Slippery Slope?

[dyqik]

Absolutely sure.

Then everything you say can be ignored.

Wouldn’t be that difficult for someone to look up previous discussions on the topic on this forum.

Which definitely wouldn't show what was claimed. Unless the majority of forum users decided to take part in that conversation, and to fully state their opinions, rather than responding to others. Which I can guarantee they didn't.

[Tristan]

Let’s not get all witty on this one, it’s grim.

Was there an issue in Canada before they expanded it to non end of life situations?

Not sure what the point of that question is in this context. You’re effectively saying “was there an issue before the issue?”

The expanding to non end of life situations is a large part of what the issue is.

[bjn]

Let’s not get all witty on this one, it’s grim.

Was there an issue in Canada before they expanded it to non end of life situations?

Not sure what the point of that question is in this context. You’re effectively saying “was there an issue before the issue?”

The expanding to non end of life situations is a large part of what the issue is.

So don’t do that.

[Grumble]

Was there an issue in Canada before they expanded it to non end of life situations?

Not sure what the point of that question is in this context. You’re effectively saying “was there an issue before the issue?”

The expanding to non end of life situations is a large part of what the issue is.

Maybe what I would really want to know is how far in advance of foreseeable death were people being helped to die. Was it only when people were being given palliative care or was it when they were told they only had 12 months to live? Were people pressured to end it early for convenience?

[Tristan]

Let’s not get all witty on this one, it’s grim.

Was there an issue in Canada before they expanded it to non end of life situations?

Not sure what the point of that question is in this context. You’re effectively saying “was there an issue before the issue?”

The expanding to non end of life situations is a large part of what the issue is.

So don’t do that.

Don’t trust people not to. They did it in Canada.

[lpm]

Let’s not get all witty on this one, it’s grim.

Was there an issue in Canada before they expanded it to non end of life situations?

Not sure what the point of that question is in this context. You’re effectively saying “was there an issue before the issue?”

The expanding to non end of life situations is a large part of what the issue is.

So don’t do that.

They did do that.

[Gfamily]

I found this an interesting article, that has arguments from both sides.

https://www.cbc.ca/news/politics/maid-c ... -1.7009704

What I found notable is that a very large proportion of those whose life was ended medically had previously accessed palliative care, and that only a relatively small proportion (<4%) did not have a reasonably foreseeable death.

I would want to know that more was being offered to those experiencing mental illness before extending their access to MAID, but I would not want to see MAID denied to those who see it as a more humane alternative to suffering through a terminal illness.

[bjn]

Not sure what the point of that question is in this context. You’re effectively saying “was there an issue before the issue?”

The expanding to non end of life situations is a large part of what the issue is.

So don’t do that.

They did do that.

Not everybody has, so it's not inevitable.

[Woodchopper]

I found this an interesting article, that has arguments from both sides.

https://www.cbc.ca/news/politics/maid-c ... -1.7009704

What I found notable is that a very large proportion of those whose life was ended medically had previously accessed palliative care, and that only a relatively small proportion (<4%) did not have a reasonably foreseeable death.

I would want to know that more was being offered to those experiencing mental illness before extending their access to MAID, but I would not want to see MAID denied to those who see it as a more humane alternative to suffering through a terminal illness.

It states:

According to the report, 3.5 per cent of all MAID recipients — 463 people — did not have reasonably foreseeable deaths.

"The proportion of MAID recipients whose natural death was not reasonably foreseeable continues to remain very small compared to the total number of MAID recipients," the report says.

In 2021, just 2.2 per cent of MAID recipients — 223 people — were patients whose natural deaths were not reasonably foreseeable. Gaind said the report "completely minimizes the numbers."

The 463 still seems like a lot in absolute terms. But as per the original post, still far too few to have a meaningful effect upon national budgets.

[Gfamily]

The 463 still seems like a lot in absolute terms. But as per the original post, still far too few to have a meaningful effect upon national budgets.

I'm not going back to the original post, as that's a despicable place to start. What I would say, is that the number of people dying without a RFD represents about 10% of the number of people in Canada who die by suicide each year.
We know that the age profile of those who die by suicide is very different to those who die by MAID, I don't know how closely the age profile of the 463 matches the former.

[dyqik]

The 463 still seems like a lot in absolute terms. But as per the original post, still far too few to have a meaningful effect upon national budgets.

