MonthFebruary 2016

Reading of the Week: Doctor-Assisted Suicide: The Dutch Experience

From the Editor

Is the practice of psychiatry about to change?

We often think of change in terms of treatment developments – new drugs and therapies. But mental health services are delivered in a larger societal context, and our work is shaped by laws and court rulings. With that in mind, Carter v. Canada has the potential to reshape our work. As you know, last year, the Supreme Court of Canada struck down the provision of the Criminal Code prohibiting doctor-assisted suicide. Later today, a special joint parliamentary committee will issue its report, guiding the drafting of legislation that will legalize doctor-assisted suicide.

How will this future legislation affect those with mental illness? What will it mean for people like us who do clinical work? Obviously, it’s not possible to comment on legislation that hasn’t been drafted yet. But it is possible to look to other countries and consider their experience. In this week’s Reading, Kim et al. consider physician-assisted suicide and euthanasia in the Netherlands. In their study of a country across the ocean, there are lessons for our patients here.

DG Continue reading

Reading of the Week: The Good Life of Oliver Sacks, and More

From the Editor

Is the incidence of dementia falling?

What makes a good clinician?

This week, I’ve selected two Readings. We open with a NEJM paper suggesting a big trend: a decline in the incidence of dementia. That paper obviously has major implications for public policy. We then move on to a big and eloquent essay on a famous doctor, Oliver Sacks.

There isn’t much connecting these selections – except that both were suggested by readers, and they both raise big questions.

Enjoy.

DG Continue reading

Reading of the Week: Biron’s Illness and Recovery

From the Editor

Drug breakthroughs, better imaging, less invasive procedures. There are many amazing health-care stories from the past three decades but perhaps the most important one is decidedly low tech: the decline of stigma about mental illness, allowing millions of Canadians to discuss their problems and seek care.

That’s not to suggest that stigma doesn’t exist, of course. In November, we considered the Dabby et al. paper from The Canadian Journal of Psychiatry, which showed bias even on the part of psychiatrists and psychiatric residents. Though the problem continues, it’s difficult not to believe that we have turned a significant corner: late last month, for instance, Bell Canada Let’s Talk campaign managed to raise more than $6 million in a single day.

In terms of reducing stigma, it helps immeasurably when people come forward and discuss their mental health illness. I remember talking to a patient who had struggled with her diagnosis. Inspired by Olympian Clara Hughes, she posted on Facebook that she has Bipolar. In my office, she wept when describing the outpouring of support – from friends and families, yes, but also from strangers.

Stigma still exists; it takes great courage to come forward – but it’s incredibly important that people do.

This week’s Reading is one person’s story of mental illness and recovery, and his choice to tell his story.

He also happens to be the President and CEO of my hospital. And I’ve never been prouder to work at The Scarborough Hospital.

DG Continue reading

Reading of the Week: To Screen or Not to Screen – Pregnancy & Depression Screening

From the Editor

“Panel Calls for Depression Screenings During and After Pregnancy”

A government health-care panel making a revision to a past recommendation seems pretty ‘inside baseball’ – and hardly the stuff of international headlines. Last week, though, the decision of the U.S. Preventive Services Task Force to now recommend the screening of pregnant and post-partum women for depression was reported from New York to New Delhi.

For the record, The New York Times story (whose headline appears above) ran on the front page.

Why the change and what are the implications?

To screen or not to screen…

This week’s Reading looks at the big decision and we consider: is it a big bust?

DG Continue reading