Full Comment - Best of 2022： Killing off the sad and the poor with MAID

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00:01:12.740 Hi, I'm Kevin Libin, the executive producer of the Full Comment podcast.

00:01:18.220 Over the holidays, we're going to be running a couple of our favorite episodes of 2022.

00:01:22.300 With the disturbing recent developments in the federal liberals' medically-assisted dying regime,

00:01:27.760 including government workers pushing it on injured veterans,

00:01:30.700 and some doctors pondering euthanizing babies,

00:01:34.340 we wanted to bring back our interview with Sonu Gand.

00:01:37.660 Gand is a doctor and was an early supporter of medical assistance in dying,

00:01:42.260 but he's alarmed by its spread to allow the mentally ill to choose assisted suicide,

00:01:47.580 which is currently set to be legal in March.

00:01:51.120 Anthony Fury interviewed Gand way back in May of this year,

00:01:54.200 but the doctor's warnings have never been timelier.

00:01:56.960 Please enjoy the conversation, and remember,

00:01:59.220 you can always go back and listen to episodes of Full Comment

00:02:01.840 that you may have missed from earlier this year or further back

00:02:04.740 in our archive on Apple, Spotify, Amazon, or wherever you get your podcasts.

00:02:10.300 I want to wish a Happy New Year to all our listeners,

00:02:12.820 and we'll see you again with a whole new episode on January 9th.

00:02:17.240 Hello, I'm Anthony Fury.

00:02:18.640 Thanks for joining us for the latest episode of Full Comment.

00:02:21.200 Please consider subscribing if you haven't already.

00:02:23.460 Medical assistance in dying, MAID as it's called, is expanding in Canada

00:02:29.200 in ways that a lot of people are perhaps not even aware of.

00:02:33.640 Laws were first introduced permitting MAID in Canada just over five years ago,

00:02:37.480 but in early 2021, the categories and situations were broadened

00:02:41.240 in ways that are concerning to a number of experts.

00:02:45.100 Do we really know what we're getting into here?

00:02:47.580 Shouldn't we perhaps talk this out a little bit more as a nation?

00:02:50.480 To help us understand the complexity of these issues,

00:02:53.540 where we're at in this situation here in Canada,

00:02:55.620 and where we may be going awry,

00:02:57.880 we're joined today by Dr. Sonu Gand.

00:03:00.260 Dr. Gand is a professor at the University of Toronto

00:03:02.560 and the head of psychiatry at Humber River Hospital,

00:03:05.400 where he is the physician chair of the Medical Assistance and Dying Committee.

00:03:09.560 Dr. Gand, thanks so much for joining us today.

00:03:11.100 We appreciate it.

00:03:12.500 My pleasure.

00:03:13.440 Thank you both for having me,

00:03:14.900 and also more importantly for your interest in this challenging and complex topic.

00:03:20.960 Yeah, challenging indeed.

00:03:22.220 And there's definitely a lot of perspectives,

00:03:24.180 a lot of both professional perspectives,

00:03:26.860 but also very raw opinions out there that a lot of people are sharing.

00:03:31.420 I'm kind of surprised to find us so suddenly back at this conversation,

00:03:34.840 as I know it was a national conversation about five years ago,

00:03:37.680 following a court ruling.

00:03:39.040 A lot of people said,

00:03:40.340 well, it's a slippery slope, watch out.

00:03:42.480 And we said, well, okay, you know, take it one step at a time.

00:03:44.840 But it looks like recently we have gone a further step,

00:03:47.860 which I guess requires a subsequent conversation.

00:03:52.180 Yes, and this is why I'm so appreciative

00:03:54.360 that you're taking the time to look at this issue,

00:03:57.940 because I honestly believe that the vast majority of Canadians

00:04:02.020 are completely unaware of just how far things have gone,

00:04:07.240 and in such a short time.

00:04:09.340 So I think there are a lot of misconceptions out there

00:04:12.420 about where our current expanded policies are going

00:04:16.640 and how we've come to be where we are.

00:04:20.260 Well, can you explain to us how things first sort of developed

00:04:23.680 back around 2016 when there was, I guess,

00:04:27.160 a court ruling saying medical assistance in dying

00:04:30.340 would be allowed to end the suffering of terminally ill adults?

00:04:34.080 What were the confines of that?

00:04:35.640 How did that sort of work practically?

00:04:37.620 So what happened was in 20, the court ruling was from 2015,

00:04:43.260 and it led to laws that were implemented in 2016.

00:04:47.920 And the ruling was in a case called Carter v. Canada.

00:04:52.340 And in that case, there were two plaintiffs,

00:04:54.700 two plaintiffs, two people who were, they were fighting for the ability

00:05:00.340 to have a medically assisted death.

00:05:03.360 And each of those people had what we call a neurodegenerative illness,

00:05:08.060 meaning an illness that has known progression and a known course to it,

00:05:15.200 and it was known that they would not be able to improve.

00:05:17.900 One of them had ALS and the other had spinal stenosis.

00:05:22.720 So what the Supreme Court found in that case was that the,

00:05:28.360 up until then, blanket prohibition the country had against assisted dying,

00:05:32.980 that the blanket prohibition violated our charter.

00:05:36.100 And what that means is they said that you can't just say that you're unable

00:05:40.360 to provide assisted dying in any situation.

00:05:44.600 It may be suitable in some situations.

00:05:47.020 Now, keep in mind, that prohibition was actually in the criminal,

00:05:50.160 in our criminal law, is the law that needed to change.

00:05:55.300 So what changed in 2016 to conform with that ruling

00:05:59.480 was that the government brought in Bill C-14,

00:06:03.940 which allowed for assisted dying in certain circumstances.

00:06:08.720 And one of the safeguards that was required

00:06:12.740 was that a medical condition that was grievous,

00:06:16.620 meaning really serious, and irremediable,

00:06:19.200 meaning it will not get better,

00:06:21.380 that we can predict it won't get better,

00:06:23.720 that you needed to have a grievous and irremediable medical condition.

00:06:27.060 And one of the safeguards was that natural death

00:06:31.020 needed to be reasonably foreseeable.

00:06:34.000 And so that's what the initial framework was based on in 2016.

00:06:40.580 What was the response among the medical community to this ruling?

00:06:43.600 Was there the sense that, yes, we need to provide

00:06:45.680 these opportunities for people, that this is a gap?

00:06:48.340 So there was, I don't know if relief is the right term,

00:06:50.260 but a general agreement with this?

00:06:52.040 Was there anxiety?

00:06:54.120 What was the level of acceptance to resistance, would you say?

00:06:57.060 Well, it's a controversial area in some ways,

00:07:03.080 but I do think that the ruling at that time,

00:07:05.820 which was framed in the context of providing assisted dying

00:07:09.700 when someone is already dying, that's a key distinction,

00:07:13.780 because death needed to be reasonably foreseeable.

00:07:16.280 There has been a shift towards greater acceptance

00:07:19.800 that that is appropriate in some situations.

00:07:23.880 And it's not a universal shift.

00:07:25.480 I don't think there's 100% agreement on either side in this complex debate.

00:07:30.980 But it is something that shifted over time.

00:07:33.180 And to put that in context, you know,

00:07:34.860 there had been a previous Supreme Court ruling

00:07:37.520 in a case about 20, in the 1990s, in 1993,

00:07:42.960 a different case challenging the same law.

00:07:46.900 And that was a case also of a woman, Sue Rodriguez, who had ALS.

00:07:51.340 And in that ruling, the Supreme Court upheld the existing law

00:07:55.020 through a split decision.

00:07:56.960 And in the 2015 ruling, the Supreme Court unanimously ruled

00:08:02.340 that the law violated the charter.

00:08:05.220 So even that represents some sort of shift in what society

00:08:10.680 and people seem to think was acceptable.

00:08:13.980 The concern became, though, that some people did not agree with it,

00:08:20.560 and it did allow the option for people to be what are called conscientious objectors,

00:08:26.480 meaning if somebody did not want to participate on the medical side,

00:08:30.840 that they shouldn't be compelled to.

