Canada needs time for ‘deeper conversation’ on assisted dying and mental health: Netherlands


Thirteen years ago, in the midst of great political loss and personal crisis, Mark Holland experienced the darkest period of his life.

Since his return to federal politics, he has been candid about his suicide attempt and the mental health struggle that brought him “to the doorstep of my own oblivion.”

Now, as federal health minister, he is asking Parliament to slow down his government’s plan to expand access to medically assisted dying for people whose only underlying condition is mental illness.

Holland says the ordeal he survived is different from the suffering of people he believes would qualify for the program.

More time is needed for medical systems and the public to be prepared to notice the difference, he told The Canadian Press.

“I want to make sure, with every inch of me, that everyone is given the same path out of the darkness that I was able to find,” Holland said in an interview about her own mental health experience.

“Where we’re having really difficult conversations is: What do we do when there are circumstances we can’t understand? When people are in nightmarish pain?”

Under current legislation, from mid-March people suffering from mental distress will have the right to receive medical assistance in dying.

Last week, the Netherlands introduced legislation to delay expanding eligibility for three years.

Provinces told him they were either unprepared or unwilling to move forward, he said, and postponing is intended to allow more time to prepare.

The pause would also give Canadians more leeway to confront their discomfort with politics, he said.

“Because it’s uncomfortable, it’s easy to pretend there are simple solutions and not dig into them,” Holland said. “I think part of the idea of ​​this pause is to provide an opportunity for a deeper conversation.”

Holland was a career politician until he lost his seat in the 2011 federal election. After that loss, he said he fell into despair.

“There is a feeling of complete hopelessness, isolation and abandonment and the feeling that… there is no way out of the pain that you are suffering,” he said.

What separates her experience from those with mental illnesses who might eventually have access to assisted dying is that she sought help and it worked, she said.

“When you are in that circumstance and you go and seek help, the vast majority of people, with clinical support, support and love from friends and family, will be able to get out of that circumstance and see that it was a moment in time,” he said.

Many people suffering from mental health problems struggle to get help, the minister acknowledged.

But medical assistance in death is intended for people who “have tried everything” and are “unable to escape their mental hell,” he said.

“That’s a big difference.”

It is difficult to measure public sentiment about politics.

A September Angus Reid poll commissioned by Cardus found that while there was broad support across Canada for existing assisted dying policies, half of respondents opposed expanding eligibility to people suffering only from mental illness.

Meanwhile, an Ipsos poll conducted on behalf of Dying With Dignity Canada last summer suggested that 80 per cent of respondents thought an adult should be able to be assessed and, if eligible, receive assisted dying for severe and resistant mental disorders. to treatment if they are. experiencing intolerable suffering.

While some people conflate suicidal thoughts and untamed long-term suffering with good-faith concern, Holland said he believes fears are sometimes expressed to “play games and play politics.”

If Parliament grants the extension, it will be primarily up to the provinces to prepare staff to separate people in crisis from the few who should qualify, he said.

“My job, when I talk to my provincial and territorial counterparts every day, is to make sure they’re working towards it and ask them how we can support them in that,” he said.

The pause would delay expansion until well after the next election. The Liberals’ conservative opponents have said they would scrap the expansion if elected.

The scale of mental health problems in Canada is enormous, Holland said, and the government is taking steps to improve access as part of a series of bilateral agreements with provinces and territories.

“I didn’t understand that what I was going through was so common to other people’s experience, that many of us reach that point where we think we can’t take it anymore and feel like we’re alone,” he said.

But that’s not an argument against assisted dying, he said.

“The challenges we have in mental health and how we are going to address them as a society are separate and totally different from conversations about the extremely limited circumstances in which you have an untreatable mental illness.”

If you or someone you know is thinking about suicide, support is available 24/7 by calling or texting 988, the national suicide prevention helpline.

This report by The Canadian Press was first published Feb. 6, 2024.

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