#200: Dr. Karen Neufeld and Dr. Jack Haggerty, Beyond the Verdict: Navigating MAID and Mental Health

Open Minds with Christopher Balkaran

Summary
Dr. Jack Haggerty and Dr. Karen Neufeld discuss the inclusion of irremediability in Bill C-7, which allows for medical assistance in dying (MAID) even if natural death is not reasonably foreseeable. They explain that this inclusion was compelled by case law, specifically the Truchon case. However, they express concerns about the challenges of implementing this provision, particularly in the field of psychiatry. They highlight the difficulty of determining irremediability in mental illnesses and the potential overlap between requests for MAID and suicidal intent. They also emphasize the need for a deeper conversation and more careful consideration of the implications of expanding MAID to include mental disorders. Finally, they discuss the evidence of psychiatric recovery and the importance of providing hope and support to individuals experiencing mental illness. The conversation explores the importance of hope and treatment options in psychiatry, the stigma surrounding mental illness, the ability to adapt to traumatic events, the therapeutics of hope and consistency, the barriers to accessing mental health care, and the public perception of MAiD.
Chapters

00:00
Introduction and Overview

00:29
Bill C-7 and Medical Assistance in Dying

01:12
Compelled by Case Law

05:29
Concerns about Irremediability

07:39
Challenges in Distinguishing Suicidality from Made Requests

12:00
Evidence of Psychiatric Recovery

33:42
The Stigma of Mental Illness and Conveying Hope

36:22
Adapting to Traumatic Events and the Long-Term Effects

38:36
The Therapeutics of Hope and Consistency

42:11
Access to Mental Health Care and Barriers

48:12
The Public Perception and Support for MAiD
Takeaways

• Bill C-7 allows for medical assistance in dying (MAID) even if natural death is not reasonably foreseeable.
• The inclusion of irremediability in MAID has raised concerns about implementation, particularly in the field of psychiatry.
• Determining irremediability in mental illnesses is challenging, and there is potential overlap between requests for MAID and suicidal intent.
• Expanding MAID to include mental disorders requires a deeper conversation and careful consideration of the implications. Hope is a crucial component of psychiatric treatment and should be instilled in patients to provide them with a sense of purpose, meaning, and belonging.
• The stigma surrounding mental illness makes it challenging to convey hope and educate the public about the effectiveness of psychiatric interventions.
• People have the ability to adapt to traumatic events and find hope for the future, even in the face of severe disabilities.
• Consistency in providing evidence-based care and support is essential for long-term mental health outcomes.
• Access to mental health care is a significant barrier, both in underserved areas and highly resourced regions, and more investment and systemic improvements are needed.
• Public support for medical assistance in dying (MADE) for severe treatment-resistant mental disorders is high, but there are concerns about defining treatment resistance and ensuring adequate access to other treatment options.

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