00:08:34.660 But there were others who were not conscientious objectors,

00:08:38.820 but they had concerns about further expansion.

00:08:42.120 And that's the category I fall in.

00:08:44.180 I'm not a conscientious objector.

00:08:46.060 I actually, as you mentioned, I chair our,

00:08:49.540 I'm physician chair of our hospital MADE team.

00:08:52.020 I've seen the potential benefit and value

00:08:55.500 that MADE can bring in appropriate situations.

00:08:59.340 I have also been sensitized to what I think are the dire dangers

00:09:04.460 of providing assisted suicide in inappropriate situations.

00:09:10.120 That is where I believe we're heading.

00:09:12.640 And Dr. Gand, this position, physician chair of this committee,

00:09:16.020 can you break down what that is, what you do in that capacity?

00:09:20.560 So we have developed policies.

00:09:22.980 Every site would have done this to develop policies

00:09:25.840 to allow for assisted dying under the existing laws.

00:09:32.700 And part of my role in that committee has been to assist the hospital

00:09:37.220 and the team in developing those policies.

00:09:39.880 And there's also a role of oversight of the actual cases

00:09:44.540 and applications that come through for assisted dying.

00:09:47.780 Now, I'm a psychiatrist.

00:09:48.900 My background is psychiatry and psycho-oncology.

00:09:53.260 In other words, when patients have cancer as well.

00:09:57.540 And the MADE laws that we have had up until now,

00:10:01.700 because that reasonably foreseeable death,

00:10:05.080 safeguard had been there,

00:10:07.140 and mental illnesses on their own

00:10:09.540 do not, by and large, lead to death.

00:10:12.660 Soul mental illness conditions have not been things

00:10:16.520 that have really been open for getting MADE for.

00:10:20.560 So people could apply for MADE if they have a mental illness,

00:10:24.740 plus another condition that had been leading to foreseeable death.

00:10:28.840 But mental illness conditions alone

00:10:30.900 generally would not qualify for that.

00:10:33.600 And as a result, in terms of my role,

00:10:36.760 we haven't had applications for soul mental illness.

00:10:40.160 So as a psychiatrist, I wouldn't have a role

00:10:42.760 in doing the clinical assessment

00:10:44.460 of whether somebody's ALS is irremediable, for example,

00:10:48.800 or whether their lung disease is irremediable.

00:10:51.600 So it's more of an oversight role

00:10:53.520 where we would review things as a team.

00:10:56.060 But again, we so far have not had MADE

00:11:00.240 for soul mental illness, by and large.

00:11:03.140 So now we're in a situation, March 2021,

00:11:05.860 the law further amended by Bill C-7,

00:11:08.560 which has expanded the situations and categories

00:11:12.100 where MADE is made available to patients.

00:11:16.640 In what sort of scope has this now changed?

00:11:20.500 So if I can take a second, I'll rewind a little bit.

00:11:24.380 Yeah, please.

00:11:24.980 In order to get to that question,

00:11:26.900 because you mentioned at the beginning

00:11:29.460 that some people had concerns

00:11:31.160 there could be a slippery slope,

00:11:33.020 and others were saying,

00:11:34.260 no, there's no need to worry about a slippery slope.

00:11:36.660 So, you know, in my opinion,

00:11:39.360 I would say that we have not actually experienced

00:11:45.120 a slippery slope.

00:11:46.440 There's no slope.

00:11:47.260 There's a cliff.

00:11:48.520 And I believe our MADE laws are falling off that cliff.

00:11:52.040 And I'll tell you why I say that.

00:11:54.020 So before even getting to the expansion

00:11:56.460 in C-7 from 2021,

00:11:59.700 before getting there,

00:12:00.920 let's just talk for a minute

00:12:02.400 about what has been happening with MADE

00:12:05.000 under the old system

00:12:06.300 when death needed to be reasonably foreseeable.

00:12:09.020 And this is part of what I think

00:12:10.640 many people don't understand.

00:12:12.920 When death needed to be reasonably foreseeable,

00:12:15.260 it did not mean that you only had two weeks

00:12:17.740 or two months

00:12:18.800 or even two years left to live.

00:12:21.580 It was generally acknowledged

00:12:23.640 through other case law

00:12:25.420 that occurred during that time,

00:12:26.800 that even if someone had up to a decade to live,

00:12:29.740 up to 10 years to live,

00:12:31.700 that could qualify and would qualify

00:12:33.560 and did qualify for getting MADE.

00:12:36.280 So we're not talking about people

00:12:37.360 right on death's doorstep,

00:12:38.660 even under the old system.

00:12:41.580 I wasn't aware of that,

00:12:42.740 to your point about Canadians

00:12:43.860 not really understanding.

00:12:45.320 I did not know that part.

00:12:46.780 Yeah.

00:12:47.000 And so what that means,

00:12:48.380 quite literally,

00:12:49.500 is that even age

00:12:50.920 ended up becoming a potential

00:12:53.500 quote-unquote qualifier

00:12:55.080 because the issue of age

00:12:57.300 and frailty

00:12:57.960 did come into play.

00:13:00.960 And, you know,

00:13:01.600 and so if you could say to anyone

00:13:02.960 that, yeah,

00:13:03.640 we think it's reasonable

00:13:04.620 that you might have

00:13:05.620 10 years or a bit less to live,

00:13:08.400 they actually would have qualified

00:13:09.500 under the old system

00:13:11.040 without expansion.

00:13:12.680 Now, under the old system,

00:13:14.740 let's look at briefly

00:13:15.940 what the numbers were,

00:13:16.920 that the country gets

00:13:18.600 national statistics.

00:13:19.900 The way we've compiled them,

00:13:22.460 there's always a bit of a delay

00:13:24.120 in the national reporting.

00:13:26.280 So I'm going to give you

00:13:27.040 two years of national reporting.

00:13:28.840 The latest national reporting

00:13:30.500 we have is from 2020.

00:13:32.600 In other words,

00:13:33.480 pre-expansion of C7.

00:13:36.340 But I'm going to talk first

00:13:37.860 about 2019.

00:13:40.020 So in the year 2019,

00:13:41.760 which was just a few years

00:13:43.260 after MAID came in in 2016,

00:13:45.480 in that short time,

00:13:47.240 our national death rate

00:13:48.900 from MAID was 2%,

00:13:51.180 meaning that 2%

00:13:53.340 of all deaths in Canada

00:13:54.920 by 2019 were by MAID.

00:13:58.100 Some provinces

00:13:59.140 were quite a bit higher than that.

00:14:01.600 So Quebec was at

00:14:02.580 almost 2.5%

00:14:03.900 and BC at about 3.3%.

00:14:06.960 Over the next year,

00:14:09.280 so into 2020,

00:14:10.560 again,

00:14:11.220 before expansion of C7,

00:14:13.580 the death rate

00:14:14.580 in every single province

00:14:15.960 went up.

00:14:16.700 They quite remarkably

00:14:17.580 called the term

00:14:18.440 a growth rate.

00:14:19.120 They call it a growth rate

00:14:20.240 in the death rate

00:14:21.360 by MAID.

00:14:22.840 And so by 2020,

00:14:24.540 2.5% of all Canadians

00:14:27.360 dying that year

00:14:28.480 died by MAID.

00:14:30.240 And Quebec had gone up

00:14:32.320 to over 3%.

00:14:33.440 BC had gone up

00:14:34.580 to over 4%.

00:14:35.700 And we know that

00:14:37.180 even within there,

00:14:38.740 there are pockets

00:14:39.400 that are even higher.

00:14:40.680 It's reported that

00:14:41.740 Vancouver Island's

00:14:43.540 death rate by MAID

00:14:45.180 is over 7%.

00:14:46.860 And it's been dubbed

00:14:48.240 the MAID capital

00:14:49.960 or assisted dying capital

00:14:51.300 of the world.

00:14:52.880 Now, all of that

00:14:54.040 is before

00:14:54.760 Bill C7 expansion.

00:14:56.680 Now let's look at

00:14:57.740 what happens

00:14:58.220 with Bill C7 expansion.

