that strengthen the vagal nerve, it complimented my talk therapy sessions beautifully as it began to regulate my nervous system, which strengthened my capacity for stress, disarmed my fight/flight reactions and rewire my mind to change my perspective. 

I became a better mom, and climbed the latter in the corporate world becoming a client experience director, building teams, building up people, mentoring and recognizing skills while restructuring support channels. I became a healthier, loving, motivated version of myself. In 2024, I left the corporate world to pursue deeper learning of trauma therapy through The Crisis and Trauma Resource Institute out of Alberta. To add to my nervous system regulation skills, knowing I wanted to work with the body, I studied therapeutic Swedish massage which opened the door for insurance receipt support so I could open a clinic.

Life didn't stop throwing its curve balls;  facing mental health struggles with my youngest daughter almost rocked me to my core, in fear of losing her as I did her dad  - but with great support, and being more resilient with a broader capacity for stress we made it through. 

Again, I couldn't imagine if she was offered euthanasia support at the Children's Hospital in Montreal or the Douglas mental health institute instead of the incredible knowledge-based help we received. Now studying dance full time, she's focused on her dreams and I'm able to start mine, the opening of espace d'espoir. The Space of Hope. A women focused business I've recently created to continue the care for women who have lost hope, desire to feel safe and loved - possibly for the first time, and help them reintegrate their lives into society by supporting their bodies to soften the effects of shame, pain and trauma, so they can find joy in living. 

There is no world where euthanasia should be a welcomed option. As I said today, euthanasia eliminates the opportunity for hope - and Canada should be ashamed to believe that killing those in need makes us a valued, reputable country.  People are worthy of life. 

Dr Paul Saba: In most cases the desire to die is a symptom of mental illness.

Dr Paul Saba

This is the Speech by Dr Paul Saba at the EPC Parliamentary Press Conference on April 13, 2026. 

Dr Saba is a family physicians from Lachine Quebec who is well known for his clinical experience for caring for patients with disabilities and difficult health conditions.

His presentation was delivered in English and French.

People with only a mental disorder will be euthanized as of March 17, 2027. This, despite the overwhelming evidence that people with mental disorders can be treated, and that most psychiatrists cannot determine which patient has an irremediable (irreversible) condition.

From a legal standpoint, those with mental disorders requesting euthanasia which has been euphemistically called medical assistance in dying (MAID), do not meet the condition of free and informed consent because the desire to die is in most cases a symptom of mental illness.

Bill C-218 which will be voted this week in Ottawa, would stop euthanizing (MAID) people with mental health disorders as the sole criterion. This bill must be supported by our Members of Parliament.

Dans la plupart des cas, le désir de mourir est un symptôme de maladie mentale.

90% des personnes qui mettent fin à leurs jours sont atteintes d'un trouble mental au moment de leur suicide. La plupart des personnes qui ont tenté ou réussi à se suicider ne veulent pas mourir ; ils veulent plutôt échapper à leur détresse émotionnelle

Selon une étude de la Harvard School of Public Health, 90% personnes ayant tenté de se suicider sans succès ne se sont pas suicidées après le traitement. Avec le bon traitement, le suicide a disparu.

In most cases the desire to die is a symptom of mental illness.

According to a Harvard School of Public Health study, 9 out of 10 people who attempted suicide but were unsuccessful in their attempt, did not commit suicide following treatment. With the right treatment, suicide disappeared.

One of my patient’s who couldn’t be here today, asked me to tell her story. In her 20’s she was a mother of three small children. She was involved in an abusive relationship. To end her emotional anguish she attempted suicide by hanging. Her neighbour found her and removed the cord around her neck saving her life. If she had been euthanized she wouldn’t have survived because euthanasia with a lethal injection is a guaranteed death- no survivors. Today she’s happy to be alive and mothered another son and has 4 grandchildren.

La plupart des personnes atteintes de troubles mentaux ont besoin du soutien de psychiatres, de psychologues et de travailleurs sociaux qui sont rares dans notre système de santé publique.

Beaucoup vivent dans des situations financières et sociales précaires. Ils ont besoin d’un soutien financier, notamment d’un logement abordable et d’une sécurité alimentaire.

Au Québec, le délai moyen d'attente entre la référence à un psychiatre et le traitement est de 5 mois. 

Most people with mental health conditions need support from psychiatrists, psychologists, and social workers, who are scarce in our public healthcare system.

Many live in precarious financial and social situations. They need financial support, including affordable housing and food security. 

In Quebec, the average wait time between a referral to a psychiatrist and treatment is five months.

In Quebec, where the waiting time is to see a psychiatrist after being referred is at least five months and most cases longer. In the MAID law next year a patient after being accepted for euthanasia will have a three month wait before the lethal injection is given.

With an average five month waiting time to see a psychiatrist, it’s likely that that a person would get a call to see a psychiatrist 2 months or longer after having been legally injected.

