Experts Debate Expansion of Assisted Dying Legislation to Psychiatric Patients


Recently, the Supreme Court of Canada ruled that adults with a “grievous and irremediable” condition have a right to medically assisted suicide. In an effort to legislate this right, a parliamentary committee was formed that suggested extending this definition to nonterminal medical conditions, including psychiatric disorders. In response, the Canadian Medical Association Journal printed an editorial by bioethics and public health experts Scott Kim and Tudo Lemmens. Kim and Lemmens argue that extending assisted dying laws to include patients diagnosed with psychiatric disorders “will put many vulnerable and stigmatized people at risk.”

assisted dying

The Canadian government recently passed bill C-14, which did not extend the assisted dying measures to psychiatric conditions, but the editorial warns that this issue may not yet be settled, as the government has indicated that it is still studying the issue.

“Arguments for including mental illness as an eligible condition for assisted dying almost always focus on severe depression. The assumption is that doctors can accurately determine medical futility and decisional capacity, with the implication that no ineligible person would receive assisted death,” Kim and Lemmens write. “However, evidence suggests this focus is too narrow and fails to consider real threats to patients with mental illness.”

Previous studies out of Belgium, and the Netherlands reveal that patients who would meet the “irremediable” standard for assisted dying with severe depression might actually be able to achieve remission if given access to high-quality treatment.

“The assumption that only patients with true irremediable depressive disorders would have access to assisted dying — after careful assessment of their decision-making capacity based on rigorous thresholds — is not supported by evidence,” they write.

Another concern is that some patients who request assisted dying while in an extreme state might not meet the criteria for mental capacity necessary to make such a final decision. While “psychiatric diagnoses should not be equated with incapacity,” the authors point out that past research has shown that psychiatrists report difficulty evaluating decision-making capacity.

“We believe there is a serious gap between the idealized basis upon which assisted dying for patients with psychiatric conditions is advocated and the reality of its practice, as reflected in evidence from Belgium and the Netherlands.” The conclude. “A policy for access to assisted dying by nonterminally ill patients with psychiatric conditions will put many vulnerable and stigmatized people at risk.”



Kim, S.Y. and Lemmens, T., 2016. Should assisted dying for psychiatric disorders be legalized in Canada?. CMAJ: Canadian Medical Association journal= journal de l’Association medicale canadienne. (Abstract)

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Justin Karter
MIA Research News Editor: Justin M. Karter is the lead research news editor for Mad in America. He completed his doctorate in Counseling Psychology at the University of Massachusetts Boston. He also holds graduate degrees in both Journalism and Community Psychology from Point Park University. He brings a particular interest in examining and decoding cultural narratives of mental health and reimagining the institutions built on these assumptions.


  1. While I am morally opposed to suicide, I view it as a civil right ((not something I would do, but I think other people should have the right to suicide)). What bothers me about “assisted dying” is that it brings suicide under the control of the medical establishment and government. In addition, I think that such legislation puts all kinds of vulnerable people–both those with and those without psychiatric labels–in a potentially dangerous situation. With the mentally distressed, “assisted dying” gives Mental Health, Inc. an even greater level of power and control over “patients.”

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    • I don’t think someone has the absolute right to commit suicide in my face, though at that point it’s sort of academic. I don’t think the state should be involved except maybe when someone is too utterly incapacitated to facilitate their own death. Generally speaking I think someone who wants to leave their 3D matrix that badly should be responsible for engineering their own way out, and without unduly traumatizing others..

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  2. But the psychiatric system is so good at providing a living death. Its no coincidence that people say those pills make me feel like a zombie.

    I am alive but can’t feel cause all my dopamine receptors are antagonized. If I could use words to describe the hell of anhedonia I would make Steven king look like an amateur writer. It sucks.

    So its my argument that psychiatry already provides assisted death.

    I recently met another Zyprexa victim that’s still takes the stuff, I know how that suck the life out zombifying poison works. Dude was sharing some deep thoughts and ideas with family so they got him some “help” Zy-prex-hell.

    What makes Zy-prex-hell truly evil and diabolical is that outside observers will observe the victim and say they seem “better” and they will but the victims hell is that anhedonia blockaid, that robbery of the ability to feel the reward of fun activities or that seance of awe and wonder from maybe seeing something like a shooting star or a trip to a museum. Total robbery that even the victim can’t name or identify.

    Anyway giving the authority to say who can live and who can die to psychiatry is a real bad idea considering their track record with ethics and morals and stuff. These are the people that drug up foster kids and help the drug companies hide side effects before marketing to children.

    If you want a living death psychiatry is real good at it.

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  3. All of you are immoral for supporting any inch of this.

    No one has a good reason to be euthanized by the state, or by themselves just because of feeling really sad?

    People are sad people other people aren’t doing enough to make them happy, so everyone here is responsible when someone is too sad to live because you are selfish with your own happiness that you don’t want to share it with others.

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  4. Believing a (first) diagnosis without a second or third opinion is a mistake, both in psychiatry and in the prediction of death.
    A doctor (Dr. Paul Saba) is contesting the new law on the grounds of the percentages of bad diagnosis.

    “He argued the medical field is filled with errors in diagnoses and prognoses and too often patients are making the difficult choice of dying based on erroneous facts.”

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  5. Medically “assisted” killing sounds very scary to me, even for those with physical disabilities. It is even scarier for people with the social disabilities imposed by bogus psychiatric labels. Too often, medical killing has been perpetrated by fascists and I think there may be a danger that psychiatric “euthanasia” might be motivated by stigma rather than the true desires of the labeled person. Greedy relatives could enter the picture too. Even though I disagree with “suicide prevention” as an “excuse” for psychiatric intervention, psychiatrically “facilitated” “mercy” killing sounds pretty scary. I read that psychiatrically labeled people die 25 years younger than “normal”people as it is. I think that is because of the toxic drugs. Psychiatry may already be slowly killing people, likely as part of the depopulation agenda. Jim Marrs has authored a book about the depopulation agenda.

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  6. The problem with the ‘near death” criterion is that at leaves a lot of people stranded whose medical conditions are such that without assistance they are not able to achieve the relief that they seek, despite them being utterly “competent” and fitting every other criteria.

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