00:14:59.740 Okay, can I just ask you

00:15:00.700 one question though?

00:15:01.460 Because I imagine

00:15:02.060 some advocates of this

00:15:03.360 would say

00:15:03.880 that that increase

00:15:04.920 in rates

00:15:05.420 is an indication

00:15:06.480 of what people

00:15:07.500 have always wanted anyway

00:15:08.780 and that it's,

00:15:10.320 well, maybe not good news.

00:15:11.420 These are people

00:15:12.000 who are avoiding

00:15:13.460 the great pains

00:15:15.380 that they anticipated

00:15:16.340 at what would be

00:15:18.120 a more natural

00:15:18.620 end of life

00:15:19.200 or they are allowed

00:15:19.980 a death with dignity now

00:15:21.640 and that that number

00:15:22.680 is something,

00:15:23.660 again, not to be celebrated

00:15:24.820 but that people

00:15:25.680 got what they wanted.

00:15:27.120 How do you respond

00:15:28.140 to that position

00:15:29.260 which I've heard advocated?

00:15:31.160 And I've heard people say,

00:15:33.160 I've heard the MAID advocates

00:15:34.640 for expansion

00:15:35.340 or expansionists.

00:15:37.120 I've heard them say

00:15:38.240 precisely that.

00:15:39.520 That, oh,

00:15:40.060 that's a good thing.

00:15:40.980 Right.

00:15:41.260 The more MAID,

00:15:41.980 the better.

00:15:42.700 And in fact,

00:15:43.600 I've literally heard them say,

00:15:44.320 more than better.

00:15:45.260 Pardon me,

00:15:45.860 but what a line.

00:15:47.500 I'm not trying to be facetious.

00:15:49.880 I've literally heard that.

00:15:51.420 I've also heard them say

00:15:52.960 that the problem

00:15:54.060 is not that the rate

00:15:55.100 is high in some provinces,

00:15:56.980 it's that it's low in others

00:15:58.540 and that that reflects

00:16:00.040 that there's not enough

00:16:01.080 availability of people

00:16:02.260 to get MAID.

00:16:03.460 Now,

00:16:04.900 before kind of saying

00:16:07.080 which way should we fall on that,

00:16:09.780 I have to point out

00:16:11.320 that people need to realize,

00:16:13.240 especially as MAID laws expand,

00:16:15.440 they affect different people

00:16:16.860 and different populations

00:16:18.260 in different ways.

00:16:21.100 And we'll hopefully come back

00:16:23.520 to this near the end

00:16:25.500 because I think

00:16:26.100 this is really a key, key point.

00:16:28.720 But when we look at

00:16:31.000 the number of people

00:16:32.720 dying by MAID,

00:16:33.820 we also need to look at

00:16:35.180 who are those people

00:16:36.880 who are dying by MAID

00:16:37.820 and why are they getting it?

00:16:39.400 Right.

00:16:39.760 There is a pocket of people.

00:16:41.260 There are some people

00:16:42.460 who get MAID

00:16:43.440 because they want

00:16:44.420 to die with dignity.

00:16:47.200 They've lived a life

00:16:48.260 of autonomy

00:16:48.840 and they want to preserve

00:16:51.060 their dignity and autonomy

00:16:52.240 and die with dignity.

00:16:54.020 As we expand MAID laws,

00:16:55.600 especially,

00:16:56.240 there is also

00:16:57.080 a second group of people,

00:16:58.780 and evidence shows this,

00:17:00.980 who,

00:17:01.660 it's not that they're seeking

00:17:02.760 death with dignity,

00:17:04.000 they're seeking an escape

00:17:05.540 from life suffering.

00:17:06.640 And the life suffering

00:17:08.520 includes social suffering.

00:17:10.740 When we look at

00:17:12.000 who's actually been getting MAID

00:17:13.280 when death is foreseeable,

00:17:15.720 right,

00:17:15.920 so if death is predictable

00:17:17.720 and foreseeable,

00:17:19.380 that group does actually tend to be,

00:17:22.100 according to the research,

00:17:24.000 that group tends to be

00:17:25.160 more privileged.

00:17:26.580 They have had higher education,

00:17:28.240 they come from higher

00:17:29.000 socioeconomic status,

00:17:31.100 and they tend to be white.

00:17:32.680 That's the description

00:17:34.260 in the terms of the researchers

00:17:35.740 in multiple places

00:17:37.580 that have looked at this.

00:17:39.480 But when you expand MAID,

00:17:41.300 which is now what we're doing,

00:17:42.780 when you expand MAID

00:17:43.820 for conditions beyond

00:17:45.980 death being foreseeable,

00:17:48.320 in other words,

00:17:49.180 when you expand MAID

00:17:50.400 to people who are not dying,

00:17:53.040 then a different group

00:17:54.140 starts to be affected,

00:17:55.240 and they seek it

00:17:55.860 for different reasons.

00:17:57.100 They seek it

00:17:57.960 because they are suffering

00:17:59.880 from things like poverty,

00:18:01.920 loneliness,

00:18:02.220 isolation.

00:18:03.580 You also see,

00:18:04.840 and I'll talk about this

00:18:05.860 a bit later,

00:18:06.800 a gender gap emerging

00:18:07.900 with twice as many women

00:18:10.180 as men getting MAID

00:18:11.900 for psychiatric euthanasia

00:18:13.440 in the European countries

00:18:15.200 that allow it.

00:18:16.640 So it's not just

00:18:18.540 a population number

00:18:19.940 of 2% or 2.5%.

00:18:21.520 It is who is getting MAID

00:18:24.240 for what reasons,

00:18:25.040 and then who keeps getting it

00:18:26.540 as we expand the laws more.

00:18:28.600 And to me,

00:18:29.220 that shifts the question

00:18:30.200 from not,

00:18:32.820 well,

00:18:33.020 where do we think

00:18:34.300 the perfect balance is?

00:18:35.560 It shifts the question

00:18:36.300 to which mistakes

00:18:37.400 do we want to make?

00:18:39.500 Do we want to say

00:18:40.460 that somebody

00:18:41.980 to preserve their autonomy,

00:18:44.100 we want to make it

00:18:45.120 even easier for them

00:18:46.140 to get it,

00:18:46.620 even if they have

00:18:47.180 more than 10 years

00:18:47.940 left to live?

00:18:49.640 But by doing that,

00:18:52.100 we also change

00:18:53.060 the goalposts,

00:18:54.160 and we know

00:18:55.120 that others

00:18:55.820 are now going to get it

00:18:56.900 because they've had

00:18:57.800 life-suffering society

00:18:58.860 refuse to help them with.

00:19:02.580 Is it preferable

00:19:03.680 to have

00:19:04.680 MAID available

00:19:06.180 for someone

00:19:07.140 who otherwise,

00:19:09.920 and I can't think

00:19:10.800 of a more diplomatic

00:19:11.840 way to say this,

00:19:12.960 would otherwise

00:19:13.520 have just had

00:19:15.020 a messier suicide?

00:19:16.560 When we look

00:19:19.300 at the actual evidence,

00:19:20.740 and, you know,

00:19:21.140 that is something

00:19:22.140 that the expansion

00:19:23.980 advocates have,

00:19:26.320 or activists,

00:19:27.500 have said

00:19:30.940 is an issue,

00:19:31.700 oh,

00:19:31.840 we're trying

00:19:32.240 to avoid people

00:19:33.440 from having,

00:19:35.500 in the terms

00:19:36.120 you're using,

00:19:36.740 a messier

00:19:37.400 or painful suicide.

00:19:39.220 The evidence

00:19:39.840 does not support that.

00:19:41.820 Okay.

00:19:42.180 What we actually

00:19:42.940 find is this,

00:19:44.420 that in the,

00:19:46.440 so if we look

00:19:47.020 at psychiatric

00:19:47.800 suicide

00:19:48.860 and suicide attempts,

00:19:51.220 it's an interesting

00:19:52.440 statistic,

00:19:53.540 which is universally,

00:19:54.780 this is repeatedly

00:19:55.960 found,

00:19:56.800 that by a

00:19:58.360 two-to-one ratio,

00:20:00.020 more women

00:20:00.680 than men

00:20:01.200 attempt suicide.

