MAID and mental disorders: André’s story

Personal Stories | March 10, 2023 | André Tassé

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Note from DWDC: If your sole underlying medical condition is a mental disorder, you are not eligible to apply for medical assistance in dying (MAID) until March 17, 2027. Learn more

Warning: This blog post mentions suicide.


You don’t have to look too hard lately to find media reporting negatively on medical assistance in dying (MAID) for those who live with a mental disorder. Before I go on, I think it’s important to point out that the decision has already been made to include people whose sole underlying condition is a mental disorder in Canada’s MAID law. In March 2021, Bill C-7 amended the eligibility criteria to include mental illness as a grievous and irremediable condition, after a two-year sunset clause allowing experts to make recommendations and prepare for the change. The sunset clause was due to end in March 2023, but now we are told it will be delayed by a year. 

To all the reporters and people opposed to this change: 

What would it take to change your mind on MAID for mental illness? Under what conditions would you support my right to die? What do I have to do to prove my mental suffering is so severe that death is the last remaining help available to ease it? How many more anti-depressants do I have to swallow for you to “give up” and allow me autonomy over my own health care? How many more therapies will I have to endure so that you will eventually acquiesce to my leaving peacefully, without having to justify myself like I had to do all my life? And to people who really don’t want to listen and are coming from a field that has hurt me more than helped me all my life? If you blindly refuse me, then you are not acting in good faith. 

I’m sorry I have nothing else to offer you but this poorly written, angry letter from a desperate and demented old fag who has been waiting for March 17, 2023, since August 2022. Well, actually, since the beginning of my life, really. I was 12 when I first attempted suicide, and that was before the sexual abuses I experienced. I’m mad at you! I resent the influence you have, and the effect it has on my life and my death. What kind of power do I have over yours? I wish I were allowed to do what I want with my body, with my life, and have some choice about my death. It is hard enough in my mental state. I’ve let go of the rope a long time ago, I’ve just been falling forever! Please help me land gently. 

You’ve succeeded to get the government to postpone this date. I am now registered with Pegasos, in Switzerland. I’ll have to leave my country to go die alone in a strange land, while the person who has been my friend the longest and the only one who asked to be with me till the end has to stay behind.  

What I have learned is that the common thread among dissenters is FEAR! 

We all know we’ll end up dead, one day, one way or another. Have you got your “affairs in order”? If you are avoiding your own mortality, maybe we shouldn’t listen to what you have to say about other’s. You might be bringing into the discussion a whole bunch of unexamined fears, discomfort, skewed believes, misinformation, etc. 

“Has there been enough time?” many dissenters ask. If you just started to think about it, of course not. But, let’s at least acknowledge where in history MAID fits (see the 43-year timeline on Dying With Dignity Canada’s website). I wish there were a way to rank opinion according to how long it’s been in the making. If 43 years weren’t enough, how many more will you be needing? If we leave it to you, it will never happen. Asking for more time is like the bad students that have procrastinated for way too long and are now asking for yet another extension. Just do your darn homework already! 

My personal beginning was 1990 when David Lewis died by suicide. I was in his Gay Smoking Cessation Program. I visited David in the hospital, and while many of us were dying of AIDS, and assisted dying was a crime, we had to fight both AIDS and criminalization! 

You could argue it started in 1993 when Sue Rodriguez challenged the validity of the Criminal Code prohibition on assisted suicide under the Canadian Charter of Rights and Freedoms. She failed, but people didn’t stop asking for the right to die on their own terms 

To paraphrase Jocelyn Downie of the University of Dalhousie, “Don’t punish the suffering individual for their society’s failures.” Many contributors seem to oppose MAID for fear we, as a society, will end up killing those “at-risk” populations instead of helping them. But, refusing one more option to those who have already been denied so much is not going to solve their problems. It only solves yours. Stop denying the poor and destitute their access to MAID just because you don’t feel comfortable about what it says about your own society and ethics, your past failures.  

Can someone explain how refusing MAID would solve poverty, mental health underfunding, discrimination, or oppression? With or without MAID, systemic problems exist. But, I don’t want to die just because of today’s bad conditions. I would need to go visit my baby self to give him at least one responsible adult – my parents were failures, school staff were inept when it came to bullying of queer students, yet very good at covering up sexual abuse of kids – to help him build the very foundation of our being that is so needed to have a chance to grow up. My formative years were a failure. What you gonna do about it? It’s too late. Show me your time machine or get out of the way! 

With MAID, we will be equipped to monitor the situation when it comes to socio-economic status of applicants. Remember, you have to be found eligible for MAID based on the strict criteria.  If it reveals the disadvantaged apply in disproportionate numbers, then we can act on it. Reality is that this society is failing its most vulnerable and marginalized citizens, MAID or no MAID. Refusing us MAID is one more slap in the face, thank you very fn much! 

“Don’t worry about equal opportunities” is something I’ve heard throughout my life. I’ve been told by straight people how to be a good gay. I’ve heard so often, “I’ve got nothing against the gays” but it is followed by a silent “… as long as you do nothing that’s too gay, so I can keep on pretending you aren’t or that it doesn’t matter.” So, when people pretend to speak on behalf of the marginalized, I am more than a bit skeptical. My senses tell me something’s wrong. This is about the autonomy of the privileged at the expense of the marginalized. It looks to me that they are lobbying against the expansion of MAID, which they see as benefiting the marginalized. “It’s good for the rich, but not for the poor!?!”

All the talk about mental and physical illness being equally valid is B.S. as long as they are treated differently in light of MAID. If you draw a line before MAID for mental illness that is not there for a physical illness, it’s hypocrisy. Same thing with gay rights; don’t tell me we’ve reached equality until suicide stats no longer show disproportions.  

This is the fight of my life. With a small group of activists, I spent more than 15 years trying to get the census to ask the sexual orientations of Canadians. I failed miserably. 11 years ago, and after 21 years of trying, I quit smoking; I needed the help of my friends. This is going to be more difficult than all that. Do I have a chance in hell of convincing you to just let me get the help I need to die peacefully? Did you help make this society more tolerable for Queer people? No? So, please, step aside, now. Please. 

You are so close to creating a Catch 22: If you decide to die, you’re crazy; if you’re crazy, you can’t make a valid decision. I guess you’d do anything to justify the refusal of MAID in all circumstances. 

Note from Dying With Dignity Canada (DWDC)

DWDC is sharing the perspectives of those with lived experience who are considering applying for an assisted death when the sunset clause ends.

When the sunset clause on MAID for mental disorders concludes, individuals whose sole underlying medical condition is a mental disorder will be eligible to apply for medical assistance in dying. This does not, however, mean that anyone with a mental disorder who applies for MAID will be found eligible. Clinicians will be looking for evidence of the longstanding nature of the illness, a history of interventions and treatment attempts, and the voluntary, repeated nature of the request by the person in question (being 18 years of age or older). 

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