Is There a Definition of Irremediable?

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers Medical Assistance in Dying (MAiD) and mental illness with our guest expert Dr. Sonu Gaind. This episode was originated by Dr. Urvashi Prasad for her Grand Rounds. 

The learning objectives for this episode are as follows:

By the end of this episode, you should be able to…

1. Briefly summarize the history of Medical Assistance in Dying in Canada
2. Define the present policy on Medical Assistance in Dying and Mental Health in Canada
3. Evaluate the arguments in support of and against the implementation of Medical Assistance in Dying in Mental Health
4. Discuss the possible impact that Medical Assistance in Dying might have on the profession of psychiatry

Guest expert: Dr. Sonu Gaind  is a Professor in the Faculty of Medicine at the University of Toronto (U of T) and Chief of Psychiatry at Humber River Hospital. Dr. Gaind has testified in front of the Federal External Panel on Options for a Legislative Response to Carter v. Canada, the Provincial-Territorial Expert Advisory Group on Physician-Assisted Dying, the Special Joint Commons/Senate Committee on Physician-Assisted Dying, and the Senate Committee on Legal and Constitutional Affairs on issues relevant to mental health and mental illness that need to be considered in the MAiD framework. Dr. Gaind chaired the time-limited Canadian Psychiatric Association Task Force on Assisted Dying, was selected to sit on the Council of Canadian Academies Expert Panel on Mental Disorders and Assisted Dying, and has spoken across the country and internationally on the subject.

Grand Rounds Presenter: Dr. Urvashi Prasad (PGY3)

Produced by: Dr. Urvashi Prasad (PGY3) and Dr. Alex Raben  (staff psychiatrist)

Hosts: David Eapen-John (MS2), Dr. Alex Raben (Staff Psychiatrist)

Audio editing by: Dr. Alex Raben (Staff Psychiatrist)

Show notes by: Dr. Urvashi Prasad (PGY3)

Resources:

Assisted Suicide in Canada https://www.thecanadianencyclopedia.ca/en/article/assisted-suicide-in-canada (Website)

Council of Canadian Academies, 2018. The State of Knowledge on Medical Assistance in Dying Where a Mental Disorder Is the Sole Underlying Medical Condition. Ottawa (ON):  The Expert Panel Working Group on MAID Where a Mental Disorder Is the Sole Underlying Medical Condition 

https://cca-reports.ca/wp-content/uploads/2018/12/The-State-of-Knowledge-on-Medical-Assistance-in-Dying-Where-a-Mental-Disorder-is-the-Sole-Underlying-Medical-Condition.pdf

References:

• Government of Ontario, Ministry of Health and Long-Term Care. “Medical Assistance in Dying.” Health Care Professionals - MOH, Government of Ontario, Ministry of Health and Long-Term Care, 13 May 2021, https://www.health.gov.on.ca/en/pro/programs/maid/.
• Tabitha Marshall. “Assisted Suicide in Canada.” The Canadian Encyclopedia, 3 Dec. 2021, https://www.thecanadianencyclopedia.ca/en/article/assisted-suicide-in-canada.
• “Get the Facts: Canada's Medical Assistance in Dying Law.” Dying With Dignity Canada, https://www.dyingwithdignity.ca/get_the_facts_assisted_dying_law_in_canada#mental_illness.
• Jones, Roland M, and Alexander I F Simpson. “ Medical Assistance in Dying: Challenges for Psychiatry.” Frontiers in psychiatry vol. 9 678. 10 Dec. 2018, doi:10.3389/fpsyt.2018.00678
• Thienpont, Lieve et al. “Euthanasia requests, procedures and outcomes for 100 Belgian patients

suffering from psychiatric disorders: a retrospective, descriptive study.” BMJ open vol. 5,7

e007454. 27 Jul. 2015, doi:10.1136/bmjopen-2014-007454

• Gaind, KS. (2020). What does “irremediability” in mental illness mean? Canadian Journal of

Psychiatry. Online first May 22, 2020. pp 1‐3. doi: 10.1177/0706743720928656

• “Maid Volunteer Advocacy Council.” Mental Illness and MAID, https://sencanada.ca/content/sen/committee/432/LCJC/Briefs/MentalIllnessandMAID_e.pdf.
• Canada, Health. “Second Annual Report on Medical Assistance in Dying in Canada 2020.” Canada.ca, / Government of Canada Gouvernement Du Canada, 30 June 2021, https://www.canada.ca/en/health-canada/services/medical-assistance-dying/annual-report-2020.html#highlights. 
• Komrad, Mark S. “Oh, Canada! Your New Law Will Provide, Not Prevent, Suicide for Some Psychiatric Patients.” Psychiatric Times, 1 June 2021, https://www.psychiatrictimes.com/view/canada-law-provide-not-prevent-suicide. 

CPA Note: The views expressed in this podcast do not necessarily reflect those of the Canadian Psychiatric Association (CPA).

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