00:20:02.800 So they try

00:20:03.500 to end their lives

00:20:04.460 when they have,

00:20:06.060 when they're suffering

00:20:06.700 from a mental illness.

00:20:08.280 And the vast majority

00:20:09.740 of them do not

00:20:10.940 end up

00:20:11.920 taking their lives.

00:20:13.580 So the initial

00:20:14.960 suicide attempt,

00:20:16.020 they end up

00:20:16.680 surviving it.

00:20:17.820 And most

00:20:18.520 do not try again.

00:20:20.740 And this is

00:20:21.640 a clear thing

00:20:22.520 we see with

00:20:23.020 the suicide research,

00:20:23.980 that in the vast

00:20:24.760 majority of cases,

00:20:25.780 suicide,

00:20:26.640 in those contexts,

00:20:28.040 is something

00:20:28.600 that there's

00:20:31.080 a lot of

00:20:31.420 ambivalence about.

00:20:33.040 But people

00:20:34.360 may have that

00:20:34.980 ambivalence

00:20:35.500 for a prolonged

00:20:36.260 period of time.

00:20:37.280 It's not that

00:20:37.860 it's only there

00:20:38.820 for one day

00:20:39.400 or two days.

00:20:40.000 It can be

00:20:40.380 for a long

00:20:40.840 period of time.

00:20:41.920 And if

00:20:42.980 they get to

00:20:43.400 the point

00:20:43.740 of acting

00:20:44.340 on it,

00:20:45.060 that's when

00:20:45.480 they have

00:20:45.700 a suicide

00:20:46.080 attempt.

00:20:47.180 What we're

00:20:47.780 doing with

00:20:48.140 MAID is

00:20:49.440 we are

00:20:49.960 changing

00:20:50.400 a transient

00:20:51.080 suicidality

00:20:52.020 in those

00:20:52.600 situations

00:20:53.240 into a

00:20:53.980 permanent

00:20:54.360 death.

00:20:55.180 Because when

00:20:55.980 you look

00:20:56.320 at the

00:20:56.740 European

00:20:57.140 countries

00:20:57.660 that provide

00:20:58.460 psychiatric

00:20:59.180 euthanasia,

00:21:00.300 you see

00:21:00.600 that exact

00:21:01.100 same

00:21:01.400 two-to-one

00:21:01.860 ratio

00:21:02.180 of women

00:21:02.520 to men

00:21:02.900 who actually

00:21:03.540 get their

00:21:04.460 lives

00:21:04.680 ended.

00:21:05.020 So in

00:21:05.720 other words,

00:21:06.840 something which

00:21:07.720 they might

00:21:08.160 otherwise have

00:21:09.480 a suicide

00:21:09.940 attempt and

00:21:10.960 survive and

00:21:12.020 then not try

00:21:13.040 again and go

00:21:13.940 on to live

00:21:14.320 meaningful lives,

00:21:15.640 we're now

00:21:16.680 making it easier

00:21:17.360 for them in

00:21:18.200 that initial

00:21:18.720 period to

00:21:19.980 actually have

00:21:20.800 their lives

00:21:21.260 ended by us.

00:21:22.120 So the data

00:21:22.940 shows that

00:21:23.480 suicide

00:21:24.020 attempts,

00:21:25.200 many of

00:21:25.740 them are

00:21:26.160 cries for

00:21:26.720 help,

00:21:27.780 so let's

00:21:29.000 help them.

00:21:31.140 So in

00:21:32.980 terms of

00:21:33.320 cries for

00:21:33.700 help,

00:21:33.980 the person

00:21:35.200 really is

00:21:35.900 suffering.

00:21:36.900 It's not

00:21:37.580 that they're

00:21:37.980 doing something

00:21:38.860 to manipulate

00:21:42.060 the situation,

00:21:42.880 that's not

00:21:43.480 at all what

00:21:44.080 I would

00:21:44.820 mean in

00:21:45.560 terms of

00:21:46.000 cry for

00:21:46.420 help,

00:21:46.700 but it is

00:21:47.120 a sign

00:21:47.580 that they

00:21:47.940 need help.

00:21:49.060 And the

00:21:49.540 help they

00:21:49.960 need is

00:21:51.540 help with

00:21:52.060 their illness

00:21:52.680 and help

00:21:53.840 to live.

00:21:55.760 And in

00:21:55.960 fact, I've

00:21:57.060 spoken with

00:21:57.720 many people

00:21:58.900 who have

00:21:59.600 said, you

00:22:00.140 know, I've

00:22:01.220 people who've

00:22:02.020 struggled with

00:22:02.600 chronic depression

00:22:03.400 who've said

00:22:04.620 at that point

00:22:05.680 in my life,

00:22:06.320 in the past,

00:22:07.520 I was

00:22:07.900 competent,

00:22:08.940 I still had

00:22:09.600 capacity.

00:22:10.260 So people

00:22:10.600 still usually

00:22:11.360 retain capacity

00:22:12.640 to make

00:22:13.900 decisions even

00:22:14.640 when they have

00:22:15.140 mental illness,

00:22:16.100 but the

00:22:16.560 decisions they

00:22:17.160 make change,

00:22:18.300 right?

00:22:18.500 Think about

00:22:18.880 it.

00:22:19.000 Anyone who's

00:22:19.480 been depressed

00:22:19.880 knows this.

00:22:20.540 When we're

00:22:20.800 depressed,

00:22:21.300 we think

00:22:22.460 differently,

00:22:23.140 and this

00:22:23.860 is also

00:22:24.220 backed up

00:22:24.660 by evidence

00:22:25.120 and research.

00:22:26.220 We have

00:22:26.520 what's called

00:22:26.860 a cognitive

00:22:27.360 triad of

00:22:28.960 I am

00:22:29.980 bad,

00:22:30.460 the world

00:22:30.960 is bad,

00:22:31.460 and the

00:22:31.660 future will

00:22:32.200 be bad.

00:22:32.920 It changes

00:22:33.680 how we

00:22:34.060 think.

00:22:34.520 Think about

00:22:34.960 how that

00:22:35.320 makes you

00:22:35.720 feel about

00:22:36.520 whether you

00:22:37.180 want to be

00:22:37.520 here in

00:22:37.980 the context

00:22:38.460 of suffering

00:22:39.000 from mental

00:22:40.200 illness and

00:22:40.980 poverty and

00:22:41.960 loneliness.

00:22:43.500 And so in

00:22:44.020 that context,

00:22:45.360 somebody may

00:22:46.280 actually want

00:22:47.200 to end their

00:22:47.680 life and they

00:22:48.240 can't see

00:22:48.840 anything else.

00:22:50.980 My role as

00:22:51.940 a psychiatrist

00:22:52.500 has always

00:22:53.520 been to

00:22:54.060 say,

00:22:54.560 you know,

00:22:54.800 I actually

00:22:55.440 know from

00:22:56.420 the evidence

00:22:57.480 and from

00:22:58.060 experience that

00:22:59.620 we actually

00:23:00.460 can help

00:23:00.960 you.

00:23:02.480 And I

00:23:04.200 think that's

00:23:04.680 what our

00:23:05.000 role should

00:23:05.560 be.

00:23:05.800 There's one

00:23:06.360 fellow who,

00:23:07.520 I won't say

00:23:08.200 his name,

00:23:09.580 but he does

00:23:10.260 talk publicly

00:23:11.080 about this.

00:23:12.200 It's actually

00:23:12.680 a bit painful

00:23:13.240 for me to

00:23:14.080 even say.

00:23:14.880 I always

00:23:15.200 get a little

00:23:15.580 emotional

00:23:15.980 thinking about

00:23:16.580 this.

00:23:17.320 But he

00:23:18.100 struggled with

00:23:19.060 mental illness

00:23:19.840 for many

00:23:20.260 years, chronic

00:23:21.380 depression,

00:23:22.380 sometimes getting

00:23:22.980 better, other

00:23:23.620 times worse.

