Navigating Complexity: Medical Assistance in Dying and Its Impact on Suicide Prevention
Posted August 15th, 2023
Our core mission is to provide help and hope to individuals facing mental health crisis, including those struggling with thoughts of suicide.
We acknowledge the complexity of mental health issues and the diverse perspectives surrounding Medical Assistance In Dying (MAiD) as an option for individuals in Canada. The Centre has not taken a position on the morality or ethical implications of MAiD; instead, we aim to support individuals with empathy, compassion, and understanding, meeting them where they are in their mental health and day-to-day struggles.
Eligibility for people to choose MAiD whose sole medical condition is mental illness is scheduled to begin on March 17, 2024, per the federal government’s timeline. The change to include mental illness as a sole criterion for accessing MAiD has brought attention to the intersections of mental health, suicide, self-determination, quality and access to mental health care, disability, poverty, and the meaning of life and suffering. None of these intersections are simple to navigate.
The kinds of calls we get related to MAiD tend to fall into four categories:
- Callers considering applying to MAiD for a range of reasons related to physical or mental suffering: These individuals are not considering dying by suicide tonight. We hold a non-judgmental space for these callers to talk.
- Callers concerned about a loved one considering MAiD or bereaved by the loss of a loved one through MAiD: We hold a non-judgemental place for these callers to talk.
- Callers who have permission for MAiD and find knowing that option is there increases their sense of control in their lives and reduces their suffering enough to want to continue living: These callers often worry that if the MAiD option is taken away from them, their situation will be worse. We hold a non-judgemental place for these callers to talk.
- Callers expressing strong opinions one way/another about the issue itself from a political, religious, moral or personal perspective: We hold space for these callers to share their thoughts and opinions with empathy and non-judgment.
- Callers who are in immediate suicidal crisis but are also considering MAiD: No matter what, MAiD will not happen tonight, but suicide might. We hold a non-judgemental place for these callers to talk. In addition, we work to help these callers stay safe from suicide.
Just as we believe talking about suicide does not cause suicide, we believe talking about MAiD does not cause someone to decide to pursue MAiD. Instead, talking through why we decide to live and why we might want to die is exactly what crisis centres are prepared to offer those who reach out to us.
We encourage dialogue and mutual understanding. We recognize that the topic of MAiD is deeply personal and can evoke strong emotions. We aim to create a supportive environment through active listening and open conversation where individuals can express their thoughts and experiences without judgment.
In our Crisis Responder training, we have added MAiD-related training modules and engage in deep conversation to ensure crisis line responders are equipped to meet people where they are within the scope of service provision. We do not include a caller’s questions, interest, or desire to talk about MAiD as a part of any assessment of suicide risk. MAiD and suicide are not the same thing; we are committed to keeping people safe from dying by suicide, while acknowledging their ambivalence towards living and dying.
In our Community Learning and Engagement programs, we have experienced participants actively discussing MAiD related to suicide, especially in our Applied Suicide and Intervention Skills Training (ASIST) program. These conversations reflect the complexities individuals face navigating mental health and suicide and how they intersect with end-of-life decisions. We value the openness of these discussions and actively listen to the concerns and perspectives shared by our community members.
Our commitment to suicide prevention remains steadfast. We will continue to adapt and respond to the evolving needs of our community, understanding that every person’s journey is unique. We need to remain informed, compassionate, and sensitive to the complexities surrounding mental health, suicide, and end-of-life decisions.
As we move forward, we encourage everyone to respect one another’s perspectives and recognize that discussions surrounding MAiD can be challenging for many. We aim to foster a safe and supportive community where individuals can find hope and strength in times of struggle. Together, we can create a space where open dialogue is embraced and those who need support are met with compassion and understanding.
At the Centre, we remain dedicated to supporting our community in the best way possible and committed to providing help, hope, and healing to those in need.
Resources
BC Ministry of Health
https://www2.gov.bc.ca/gov/content/health/accessing-health-care/home-community-care/care-options-and-cost/end-of-life-care/medical-assistance-in-dying
Vancouver Coastal Health
https://www.vch.ca/en/service/medical-assistance-dying
Government of Canada
https://www.canada.ca/en/health-canada/services/health-services-benefits/medical-assistance-dying/supports-resources.html