In his letter of February 7, Mr.me Vrakas delivers a very touching testimony on his very great suffering from suicidal thoughts. In these pains, many will most certainly recognize themselves. Faced with these long misdiagnosed episodes of major depression, she welcomes the postponement of eligibility for medical assistance in dying for people suffering from mental illnesses, who would not otherwise be eligible (for example, by a physical condition coexisting).
She is delighted with this postponement because she considers that she would have had recourse to it and especially that she would have been eligible for it in the moments of great suffering that she describes.
This is not the first time that M.me Vrakas tells his story and makes this conclusion to advocate against expanding medical assistance in dying. The problem is that each time, she is content to insist on her unbearable suffering, but does not mention how she could have qualified for medical assistance in dying. Each time, it ignores the applicable criteria.
How can she be so adamant that she would have been eligible for medical assistance in dying in her acutely distressed state?
The interpretive guidelines for the eligibility criteria for medical assistance in dying in the event of mental illness as the sole reason for requesting it are precisely what is delaying its expansion. We want to ensure that the eligibility criteria will be respected, given the irremediable nature of medical assistance in dying.
Remember that to be eligible for medical assistance in dying, an assessment by two or even three doctors (here, the third doctor would probably be a psychiatrist) must allow the conclusion to be drawn that the person is fit to take this decision, that she is suffering from an “incurable” disease which causes the “irreversible” decline of her capacities and that she suffers in a “constant” and “intolerable” way.
It should also be remembered that the criteria for capacity to consent provide that a person may be deemed incapacitated if their capacity or judgment are impaired by illness.
Remember that a 90-day period is mandatory between the request and medical assistance in dying when the death of the person is not reasonably foreseeable and that person must have considered other treatment alternatives.
Let us finally recall that the stop Carter of the Supreme Court of Canada, which declared sections of the Criminal Code unconstitutional, recognized that the Criminal Code’s objective of preventing “the vulnerable from being induced to commit suicide in a moment of weakness” was real and urgent, but that it was necessary to ensure that people who did not belong to this category could put an end to their suffering with dignity.
According to the criteria of the law and given its objectives and the great rigor of the medical evaluations of admissibility to medical assistance in dying, how can one radically claim that one would be eligible for it in a moment of great distress? I respectfully say that in my opinion the answer would be exactly the opposite.
*Mme Grégoire teaches and has published several texts on the rights of natural persons, including the criteria for access to medical assistance in dying.