00:23:24.920 And it did

00:23:26.400 have suicidal

00:23:27.580 thoughts for

00:23:28.660 much of that.

00:23:30.180 And he

00:23:30.660 tells the

00:23:31.100 story.

00:23:33.660 He tells the

00:23:34.600 story of

00:23:34.960 standing on a

00:23:35.540 bridge.

00:23:37.460 And he

00:23:38.620 was planning,

00:23:41.700 contemplating,

00:23:42.440 jumping.

00:23:43.400 And literally

00:23:44.020 somebody in

00:23:44.820 a crowd

00:23:45.100 behind him

00:23:45.780 said,

00:23:46.300 jump.

00:23:47.800 Jump, if

00:23:48.520 you can

00:23:48.760 believe that.

00:23:49.720 And somebody

00:23:50.740 else pulled

00:23:52.600 out their

00:23:53.100 hand, held

00:23:54.640 his collar,

00:23:55.720 and just

00:23:56.120 pulled him

00:23:56.540 back.

00:23:57.560 And he

00:23:58.160 came back,

00:23:59.400 and he

00:24:00.500 didn't

00:24:00.660 instantly

00:24:01.060 recover.

00:24:01.600 It's not

00:24:01.880 that.

00:24:02.620 But he

00:24:03.200 did recover.

00:24:04.600 He got

00:24:05.240 better.

00:24:05.660 He lived

00:24:06.360 and is

00:24:07.280 living a

00:24:07.800 meaningful,

00:24:08.460 fulfilling

00:24:08.740 life.

00:24:09.200 He's

00:24:09.320 actually

00:24:09.600 become a

00:24:10.060 mental health

00:24:10.520 advocate.

00:24:10.900 And I

00:24:13.520 don't want

00:24:14.740 to be the

00:24:15.120 person on

00:24:15.580 that bridge

00:24:16.140 that doesn't

00:24:16.820 say, we're

00:24:17.560 going to

00:24:17.760 help you

00:24:18.140 live and

00:24:18.860 find a way

00:24:19.380 to live a

00:24:19.820 meaningful life

00:24:20.440 again.

00:24:21.000 And that

00:24:21.420 is what the

00:24:21.820 evidence

00:24:22.240 actually shows

00:24:23.440 the risk is

00:24:25.160 with expanded

00:24:25.980 MAID and

00:24:26.420 psychiatric

00:24:26.840 euthanasia.

00:24:27.620 We'll be

00:24:27.940 back with

00:24:28.260 more full

00:24:28.640 comment in

00:24:29.200 just a

00:24:29.540 moment.

00:24:30.780 Dr.

00:24:31.340 Gand, in

00:24:31.640 response to

00:24:32.660 the expanding

00:24:33.380 legislation,

00:24:34.460 would your

00:24:34.760 perspective be

00:24:35.620 that we just

00:24:37.040 need to think

00:24:37.560 this through

00:24:37.980 more and

00:24:38.460 maybe not go

00:24:39.240 ahead with

00:24:39.640 this or is

00:24:40.400 it that we

00:24:41.380 need different

00:24:42.040 safeguards involved

00:24:43.520 to act as

00:24:44.800 further checks

00:24:45.500 and balances?

00:24:47.400 You know,

00:24:48.040 that's an

00:24:48.420 excellent question

00:24:49.240 and one of

00:24:49.920 the fundamental

00:24:51.500 issues here is

00:24:52.660 that if you

00:24:53.860 bypass the

00:24:54.700 fundamental

00:24:55.380 safeguard, no

00:24:56.540 other safeguard

00:24:57.200 means anything.

00:24:59.400 And what I

00:24:59.820 mean by that

00:25:00.360 is this, one

00:25:01.820 of the

00:25:02.140 fundamental

00:25:02.740 safeguards,

00:25:03.460 this is embedded

00:25:04.920 in our

00:25:05.300 legislation, this

00:25:06.160 is what

00:25:06.600 Canadians have

00:25:07.380 been told

00:25:08.120 and sold

00:25:09.360 that MAID

00:25:10.020 is about.

00:25:11.220 They've been

00:25:11.700 told that

00:25:12.460 MAID is for

00:25:13.120 a grievous

00:25:13.700 and irremediable

00:25:14.980 condition.

00:25:16.420 That is

00:25:16.940 something which

00:25:18.020 for mental

00:25:18.480 illnesses is

00:25:20.140 a fallacy to

00:25:21.380 be able to

00:25:21.860 apply to

00:25:22.480 MAID laws

00:25:23.100 because mental

00:25:23.800 illnesses can

00:25:24.580 be grievous

00:25:25.260 and absolutely

00:25:26.600 can lead to

00:25:27.560 terrible suffering,

00:25:28.560 as bad or

00:25:29.760 worse suffering

00:25:30.380 than physical

00:25:31.260 or other

00:25:31.940 medical

00:25:32.240 illnesses.

00:25:33.440 However,

00:25:34.360 what you

00:25:34.880 cannot do

00:25:35.580 with any

00:25:36.140 mental illness

00:25:36.880 is predict

00:25:38.380 when it

00:25:39.060 won't get

00:25:39.460 better.

00:25:40.600 So the

00:25:41.360 issue of

00:25:41.880 it being

00:25:42.440 irremediable,

00:25:43.620 that's actually

00:25:44.320 impossible to

00:25:45.320 predict, and

00:25:45.840 that's not me

00:25:46.480 saying this.

00:25:47.120 This is

00:25:47.380 something which

00:25:48.060 every group

00:25:48.960 that's actually

00:25:49.480 looked at

00:25:50.020 this has

00:25:51.040 reached that

00:25:52.200 conclusion,

00:25:52.900 that that's

00:25:53.400 what the

00:25:53.860 national and

00:25:55.220 worldwide evidence

00:25:56.060 shows, that

00:25:57.520 in any

00:25:58.280 individual case,

00:25:59.940 you cannot

00:26:00.600 predict when

00:26:02.000 the person

00:26:02.860 will or will

00:26:03.860 not get

00:26:04.300 better.

00:26:05.700 CAMH has

00:26:06.280 said this.

00:26:07.120 They've

00:26:07.300 said it

00:26:07.660 very bluntly.

00:26:09.140 The American

00:26:10.400 Psychiatric

00:26:10.980 Association does

00:26:12.520 not support

00:26:13.340 this sort of

00:26:14.040 expanded MAID.

00:26:14.860 The Australians

00:26:15.460 don't.

00:26:16.020 The Canadian

00:26:16.500 Mental Health

00:26:17.380 Association

00:26:17.940 doesn't.

00:26:19.220 And so this

00:26:20.020 idea that

00:26:21.580 we're telling

00:26:22.060 people that,

00:26:23.200 oh yeah, I

00:26:23.640 think you're

00:26:24.020 not going to

00:26:24.400 get better,

00:26:25.500 that is not

00:26:26.300 based on any

00:26:27.480 scientific evidence.

00:26:28.800 And in fact,

00:26:29.280 the scientific

00:26:29.720 evidence shows

00:26:30.560 we can't make

00:26:31.400 those predictions.

00:26:32.440 So my

00:26:32.760 question is,

00:26:33.300 if we are

00:26:35.060 not providing

00:26:35.840 MAID for

00:26:36.660 when the

00:26:38.040 condition can't

00:26:38.800 get better,

00:26:39.320 when it's

00:26:39.620 irremediable,

00:26:40.340 what are we

00:26:40.920 providing it

00:26:41.480 for?

00:26:42.060 And then it

00:26:43.740 opens the

00:26:44.240 door to all

00:26:44.740 of that other

00:26:45.240 life and

00:26:45.800 psychosocial

00:26:46.440 suffering.

00:26:47.760 You know,

00:26:47.920 even groups

00:26:48.880 that support

00:26:50.600 MAID for

00:26:52.420 mental illness,

00:26:54.320 even they

00:26:55.120 acknowledge and

00:26:56.920 admit that

00:26:58.520 you cannot

00:26:59.540 make these

00:27:00.140 predictions.

