Opinion: Alberta's proposed blanket ban on MAID for mentally ill is unjust As the debate over medical assistance in dying (MAID) for individuals with mental illness as a sole condition heats up, there has been little to no clear or substantive public position from Alberta’s opposition on this issue. |
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Opinion: Alberta's proposed blanket ban on MAID for mentally ill is unjust
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As the debate over medical assistance in dying (MAID) for individuals with mental illness as a sole condition heats up, there has been little to no clear or substantive public position from Alberta’s opposition on this issue.
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The predictable response is that mental-health care and supports are underfunded. While this is also true, it deliberately avoids the central issue. This is undeniably a political hot potato. It provokes debate within caucuses, carries the risk of being labelled as “supporting assisted suicide,” and is far more nuanced — and therefore more challenging — than broader funding arguments. It is easier to critique from the sidelines than to engage directly.
The individuals at the centre of this debate are rarely acknowledged. People with treatment-refractory mental illness who are being denied the option of a dignified and controlled end to their suffering represent a uniquely disenfranchised group.
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Eligibility for MAID is not based on any suffering, but on “grievous and irremediable suffering.” This means multiple treatments, interventions, and supports have been tried — and the individual continues to live in intolerable conditions. There are individuals in this province who have undergone years, sometimes decades, of treatment without relief. Their existence is not theoretical.
This also raises serious Charter concerns. Denying access to a legally recognized medical service based solely on diagnosis engages Section 15 equality rights under the Canadian Charter of Rights and Freedoms. While governments may attempt to rely on the notwithstanding clause, its use is not without limits and remains subject to challenge, including protection of equality and mobility rights.
It is also important to be clear about what MAID is and is not. It is not “assisted suicide,” a term that implies impulsivity or reversibility. MAID involves a structured and carefully regulated process. Capacity is assessed. Decisions must be persistent over time. Individuals are evaluated to ensure that lack of knowledge, access to treatment, or external pressure is not driving the request.
There is, understandably, concern about premature death in potentially treatable cases. That concern is legitimate. It is precisely why strict safeguards and longitudinal assessment by qualified health providers are required.
The individuals being discussed here are not those with typical, treatable mental illness. They are rare cases of “grievous and irremediable suffering,” individuals for whom every day remains intolerable despite sustained and appropriate care.
Determining irremediability in mental illness is complex. But complexity is not justification for blanket denial. It requires careful, expert, longitudinal assessment — not political prohibition.
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At its core, this is an issue of dignity and autonomy. A meaningful public conversation must move beyond political avoidance and acknowledge the reality that some individuals continue to experience suffering that is both profound and unrelieved. Denying access to MAID solely because that suffering arises from a mental-health condition risks being both dehumanizing and unjust.
As a society, we need to do better.
Kathryn Andrusky, MD, CCFP, MBA, is an Edmonton physician.
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