Mental Health
Mental Health, MAID, and Governance in Trudeau’s Canada
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The Opposition with Dan Knight
A Critical Examination of Governance, Ethical Implications, and the Search for Compassionate Solutions in a Nation in Crisis
The mental health crisis in Canada, deepened and exacerbated under Prime Minister Justin Trudeau’s leadership, has laid bare the stark realities and the fundamental cracks in our national mental health support structures. The haunting statistics released by the Angus Reid Institute have catapulted this crisis to the forefront of national discourse, but it seems that the ramifications extend far beyond mere numbers. Approximately 80% of Canadians are grappling with the inadequate availability of mental health resources, and the governmental response, or lack thereof, has amplified this concern.
Under Trudeau’s regime, the pervasive decline in mental health has not only been met with superficial commitments but has also seen the advancement of policies that many argue are an affront to the sanctity of life and individual liberty, namely, the Medical Assistance in Dying (MAID) legislation.
The Trudeau administration, amidst the throes of a profound mental health crisis, had pledged a seemingly substantial $4.5 billion over five years to address mental health care during the 2021 federal election. However, the tangible execution of this commitment remains elusive, with the funds ostensibly being absorbed into broader health care allocations. A dire need, once seemingly acknowledged, now seemingly diluted in priorities.
It’s in this same disconcerting timeframe that the contentious discussions around MAID have intensified. The proposed legislative modifications seek to expand the eligibility criteria to include individuals whose sole medical condition is a mental illness. This proposition has resulted in a fierce national debate and has amplified concerns over the values and the ethical compass guiding our nation’s leadership.
While the inception of MAID in 2016 found support among 64% of Canadians, the broadening of its scope to include mental illnesses has sparked widespread hesitation and reflection on its ethical implications. A mere 28% of Canadians support allowing those with only a mental illness to seek MAID. This shift in public sentiment is indicative of a collective realization of the complex moral, ethical, and societal implications of such a policy in a nation already strained by a lack of mental health support.
There’s an unsettling correlation between the difficulties in accessing mental health care and the support for the expansion of MAID. Two in five Canadians who’ve encountered barriers in accessing mental health care express support for the inclusion of mental illnesses in MAID eligibility. This correlation rings alarm bells about the level of desperation and despair fueled by inadequate mental health resources and support.
The MAID legislation, particularly its proposed expansion, is symptomatic of a deeper, more entrenched disregard for life and liberty. The policies and legislation emanating from Trudeau’s administration seem to foster an environment where the value of life is underplayed, and individual freedoms are undervalued. Rather than addressing the root causes and formulating holistic, compassionate solutions for mental health struggles, the government seems poised to offer an expedited escape route, overlooking the sanctity of life and the intrinsic rights of the individuals.
The urgency to address mental health challenges, especially those disproportionately affecting women, young adults, and lower-income households, is paramount. It requires genuine, sustained commitments and actions, far removed from mere electoral promises and rhetoric. The dialogue surrounding MAID, although crucial, risks overshadowing the fundamental issues at hand – the acute need for enhanced, accessible mental health care resources and a governmental ethos that values and preserves life and liberty.
In light of these pivotal concerns, this beckons a grave question to us all: Is this truly the Canada we desire? A Canada where, when faced with life’s vicissitudes, the solution provided by the government is simply to opt for MAID? Or do we yearn for a Canada that embodies hope, a belief that circumstances can, and will, improve? When 2025 arrives, the bell will indeed toll for Justin Trudeau and his Liberal compatriots, and we, as staunch Canadians, will need to rise to the occasion and answer this question. It’s a query not merely about policies or governance but about the very soul and essence of our great nation.
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Alberta
MAiD In Alberta: Province surveying Albertans about assisted suicide policies
Alberta’s government is launching a public engagement to gather input about legislation and policies around assisted suicide, also referred to as medical assistance in dying (MAID).
Medical assistance in dying is a process that allows an eligible person to receive assistance from a medical practitioner in ending their life. To be found eligible, a person must be suffering from a serious and permanent medical condition.
Alberta’s government is reviewing how MAID is regulated to ensure there is a consistent process as well as oversight that protects vulnerable Albertans, specifically those living with disabilities or suffering from mental health challenges. An online survey is now open for Albertans to share their views and experiences with MAID until Dec. 20.
“We recognize that medical assistance in dying is a very complex and often personal issue and is an important, sensitive and emotional matter for patients and their families. It is important to ensure this process has the necessary supports to protect the most vulnerable. I encourage Albertans who have experience with and opinions on MAID to take this survey.”
In addition to the online survey, Alberta’s government will also be engaging directly with academics, medical associations, public bodies, religious organizations, regulatory bodies, advocacy groups and others that have an interest in and/or working relationship to the MAID process, health care, disabilities and mental health care.
Feedback gathered through this process will help inform the Alberta government’s planning and policy decision making, including potential legislative changes regarding MAID in Alberta.