I'm not going back to the original post, as that's a despicable place to start. What I would say, is that the number of people dying without a RFD represents about 10% of the number of people in Canada who die by suicide each year.
We know that the age profile of those who die by suicide is very different to those who die by MAID, I don't know how closely the age profile of the 463 matches the former.

People who elect for MAID without RFD are going to have a very different profile to those that commit suicide by other means, because of the amount of process involved. It's not a spur of the moment thing.

I guess it's plausible to make an argument that by creating a procedure and opportunity for applying for legal suicide, you are able to make contact with, counsel and prevent potential suicides in a number of people who would otherwise take steps on their own. Hard maths and stats are required to determine if this effect is worth the effort.

This is separate from the safeguarding issues people mention above.

One particular requirement before you can make non-RFD assisted suicide available on anything like an ethical basis is a massive improvement in general mental health services, as well as things like pain management services and the social safety net. I'm not sure it can be done without e.g. UBI, efficient nationalized health care, etc.

[lpm]

So don’t do that.

They did do that.

Not everybody has, so it's not inevitable.

Several countries have, though, showing it is a thing that happens. Aren't you concerned? X is introduced, then it slips to include Y?

That is obviously going to concern the general public. If there's revulsion of Y, then the fear of a slippery slope is going to wreck the chances of X, politically speaking.

[Tristan]

Assisted suicide for depression, autism and borderline personality disorder. Not Canada this time, but Holland.

https://www.thefp.com/p/im-28-and-im-scheduled-to-die

[Woodchopper]

Assisted suicide for depression, autism and borderline personality disorder. Not Canada this time, but Holland.

https://www.thefp.com/p/im-28-and-im-scheduled-to-die

Here’s an academic article on assisted suicide for people with mental health problems in the Netherlands: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9251055/

States that mental health is also a criteria for assisted suicide in Belgium, Luxembourg and Switzerland.

In terms of the slippery slope discussion, it seems that as with Canada a court case was instrumental in extending the scope of the law to mental health conditions, and as with Canada a legal judgment was later confirmed by Parliament via a new law.

[Tristan]

Meanwhile in Belgium: https://bioedge.org/end-of-life-issues/ ... opulation/

[bob sterman]

And meanwhile in Canada...failure to provide an appropriate mattress leads to a request for assisted dying.

Quadriplegic Quebec man chooses assisted dying after 4-day ER stay leaves horrific bedsore
https://www.cbc.ca/news/canada/montreal ... -1.7171209

[Woodchopper]

And meanwhile in Canada...failure to provide an appropriate mattress leads to a request for assisted dying.

Quadriplegic Quebec man chooses assisted dying after 4-day ER stay leaves horrific bedsore
https://www.cbc.ca/news/canada/montreal ... -1.7171209

Trudo Lemmens says this case is "an illustration of problems in our health-care system."

The Scholl Chair in Health Law and Policy at the University of Toronto says people who are already vulnerable are left feeling like more of a burden in the system.

"Then the system responds by saying: 'well, you have access to medical assistance and dying,'" said Lemmens.

"Medical assistance in dying is more easily available and on a more regular basis than some of the most basic care."

He says he is increasingly hearing stories of people who are struggling in the system and turn to MAID.

"It's deeply troubling," he says.

[Imrael]

At risk of being contrarian, what are the arguments against allowing assisted death for people with chronic conditions that affect quality of life (which might well include mental health issues), with safeguards for consent.

My anecdata here is looking after my Father in Law in his declining years. In his 90's, while still lucid, he suffered from painful mobility problems, deafness and a speech problem. Despite all we could do he was bored a lot, in pain and frustrated. He frequently said to me that he would like to go to sleep and not wake up. All that lay ahead of him was a couple of years of physical and mental distress. (Made worse since he was in hospital then nursing home in Covid lockdown when we couldnt visit him).

[bob sterman]

At risk of being contrarian, what are the arguments against allowing assisted death for people with chronic conditions that affect quality of life (which might well include mental health issues), with safeguards for consent.

That it leads to the problems highlighted in the examples above - the elderly and people with disabilities and chronic conditions end up experiencing pressure to end their lives. And healthcare systems start to see offering death as an alternative to providing basic appropriate care.