In just a few months Canada will legalise Medical Assistance in Dying (MAiD) for people suffering solely from mental illness. In practical terms this means a doctor or nurse will be allowed to administer (or prescribe) a massive fatal overdose of barbiturates to any able-bodied Canadian adult who wants to end their life, providing a few basic conditions are met. From the 17th March 2023 anyone who has suffered from a “grievous and irremediable” mental health condition for at least 90 days will be eligible. Safeguards are vague and trivial - they must satisfy a healthcare practitioner that they are informed of and have “seriously considered” other treatment options for their mental health condition, but crucially there is no requirement for them to have attempted any of these treatments. MAiD for mental illness is suicide in all but name - a legal, easy, and painless new method. I’m against this development for two reasons: firstly because suicide is usually a preventable tragedy, and secondly because easier suicide results in more suicide.
Suicide is usually a tragedy
Most people who kill themselves are suffering from a treatable mental health condition. Suicide represents an irrational but certain and permanent end to a temporary spell of unbearable suffering. I can’t say with certainty that every mentally ill person who commits suicide would have recovered and lived happily ever after, but the evidence does suggest that most people who unsuccessfully attempt suicide are never unhappy enough to attempt it again .
Of the three men and one woman I’ve known who have ended their lives this way three were suffering from bouts of severe depression. Only one - a Deputy headteacher at a private catholic boys school who was jailed for exchanging extreme child pornography at chemsex parties - was reacting to objectively terrible external circumstances. When he was released from his 33 month prison sentence, having lost his career and reputation, he hanged himself at his home.
Easier suicide results in more suicide
You might assume that people who are desperate enough to end their own lives will always find a way, but in fact the availability of easy and lethal means of suicide increases the rate of suicide. Different methods of suicide differ greatly in their lethality . Easy availability of lethal means surely explains some of the transatlantic difference in suicide rates - American rates are about a third higher than in Britain - with half of American suicides using a gun. It’s probably true that people who succeed are more serious in their intent than people who fail, but this relationship isn’t clear cut - partly because people hold inaccurate beliefs about how lethal their chosen method is, and partly because strong suicidal intent can be short-lived.
Some predictions for Canada
I think from March next year the number of Canadians who kill themselves (including by the new MAiD for mental illness method) will significantly increase. Currently around 10,000 Canadians with physical illnesses end their lives through MAiD each year. Around 4000 Canadians commit suicide each year - 3000 men and 1000 women. I believe that the total number of women who kill themselves each year will double to 2000 once we include MAiD for mental illness. Women are more likely to attempt suicide than men, and their lower rate of success isn’t entirely down to their attempts being fake “cries for help”. Young women suffer from more mental health problems than men and are more vulnerable to harmful social contagion like eating disorders and transgenderism
Just as women are more likely to hire a ski instructor for a skiing holiday or attend an exercise class rather than work out alone, they will be more swayed by the prospect of a dignified comfortable suicide administered by reassuring medical “experts”. Treating suicide as a legitimate medical “treatment pathway” for people who have been depressed for several months risks a spike in deaths in a cohort who are unlikely to have successfully committed suicide on their own.
It isn’t worth it
It’s true that MAiD for mental illness will reduce the pain and suffering of some proportion of the people who currently kill themselves by violent and painful means every year. However, this pales in comparison to the hundreds of additional suicides each year that will result from the policy, mostly among people with the potential to recover from their mental health problems and lead fulfilling lives.