Tag: doctor-assisted suicide

Reading of the Week: Ethics & Medical Assistance in Dying – the new Simpson Paper. Also, Exercise for the Cognitive Symptoms of Depression?

December 14, 2017 /

From the Editor

It may soon be the law… but is it ethical?

In 2016, Parliament passed Bill C-14, legalizing doctor-assisted suicide. The legislation represents a major change in many ways: from public policy to the practice of medicine. And, in the coming years, it’s quite possible that the scope of this legislation will be expanded, and could include those with mental illness.

In this week’s Reading, Dr. Wayne (Sandy) Simpson of CAMH weighs in on the ethics of medical assistance in dying (MAiD) and mental illness in this provocative “perspective” paper just published by The Canadian Journal of Psychiatry. He considers the nature of mental illness before concluding: “[A]cting as a partner in helping people recover as well as acting as an agent in a patient’s death is an impossible burden that is not ethically justifiable or legally necessary.”

ethics-cert

Also, this week, we consider another recent paper by The Canadian Journal of Psychiatry that considers the impact of exercise on cognition in patients with depression.

DG

Continue reading

Reading of the Week: C-14 and Medically Assisted Dying

June 23, 2016 /

From the Editor

Over the years, Readings have considered big papers and big essays. This week’s Reading considers big legislation.

Last Friday, C-14 was given Royal Assent, having finally achieved Senate approval, thereby becoming law.

The Parliament of Canada

“An Act to amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying)” is unlikely to be the end of this debate. Indeed, it is likely to be part of the beginning of a larger societal debate on death and medicine.

In this Reading, we look at C-14 and, as well, an essay by Dr. Sonu Gaind on mental illness and physician-assisted death.

DG Continue reading

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

February 25, 2016 /

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: Euthanasia, Psychiatry, and the Thienpont et al. paper

September 30, 2015 /

The Belgian Euthanasia Law (2002) defines euthanasia as the physician’s “act of deliberately ending a patient’s life at the latter’s request,” by administering life-ending drugs.In Europe, psychological suffering stemming from either a somatic or mental disorder is acknowledged as a valid legal basis for euthanasia only in Belgium, the Netherlands and Luxembourg.In the Netherlands and Luxembourg, the term ‘assisted suicide’ is used when the life-ending drugs are taken orally, but in Belgium, the term ‘euthanasia’ is used whether the drugs are received orally or intravenously.

So begins a new paper on euthanasia in Belgium.

The topic is fascinating and it’s also highly relevant in Canada. As you will recall, Carter v. Canada – the Supreme Court ruling made earlier this year – speaks directly to the right to doctor-assisted suicide. (I’ll return to this point in a moment.)

This week’s Reading: “Euthanasia requests, procedures and outcomes for 100 Belgian patients suffering from psychiatric disorders: a retrospective, descriptive study” by Dr. Lieve Thienpont et al., which was just published online at BMJ Open.

Though much has been written about Belgium and euthanasia (a June Reading considered a New Yorker essay on the topic), little data has been analyzed. And that’s what makes the Thienpont et al. paper interesting. A quick summary: in a first-of-it-kind paper, the authors consider 100 psychiatric patients requesting euthanasia – from their diagnosis to their final outcome. It should be noted that the first author is a leading proponent of euthanasia and was actively involved in the care and decision making of these patients.

Continue reading