00:27:00.560 So the

00:27:01.060 Quebec

00:27:01.500 Association,

00:27:02.380 the Quebec

00:27:02.800 Psychiatrist

00:27:03.520 Association,

00:27:04.280 the AMPQ,

00:27:05.880 this was in

00:27:06.660 a paper that

00:27:07.440 was written

00:27:08.580 by their

00:27:10.520 group and

00:27:11.580 it included

00:27:12.340 the author

00:27:14.380 or as one

00:27:15.940 of the

00:27:16.200 authors,

00:27:17.120 the same

00:27:17.860 person who's

00:27:18.420 currently

00:27:18.740 chairing the

00:27:20.180 federal expert

00:27:21.600 panel on

00:27:22.340 mental illness.

00:27:23.160 And that

00:27:24.900 group actually

00:27:25.860 literally said

00:27:26.860 regarding

00:27:27.580 irremediability

00:27:28.380 and mental

00:27:28.980 illness,

00:27:29.440 it is

00:27:29.880 possible that

00:27:31.180 a person

00:27:31.600 who has

00:27:31.920 recourse to

00:27:32.580 MAID,

00:27:33.440 regardless of

00:27:34.180 his condition,

00:27:35.520 could have

00:27:36.040 regained the

00:27:36.620 desire to

00:27:37.120 live at

00:27:38.020 some point

00:27:38.480 in the

00:27:38.780 future.

00:27:40.000 And then

00:27:40.260 they remarkably,

00:27:41.220 in my opinion,

00:27:41.900 remarkably,

00:27:42.520 go on to

00:27:42.980 say that

00:27:43.920 while regarding

00:27:44.620 the certainty

00:27:45.440 and eligibility

00:27:46.180 criteria,

00:27:47.840 assessors will

00:27:48.740 have to answer

00:27:49.500 this ethical

00:27:50.340 question each

00:27:51.740 and every time

00:27:52.360 they evaluate

00:27:52.980 a request.

00:27:54.240 And you know,

00:27:54.600 our law is

00:27:55.380 not that

00:27:56.300 somebody has

00:27:57.120 a grievous

00:27:57.980 and irremediable

00:27:58.900 medical condition

00:27:59.840 if in the

00:28:00.560 ethical opinion

00:28:01.500 of each and

00:28:02.620 every assessor

00:28:03.380 they do.

00:28:04.180 That opens

00:28:04.920 it up to

00:28:06.140 such

00:28:06.980 non-scientific,

00:28:08.780 non-evidence-based

00:28:09.940 judgments that

00:28:10.700 place our

00:28:12.180 patients at

00:28:13.280 risk of

00:28:13.900 premature death

00:28:14.840 when they're

00:28:15.680 in a state

00:28:16.080 of suicidality.

00:28:18.480 Dr. Gant,

00:28:18.900 I want to get

00:28:19.560 your take

00:28:20.520 on a CTV

00:28:21.440 news story

00:28:22.200 from November

00:28:22.980 2020

00:28:23.880 that I've

00:28:24.820 never forgotten.

00:28:25.980 It surprised

00:28:26.860 me and shocked

00:28:27.540 me for a

00:28:28.720 number of

00:28:29.020 reasons.

00:28:29.720 I'm sure

00:28:30.260 you're aware

00:28:30.720 of these

00:28:31.080 incidents.

00:28:31.600 There's a

00:28:31.880 few of them.

00:28:32.420 The headline

00:28:32.840 is,

00:28:33.520 Facing

00:28:33.860 Another

00:28:34.400 Retirement

00:28:35.040 Home

00:28:35.420 Lockdown.

00:28:36.400 90-year-old

00:28:37.240 chooses

00:28:37.800 medically

00:28:38.460 assisted

00:28:39.380 death.

00:28:40.740 And you

00:28:41.440 go through

00:28:41.760 the story

00:28:42.160 and it

00:28:42.400 explains

00:28:42.880 this lady,

00:28:43.960 90-year-old

00:28:44.500 Nancy Russell,

00:28:45.720 died surrounded

00:28:46.240 by friends

00:28:46.760 and family.

00:28:47.620 It was what

00:28:48.180 she wanted.

00:28:48.760 It was the

00:28:49.040 exact opposite

00:28:49.780 of the lonely

00:28:50.280 months of

00:28:50.720 lockdown she

00:28:51.220 had suffered

00:28:51.660 through in a

00:28:52.180 retirement home

00:28:52.840 where she

00:28:53.360 had lived

00:28:53.620 for several

00:28:54.040 years.

00:28:54.980 The story

00:28:55.360 goes on to

00:28:56.040 talk about

00:28:56.960 her life.

00:28:58.240 It says

00:28:59.040 the lockdowns

00:29:00.280 were so crushing

00:29:00.880 for her.

00:29:02.080 And there's

00:29:03.720 so much that

00:29:04.180 can of course

00:29:04.580 be said about

00:29:05.300 our treatment

00:29:05.960 of elderly,

00:29:06.560 long-term care

00:29:07.060 homes,

00:29:07.380 retirement homes,

00:29:08.300 pandemic rules,

00:29:09.000 which were

00:29:09.460 legitimate,

00:29:10.200 which weren't.

00:29:10.660 But when I

00:29:11.220 read this

00:29:11.620 story,

00:29:11.940 I remember

00:29:12.360 a year and

00:29:13.700 a half ago,

00:29:14.620 I thought I

00:29:15.260 didn't think

00:29:15.840 this was what

00:29:16.600 medically

00:29:16.900 assisted dying

00:29:17.680 was for.

00:29:19.500 How did

00:29:20.000 this all

00:29:20.380 come about?

00:29:21.120 I appreciate

00:29:21.840 that she's a

00:29:22.720 90-year-old

00:29:23.300 beyond normal

00:29:24.000 life expectancy,

00:29:24.960 but she was

00:29:25.320 also not

00:29:25.820 facing an

00:29:27.020 imminent death

00:29:27.800 from a

00:29:29.360 deteriorating

00:29:29.900 health issue.

00:29:31.760 Yeah.

00:29:32.440 You know,

00:29:33.000 I actually,

00:29:34.040 I think you've

00:29:34.740 struck the nail

00:29:35.420 on the head.

00:29:36.360 How did this

00:29:36.960 come about?

00:29:38.100 Because this

00:29:38.700 is not,

00:29:39.460 it's not what

00:29:40.120 I signed up

00:29:40.640 for when I

00:29:41.640 got,

00:29:43.340 when I

00:29:43.780 actually believed

00:29:44.600 in the

00:29:46.360 value of

00:29:47.520 assisted dying

00:29:48.340 in some

00:29:48.760 situations.

00:29:49.760 It's not the

00:29:50.700 sort of thing

00:29:52.080 that I think

00:29:53.440 most people,

00:29:54.520 most Canadians

00:29:55.140 would think

00:29:55.660 MAID should be

00:29:56.200 for.

00:29:56.840 And unfortunately,

00:29:57.860 that actually

00:29:58.640 is what

00:30:00.140 this expanded

00:30:01.360 MAID is

00:30:02.160 exposing people

00:30:03.200 to.

00:30:04.440 And I

00:30:05.640 believe the

00:30:06.180 way we got

00:30:06.700 here is

00:30:07.440 is, you

00:30:08.360 know, there

00:30:08.560 are a number

00:30:08.820 of myths

00:30:09.280 that have

00:30:10.260 fueled what

00:30:11.860 has led to

00:30:13.120 expanded MAID.

00:30:14.980 As I said

00:30:16.040 at the beginning,

00:30:16.640 most people

00:30:17.060 don't even

00:30:17.520 realize that

00:30:18.300 even before

00:30:19.300 expansion,

00:30:20.160 if somebody

00:30:20.940 had even up

00:30:21.560 to 10 years

00:30:22.140 of life left,

00:30:23.460 they probably

00:30:24.040 would have

00:30:24.360 qualified.