In addition to psychiatrists, psychologists and social workers we must ensure access to a wide variety of alternative treatments, including art, music, dance, pet, recreation and other therapies. We must also ensure free medications, affordable housing, and food security.

A study published in Sage Journal last year 2025 explored the potential cost savings to governments by expanding medical assisted dying to include vulnerable groups with mental illness. These groups included people those with mental health issues, the homeless, drug users, retired, elderly, and indigenous communities. They estimated projected savings of $1.273 trillion between 2027- 2047 with an estimated 2.6 million deaths in the voluntary group mostly the mentally ill and elderly populations.

I quote the authors of the journal:

"this cost-saving measure raises significant ethical concerns. Financially incentivizing MAiD could shift healthcare priorities away from providing necessary support, potentially devaluing vulnerable lives and fostering a troubling reliance on assisted death as an economic solution."

Les personnes atteintes de problème de santé mentale ont besoin de soins, de traitements et de soutien. Ils ne doivent pas être euthanasiés (AMM).

Ils doivent voter en faveur du projet de loi C-218 et non pour l’euthanasie des personnes ayant des problèmes de santé mentale. 

People with mental health problems need care, treatment, and support. They should not be euthanized (MAID). 

Members of Parliament need to vote in favour of Bill C-218, not for the euthanasia of people with mental health problems.

Previous articles and comments by Dr Paul Saba (Articles Link).

EPC: Physicians urge Canadian government not to expand euthanasia.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Dr Blusanovics, Alex Schadenberg, Dr Saba

The Euthanasia Prevention Coalition (EPC) urges Canadians to sign our petition in support of Bill C-218. (Petition Link).

The EPC held a successful bilingual press conference at the Parliamentary Press Gallery on the morning of Monday, April 13 before our rally on Parliament Hill.

(Link to the full video of the Press Conference)

Brian Passifiume reported on the EPC Press Conference for the Toronto Sun on April 13. Passifiume outlines the article by stating that Canada is set to widen eligibility criteria for euthanasia next year. Passifiume reports:

During a Monday morning news conference in West Block, members of the Euthanasia Prevention Coalition offered their support for Bill C-218, a private member’s bill intended to prevent next year’s inclusion of mental illness as the sole medical condition for seeking physician-assisted suicide.

Dr Peter Blusanovics

Dr Peter Blusanovics, a physician from Montreal Quebec with 30 years experience caring for patients in psychiatric wards. Passifiume reported him saying:

“I want to provide a voice to our most vulnerable, those who have or are suffering from mental illness,”

“Basic needs are currently not being met in our healthcare system. Without (Bill C-218,) we are condoning a bypass towards suicide, and blatantly admitting defeat.”

Mental illness, he said, needs to be identified and treated. He said those seeking to commit medical suicide aren’t seeking death, but healing.

“There is a current lack of medical support, such as physicians, psychologists, social workers — there is a lack of psychiatric support and long waiting lists to be assessed,” said Blusanovics, a physician at a Montreal psychiatric hospital.

Passifiume stated that Canada plans to extend euthanasia to people with psychiatric conditions alone starting on March 17, 2027. Passifiume reports that:

Patients seeking MAID are assigned to one of two tracks: Track one for those with terminal illnesses or whom natural death is near; and track two for those whose death is not a reasonable outcome in the foreseeable future.

Although Statistics Canada doesn’t include MAID in its annual top-10 list of most common causes of death, government figures said 16,499 Canadians died via MAID in 2024 — making medical suicide that year’s fourth most common cause of death between accidents (20,260) and strokes (13,725.)

Passifiume explained that MP Tamara Jansen introduced Bill C-218 last year to stop the implementation of euthanasia for mental illness alone in March 2027.

Dr Paul Saba

Passifiume then commented on the statements by Dr Paul Saba, a family physician from Lachine Quebec who said:

there’s no way for most psychiatrists to determine which patients’ conditions are untreatable.

“From a legal standpoint, those with mental disorders requesting euthanasia, which has been euphemistically called ‘medical assistance in dying,’ do not meet the condition of free and informed consent, because the desire to die in most cases is a symptom of mental illness,”

Passifiume ends his article by commenting on the Alberta governments proposed changes through Bill 18 to there provincial euthanasia protocols. Passifiume reports:

Last month, Alberta’s provincial legislature tabled a bill that would prevent their physicians from prescribing MAID for track two patients — citing patient safety and growing skepticism for the federal government’s efforts to expand MAID eligibility.

“The consequences of the decision are permanent and irrevocable, and because of this, we have an obligation to consider MAID with the utmost care and caution,” Alberta Premier Danielle Smith said at a news conference in Edmonton last month.

The Euthanasia Prevention Coalition urges Canadians to sign our petition in support of Bill C-218. (Petition Link).