Currently, people are eligible for MAID if they have a “grievous and irremediable medical condition”, such as a serious illness or disability, that has put them in an advanced state of irreversible decline and caused enduring physical or psychological suffering — excluding mental illness. Anyone who receives MAID must also go through two assessments from independent health care providers, among meeting other criteria. […] As Canada prepares to legalize MAID for people with mental disorders, each province will have to develop its own protocol for how to assess people. Dr. Simon Colgan, lead physician for the Community Allied Mobile Palliative Partnership which provides palliative care to homeless people, said MAID requests “must be understood within the context of a person’s lived experience and this takes time and relationship.” He said any MAID protocols for people with substance use disorders should be made with the input of people with lived experiences. “I don’t think it’s fair, and the government doesn’t think it’s fair, to exclude people from eligibility because their medical disorder or their suffering is related to a mental illness,” said Dr. David Martell, physician lead for Addictions Medicine at Nova Scotia Health. “As a subset of that, it’s not fair to exclude people from eligibility purely because their mental disorder might either partly or in full be a substance use disorder. It has to do with treating people equally.”
On the flip side, some drug users and harm reduction advocates say they’re upset drug users are being given access to MAID, as they feel other public health measures are lacking. “I just think that MAID when it has entered the area around mental health and substance use is really rooted in eugenics. And there are people who are really struggling around substance use and people do not actually get the kind of support and help they need,” said Zoe Dodd, a Toronto-based harm reduction advocate.
Karen Ward, a drug user activist in Vancouver, said she considers the expansion of MAID to include people with substance use disorders a “statement in federal law that some people aren’t really human.” “The government has made death accessible while a better life remains impossible,” she said. “Homes for all, guaranteed dignified incomes, access to healthcare, education and employment: these aren’t radical demands.”