00:30:25.440 But I think

00:30:26.280 the key myth

00:30:27.040 that allows

00:30:28.100 this to

00:30:28.460 perpetuate,

00:30:29.040 and this is

00:30:29.660 very sad

00:30:31.120 to me,

00:30:31.860 I see so

00:30:32.700 many of the

00:30:33.300 expansion

00:30:33.940 activists

00:30:34.820 repeatedly

00:30:36.500 saying that

00:30:37.600 oh, MAID

00:30:38.060 is about

00:30:38.440 autonomy.

00:30:39.440 They're telling

00:30:39.920 people it's

00:30:40.460 about your

00:30:40.920 autonomy.

00:30:42.420 Well, and

00:30:43.860 that's very

00:30:44.900 appealing because

00:30:45.580 people say,

00:30:46.380 of course,

00:30:46.740 autonomy is

00:30:47.320 good, and

00:30:47.760 if we have

00:30:49.060 more autonomy,

00:30:49.960 all the

00:30:50.260 better.

00:30:51.160 Well, when we

00:30:52.080 actually look at

00:30:52.940 the stories you're

00:30:53.620 talking about,

00:30:54.720 about who are

00:30:55.660 some of the

00:30:56.200 people getting

00:30:56.700 MAID,

00:30:58.380 and this is

00:30:59.240 from work that

00:31:00.020 continues to

00:31:01.000 come out,

00:31:01.320 this is from

00:31:01.820 December of

00:31:02.740 2021, looking

00:31:05.000 at psychiatric

00:31:05.840 euthanasia,

00:31:06.860 what kind of

00:31:07.540 suffering is

00:31:08.340 actually leading

00:31:08.980 to these people

00:31:09.600 getting it.

00:31:10.680 There's a range

00:31:11.460 of it, but it

00:31:12.100 includes things

00:31:12.760 like perceived

00:31:13.540 failures to

00:31:14.880 live up to the

00:31:15.440 expectations of

00:31:16.380 others, and

00:31:17.500 societal standards

00:31:18.420 and norms,

00:31:19.400 feeling a burden

00:31:20.300 to society, the

00:31:21.700 accumulation of

00:31:22.380 several misfortunes,

00:31:23.580 life misfortunes,

00:31:24.820 and perceived

00:31:25.540 difficulties leading

00:31:26.600 to a so-called

00:31:27.300 culmination point.

00:31:28.460 And we've

00:31:30.100 already had

00:31:31.000 headlines, you

00:31:31.660 know, I was

00:31:31.900 on a podcast

00:31:32.640 with Canada

00:31:34.160 Land, I think

00:31:34.760 it was, in

00:31:35.620 October, and

00:31:36.660 the heading of

00:31:37.460 that podcast

00:31:38.040 was a woman

00:31:39.620 in our country,

00:31:40.400 in BC, saying

00:31:41.080 I die when

00:31:42.480 I run out of

00:31:43.180 money.

00:31:46.620 This has, as

00:31:48.100 it should,

00:31:49.300 it's attracting

00:31:50.180 international

00:31:50.900 attention.

00:31:52.080 You know, Canada

00:31:52.480 prides itself,

00:31:53.460 as a Canadian,

00:31:54.220 I like to pride

00:31:55.040 our country as

00:31:56.680 being one,

00:31:58.200 that's on the

00:31:58.840 forefront for

00:31:59.440 social justice.

00:32:00.780 In this area, I

00:32:02.180 think we're

00:32:02.480 taking a huge

00:32:03.480 step backwards,

00:32:04.140 and to be

00:32:05.420 blunt, I think

00:32:06.640 we're implementing

00:32:07.260 policies of

00:32:08.060 privilege that

00:32:09.620 actually embed

00:32:11.220 ableism, ageism,

00:32:12.980 racism, and

00:32:13.600 sexism, and

00:32:14.680 expose the most

00:32:15.420 marginalized to

00:32:17.180 unnecessary

00:32:18.000 premature deaths

00:32:18.960 for this

00:32:20.200 autonomy myth.

00:32:21.680 And I'll get

00:32:22.080 back to that in

00:32:22.680 a second, but in

00:32:23.360 terms of the

00:32:23.740 international

00:32:24.160 headlines, there

00:32:25.220 was a piece in

00:32:25.740 the UK Spectator,

00:32:26.940 just in the

00:32:28.120 past week or

00:32:28.720 two, titled

00:32:29.660 Why is

00:32:30.200 Canada Euthanizing

00:32:32.420 the Poor?

00:32:33.780 And it goes

00:32:34.520 through some of

00:32:35.320 the things there

00:32:36.400 now.

00:32:36.960 In terms of

00:32:37.720 autonomy, as I

00:32:40.000 mentioned before,

00:32:41.340 you will have a

00:32:43.520 group that has

00:32:44.440 lived well, and

00:32:46.280 now will have

00:32:47.800 the chance

00:32:48.700 potentially to

00:32:50.240 die more on

00:32:52.160 their own terms.

00:32:52.820 although I

00:32:54.400 honestly think

00:32:55.100 that even in

00:32:55.600 that group,

00:32:56.060 most people

00:32:56.460 don't realize

00:32:57.120 that they

00:32:58.060 would have

00:32:58.320 been able to

00:32:58.860 get made

00:32:59.280 even if they

00:32:59.800 had 10

00:33:00.240 years of

00:33:01.260 life left,

00:33:01.940 even before

00:33:02.540 expansion.

00:33:04.080 But let's

00:33:04.620 say the

00:33:05.480 expansion does

00:33:06.820 increase the

00:33:07.520 autonomy for

00:33:08.160 some who

00:33:08.760 have lived

00:33:09.340 well and

00:33:10.240 now want to

00:33:10.960 die well.

00:33:12.660 Well, these

00:33:14.400 other things I

00:33:14.980 was talking

00:33:15.440 about, about

00:33:16.080 people getting

00:33:16.680 it for life

00:33:17.460 suffering, that's

00:33:18.320 not autonomy.

00:33:19.000 That is

00:33:20.000 seeking an

00:33:20.940 escape from

00:33:21.640 life.

00:33:22.720 It's not

00:33:23.260 seeking a

00:33:24.240 dignified death.

00:33:25.660 And so this

00:33:26.600 myth of

00:33:27.400 autonomy, it's a

00:33:28.340 specific type of

00:33:29.220 autonomy.

00:33:29.980 It is what I

00:33:31.180 would call

00:33:31.580 privileged

00:33:32.460 autonomy.

00:33:34.280 Dr. Gant, I

00:33:34.700 must say I

00:33:35.100 myself am

00:33:35.740 conflicted on

00:33:36.460 this because I

00:33:37.280 have always

00:33:37.720 approached so

00:33:38.960 many life

00:33:39.640 choice issues

00:33:40.480 from a very

00:33:41.060 libertarian

00:33:41.700 perspective where

00:33:42.520 I say,

00:33:43.440 ultimately, even

00:33:44.200 if it's

00:33:44.600 something that I

00:33:45.800 don't agree

00:33:46.260 with, I

00:33:46.720 wouldn't do

00:33:47.100 myself, I

00:33:47.740 wouldn't want

00:33:48.360 people I

00:33:48.860 love doing

00:33:49.480 it, who

00:33:50.320 am I?

00:33:51.240 What place

00:33:51.780 do I have

00:33:52.500 to tell a

00:33:53.760 consenting adult

00:33:54.800 what they

00:33:55.440 can and

00:33:56.540 can't do?

00:33:57.400 And this

00:33:57.780 issue, hopefully

00:33:58.820 we are dealing

00:34:00.440 with poverty

00:34:01.000 issues so that

00:34:01.880 nobody even

00:34:02.380 has that

00:34:02.860 thought.

00:34:03.160 Hopefully we

00:34:03.580 are dealing

00:34:03.940 with mental

00:34:04.380 health

00:34:04.620 challenges.