“Our government has been clear that we do not support the provision of medically assisted suicide for vulnerable Albertans facing mental illness as their primary purpose for seeking their own death. Instead, our goal is to build a continuum of care where vulnerable Albertans can live in long-term health and fulfilment. We look forward to the feedback of Albertans as we proceed with this important issue.”
“As MAID is a federally legislated and regulated program that touches the lives of many Albertans, our priority is to ensure we have robust safeguards to protect vulnerable individuals. Albertans’ insights will be essential in developing thoughtful policies on this complex issue.”
The federal Criminal Code sets out the MAID eligibility criteria, procedural safeguards and reporting obligations. The federal government has paused MAID eligibility for individuals with a mental illness as their sole underlying medical condition until March 2027 to ensure the provincial health care systems have processes and supports in place. Alberta’s government does not support expanding MAID eligibility to include those facing depression or mental illness and continues to call on the federal government to end this policy altogether.
Related information
Alberta
On gender, Alberta is following the science
Despite falling into disrepute in recent years, “follow the science” remains our best shot at getting at the truth of the physical sciences.
But science, if we are to place our trust in it, must be properly defined and understood; it is at its essence an ever-changing process, a relentless pursuit of truth that is never “settled,” and one that is unafraid to discard old hypotheses in the face of new evidence.
And it is in this light—in the unforgiving glare of honest science—that Alberta Premier Danielle Smith’s three new legislative initiatives around gender policy are properly understood, notwithstanding the opprobrium they’ve attracted from critics.
Bill 26, the Health Statutes Amendment Act, proposes to prohibit the prescription of puberty blockers and cross-gender hormones for the treatment of gender dysphoria to youth aged 15 and under. It would allow minors aged 16 and 17 to begin puberty blockers and hormone therapies for gender “reassignment” and “affirmation” purposes only with parental, physician, and psychologist approval. The bill also prohibits health professionals from performing sex reassignment surgeries on minors.
Bill 27, the Education Amendment Act, seeks to enshrine parents’ rights to be notified if their kids change their names/pronouns at school, and it gives parents the right to “opt in” to what sort of gender and sex education their kids are exposed to in school.
And Bill 29, the Fairness and Safety in Sports Act, is designed to protect females in sports by ensuring that women and girls can compete in biological female-only divisions, while supporting the formation of co-ed opportunities to support transgender athletes.
Each of these initiatives is entirely reasonable, given what we know of the science underpinning “gender care,” and of the undeniable advantages that a male physique confers upon biological males competing in sports.
The notion that the trifecta of puberty blockers, cross-gender hormones, and revisionist surgery is a pathway to good health was a hypothesis initially devised by Dutch researchers, who were looking to ease the discomfort of transgender adults struggling with incongruence between their physical appearance and their gender identities. As a hypothesis, it was perhaps reasonable.
But as the UK’s Cass Review exposed in withering detail last spring, its premises were wholly unsupported by evidence, and its implementation has caused grievous harm for youth. As Finnish psychiatrist Riittakerttu Kaltiala, one of the architects of that country’s gender program, put it last year, “Gender affirming care is dangerous. I know, because I helped pioneer it.”
It’s no accident, then, that numerous European jurisdictions have pulled back from the “gender affirming care” pathway for youth, such as Sweden, Finland, Belgium, the Netherlands, and the United Kingdom.
It makes perfect sense that Canadians should be cautious as well, and that parents should be apprised if their children are being exposed to these theories at school and informed if their kids are caught up in their premises.
Yet the Canadian medical establishment has remained curiously intransigent on this issue, continuing to insist that the drug-and-surgery-based gender-affirming care model is rooted in evidence.
Premier Smith was asked by a reporter last month whether decisions on these matters aren’t best left to discussions between doctors and their patients; to which she replied:
“I would say doctors aren’t always right.”
Which is rather an understatement, as anyone familiar with the opioid drug crisis can attest, or as anyone acquainted with the darker corners of medical history knows: the frontal lobotomy saga, the thalidomide catastrophe, and the “recovered memories of sexual abuse” scandal are just a few examples of where doctors didn’t “get it right.”
As physicians, we advocate strongly for self-regulation and for the principle that medical decisions are private matters between physicians and patients. But self-regulation isn’t infallible, and when it fails it can be very much in the interests of the public—and especially of patients—for others to intervene, whether they be journalists, lawyers, or political leaders.
The trans discussion shouldn’t be a partisan issue, although it certainly has become one in Canada. It’s worth noting that Britain’s freshly elected Labour Party chose to carry on with the cautious approach adopted by the preceding administration in light of the Cass Review.
Premier Smith’s new polices are eminently sensible and in line with the stance taken by our European colleagues. None of her initiatives are “anti-trans.” Instead, they are pro-child, pro-women, and pro-athlete, and it’s difficult to see how anyone can quibble with that.
Dr. J. Edward Les, MD, is a pediatrician in Calgary, senior fellow at the Aristotle Foundation for Public Policy, and co-author of Teenagers, Children, and Gender Transition Policy: A Comparison of Transgender Medical Policy for Minors in Canada, the United States, and Europe.
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