A Canadian woman who went to a hospital for help managing her suicidal thoughts and chronic depression was asked if she had considered euthanasia.
Kathrin Mentler, 37, says that she went through a traumatic event earlier this year. When seeking psychiatric help at the Vancouver General Hospital, the doctor suggested the nation’s Medical Assistance in Dying (MAID) program.
The Globe and Mail reports, “Ms. Mentler says a clinician told her there would be long waits to see a psychiatrist and that the health care system is ‘broken.’ That was followed by a jarring question: ‘Have you considered MAID?’”
“She was like, ‘I can call the on-call psychiatrist, but there are no beds; there’s no availability,’” Mentler explained. “She said to me: ‘The system is broken.’”
Mentler said that she had not considered MAID but had considered overdosing on pills herself. The doctor told her that attempting suicide on her own could lead to brain damage and other harm but that the euthanasia program would be a more “comfortable” process as she would be sedated.
“I very specifically went there that day because I didn’t want to get into a situation where I would think about taking an overdose of medication,” Mentler said. “The more I think about it, I think it brings up more and more ethical and moral questions around it.”
Vancouver Coastal Health admitted to the conversation but claimed it was an effort to gauge how suicidal Mentler was.
“During patient assessments of this nature, difficult questions are often asked by clinicians to determine the appropriate care and risk to the patient,” said a statement from the hospital’s public affairs leader Jeremy Deutsch.
“Staff are to explore all available care options for the patient and a clinical evaluation with a client who presents with suicidality may include questions about whether they have considered MAID as part of their contemplations. We understand this conversation could be upsetting for some, and share our deepest apologies for any distress caused by this incident.”
Mentler was unimpressed by the apology, telling the newspaper, “Gauging suicide [risk] should not include offering options to die, which is what it felt like. I also think it’s worth considering that, as of right now, MAID for mental health is not legal yet, so giving someone the specifics of the process seems wrong. How can this be standard procedure for suicide crisis intervention?”
She is now waiting to see a psychiatrist in the fall.
“MAID is not currently legal for mental illness alone,” the Globe and Mail report explains. “Canada legalized assisted dying in 2016 for patients with “reasonably forseeable” deaths and expanded eligibility in 2021 to those with incurable conditions who were suffering intolerably. The legislation was set to expand again in March to allow MAID for those with mental illness as a sole condition, but the federal government sought a one-year pause to allow for further study.”
In July 2021, the Psychiatric Times published an article opposing assisted suicide. It noted that “preliminary reports suggest increased rates of suicide in the general population of states that have legalized PAS (physician assisted suicide). Specifically, ‘legalizing PAS has been associated with an increased rate of total suicides relative to other [non-PAS] states, and no decrease in non-assisted suicides.’ Similarly, suicide rates in the Netherlands (where medical euthanasia is legal) have accelerated, compared to neighboring countries that have not legalized medical euthanasia.”
They report that physician and ethicist Leon Kass, MD, has pointedly cautioned: “We must care for the dying, not make them dead.”
The American College of Physicians has said, “physician-assisted suicide is neither a therapy nor a solution to difficult questions raised at the end of life. On the basis of substantive ethics, clinical practice, policy, and other concerns, the ACP does not support legalization of physician-assisted suicide. … However, through high-quality care, effective communication, compassionate support, and the right resources, physicians can help patients control many aspects of how they live out life’s last chapter.”
If you or someone you know is struggling with depression or has had thoughts of harming themselves or taking their own life, get help. The National Suicide Prevention Lifeline (1-800-273-8255) provides 24/7, free, confidential support for people in distress, as well as best practices for professionals and resources to aid in prevention and crisis situations.
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