Physician assisted dying,Mental disorders and MEDICAL MAID: A personal perspective

In 2020, we spoke with John Scully about denying physician assisted dying or MAID to those who are diagnosed with a mental disorder. In March of 2023, those whose sole underlying condition is a mental disorder will be eligible to be assessed for assisted dying. We reconnected with John for his perspective on this change, his response to concerns about permitting MAID to those with mental disorders, and why he is an outspoken advocate for this issue.

physician assisted dying

“My name is John Scully. I am 81 years old. I am officially a drug addict due to opioids that I take for chronic somatic pain driven by psychiatric illness. I take 30 pills a day to manage my symptoms and conditions. I suffer from severe mental illness including incurable depression, incurable post-traumatic stress disorder, and incurable anxiety disorder. I was first diagnosed 30 years ago and since then I have been admitted to seven psychiatric hospitals, I have undergone every possible treatment and taken every medication known to science, including all the drugs developed since 1950. To this day, none have had any positive effects on me, and some have had dangerous effects. I have tried several natural treatments and remedies such as acupuncture and vitamins. I have attempted suicide twice, and I support the upcoming change to Canada’s physician assisted dying laws or MAID law to include mental disorders.” 

John’s introduction is staggering, and not something you hear every day, even though by age 40, about 50% of the Canadian population will have or have had a mental illness.* In our experience at DWDC, there are many people who live with mental disorders who support MAID, but very few want to discuss it publicly. 

“This speaks volumes to the stigma that still surrounds mental illness. I believe I have a moral obligation to speak out and influence change. I have a point of view, and if given a platform I will take it every time to share my insight into mental illness, and why I support MAID for mental disorders. The world needs to know about mental illness, and they do not; they need to know about assisted dying, and they do not. I have been suffering for 30 years and there is nothing left to help me; I can only share my own lived experience, but I do believe that I speak for the ones who won’t or cannot speak out and suffer in silence. Rather than attempt to end my life through suicide again, I want the option for myself and others to be able to apply and be assessed for MAID. Suicide is undignified, it is awful and shocking, and it places enormous burden and horror on the family.” 

It is a human right to be on a parallel with physical illness.

The pain and suffering and loss of hope are identical.

With March 2023 on the horizon, there have been questions raised about MAID for mental disorders. Misinformation is strife in the media suggesting that this will open the door to anyone with intermittent mental health issues, or anyone in a mental health crisis – ignoring the rigorous safeguards already used in MAID assessments – and that the health care system needs fixing before expanding access to assisted dying. 

“Fixing the mental health care system is very imprecise and far off. Yes, it needs fixing, more people need support but we also need MAID as a part of mental health care now. MAID for mental illness will not be available to everyone, because it is a massive spectrum with varying degrees of illness. Depression from the loss of a loved one, or a job, even feeling down because you missed the bus; these are the normal ups and downs of life, they do not make us eligible for MAID. But people with long-term, incurable mental disorders experience intolerable suffering. It is a human right to be on a parallel with physical illness; the pain and suffering and loss of hope are identical.” 

The Expert Panel on MAID and Mental Illness submitted their report and recommendations in May to the Ministers of Health and Justice. John believes it is appropriate to be cautious and careful given the complexity of mental health, but not create unnecessary barriers. 

“I want to see Canada take the lead with good guidelines. This would include a thorough assessment, preferably including a family doctor who knows the patient very well, but in the absence of that someone who knows the patient and the suffering. I believe in an assessment of at least 90 days; this gives the assessor time to get to know the patient and be able to identify impulsive attempts for physician assisted dying , or MAID. When it comes to young people suffering from mental disorders, they need guidance and care, and they need time to mature before any decision about assisted dying is considered.” 

As always, we are grateful to John for his honest and open conversations about mental illness. We certainly need more understanding, information, kindness and empathy for people who live with mental disorders. It’s up to all of us to ask more questions, start conversations, and end the stigma of mental illness. 

For more information about MAID for mental illness 

For mental health support or general information 

For mental health supports by province or territory 

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