00:34:05.520 Hopefully we

00:34:05.980 are providing

00:34:06.580 all the other

00:34:07.320 exit ramps,

00:34:08.000 but ultimately

00:34:08.420 if someone

00:34:08.880 has thought

00:34:09.660 through this

00:34:10.280 hopefully thoroughly,

00:34:11.220 hopefully at

00:34:11.640 length, who

00:34:12.400 am I

00:34:12.740 ultimately and

00:34:13.800 who are we

00:34:14.160 as society to

00:34:15.020 ultimately limit

00:34:16.240 this option?

00:34:17.280 How would you

00:34:17.760 respond to

00:34:18.340 people such

00:34:19.240 as myself

00:34:19.680 who are

00:34:19.960 conflicted

00:34:20.620 because of

00:34:21.340 that very

00:34:22.840 thought process?

00:34:24.600 Well, I do

00:34:26.100 understand that

00:34:26.860 conflict and I

00:34:28.280 agree with you

00:34:29.280 that when people

00:34:30.720 have true

00:34:31.320 autonomy, we

00:34:32.400 should support

00:34:33.040 them in the

00:34:33.700 decisions that

00:34:34.360 they make.

00:34:35.340 The problem

00:34:36.500 is that the

00:34:37.940 things that I

00:34:39.320 make as my

00:34:39.880 decisions in

00:34:40.820 any society,

00:34:41.780 they can also

00:34:42.280 affect other

00:34:42.800 people and the

00:34:43.880 laws that we

00:34:44.480 implement affect

00:34:45.320 different people in

00:34:46.280 different ways.

00:34:47.480 So it is

00:34:48.840 questionable

00:34:49.260 whether it's

00:34:50.040 truly an

00:34:50.620 autonomous decision

00:34:51.560 for somebody

00:34:52.580 who's in a

00:34:53.080 state of

00:34:53.440 depression,

00:34:54.400 whose mental

00:34:56.100 illness is

00:34:56.740 affecting how

00:34:57.420 they think.

00:34:58.680 They're still

00:34:59.060 capable, you

00:35:01.180 know, they still

00:35:01.520 have legal

00:35:01.920 capacity and

00:35:02.780 competency, but

00:35:04.420 as I mentioned

00:35:05.360 before, their

00:35:05.920 thoughts are being

00:35:06.580 affected by I

00:35:07.680 am bad, the

00:35:08.240 world is bad,

00:35:08.840 future will be

00:35:09.340 bad.

00:35:09.580 And there

00:35:11.180 are known

00:35:12.840 biological

00:35:13.500 correlates that

00:35:14.340 lead to the

00:35:15.600 sense of

00:35:16.140 hopelessness and

00:35:17.760 despair in

00:35:18.640 depression, and

00:35:19.920 suicidality is a

00:35:21.840 symptom of mental

00:35:23.160 illnesses.

00:35:23.560 It's actually one

00:35:24.220 of the core

00:35:24.600 symptoms of some

00:35:25.340 mental illnesses.

00:35:26.860 And so in that

00:35:27.460 state, to

00:35:28.440 facilitate somebody

00:35:29.380 to end their

00:35:30.020 life when we

00:35:31.960 cannot even say

00:35:33.020 to them that

00:35:33.540 they won't get

00:35:34.240 better, but we

00:35:35.060 pretend that

00:35:36.240 that's what we're

00:35:36.760 giving it to them

00:35:37.360 for, for an

00:35:37.940 irremediable

00:35:38.500 condition that

00:35:39.040 we can't

00:35:39.640 predict, to

00:35:40.840 me, that is

00:35:41.460 morally wrong

00:35:42.340 because we

00:35:43.880 know from the

00:35:44.800 evidence that

00:35:45.440 most of those

00:35:46.260 people actually

00:35:47.140 will get better

00:35:47.980 and will

00:35:48.460 themselves regain

00:35:49.980 the will to

00:35:50.880 live.

00:35:51.620 So it's not

00:35:52.360 about imposing

00:35:53.040 somebody's

00:35:53.780 external autonomy

00:35:54.660 on anyone.

00:35:55.580 It's about

00:35:56.240 recognizing that,

00:35:57.860 well, as I

00:35:58.980 expand my

00:36:00.160 quote-unquote

00:36:00.900 right for

00:36:02.540 made under

00:36:03.820 all of these

00:36:04.420 other circumstances,

00:36:06.100 it is exposing

00:36:07.280 a different

00:36:07.880 group of

00:36:08.420 marginalized or

00:36:09.440 vulnerable people

00:36:10.320 who are

00:36:11.480 suffering from

00:36:12.720 all sorts of

00:36:13.260 life-suffering,

00:36:14.280 who actually,

00:36:15.020 most of whom

00:36:15.540 would get

00:36:15.980 better, but in

00:36:17.260 their state of

00:36:17.820 transient wishes

00:36:19.160 for death, we'll

00:36:20.060 be facilitating and

00:36:21.200 fueling those.

00:36:22.220 That's how I would

00:36:22.980 answer that.

00:36:23.540 You know,

00:36:24.160 there's, and

00:36:26.980 this was actually

00:36:27.640 in the UK

00:36:28.900 Spectator piece

00:36:30.180 that I mentioned

00:36:31.260 to you before,

00:36:32.220 but there's a

00:36:33.940 quote from a

00:36:34.820 French poet,

00:36:37.040 I think he

00:36:37.460 was, many

00:36:38.500 years back,

00:36:39.520 and I'll

00:36:40.780 just read it

00:36:41.280 to you, and

00:36:42.120 you can kind

00:36:43.540 of figure it

00:36:44.040 out for

00:36:44.320 yourself, but

00:36:45.540 it's Anatoly

00:36:46.700 France, and he

00:36:47.140 says,

00:36:47.320 the law in

00:36:48.640 its majestic

00:36:49.340 equality forbids

00:36:51.140 the rich as

00:36:52.380 well as the

00:36:53.080 poor to

00:36:54.140 sleep under

00:36:54.800 bridges, to

00:36:55.900 beg in the

00:36:56.460 streets, and

00:36:57.580 to steal

00:36:58.060 bread.

00:36:59.260 Pointing out

00:36:59.960 that it's the

00:37:00.660 same law, but

00:37:02.140 obviously it

00:37:03.500 affects people in

00:37:04.300 different ways.

00:37:05.000 You're probably

00:37:05.320 not going to

00:37:05.700 have too many

00:37:06.360 people who are

00:37:07.520 rich needing

00:37:08.540 to sleep under

00:37:09.420 bridges or beg in

00:37:10.340 the streets.

00:37:11.360 And if Anatoly

00:37:12.360 France was alive

00:37:13.300 today, I actually

00:37:14.480 think the ghost of

00:37:15.320 Anatoly France

00:37:16.040 would say this

00:37:16.780 about Canada's

00:37:17.760 current made

00:37:18.500 laws and

00:37:19.360 expansion, that

00:37:20.560 Canada's made

00:37:21.380 law in its

00:37:22.560 majestic

00:37:23.160 equality helps

00:37:25.120 the poor as

00:37:26.640 well as the

00:37:27.200 rich to die

00:37:28.420 for life

00:37:29.160 suffering.

00:37:30.720 To me, that's

00:37:31.660 not autonomy.

00:37:33.880 Dr. Gann, when

00:37:34.320 you talk about

00:37:35.020 vulnerable persons,

00:37:36.580 one category of

00:37:37.400 individuals most

00:37:38.380 people agree are

00:37:39.000 in more vulnerable

00:37:39.660 positions are

00:37:40.520 youth or our

00:37:41.580 children.

00:37:42.500 And when we

00:37:43.140 talk about expanding

00:37:44.100 medical-assisted

00:37:44.740 death,

00:37:45.320 a lot of

00:37:45.980 concerns right

00:37:46.800 away gravitate

00:37:47.420 to what degree

00:37:48.680 does this or

00:37:49.260 does this not

00:37:49.840 involve children

00:37:51.020 or a phrase

00:37:52.560 that's used in

00:37:53.600 the medical

00:37:55.300 context, mature

00:37:56.700 minors, usually

00:37:57.760 referring to

00:37:58.940 teenagers.

00:38:00.220 What are your

00:38:01.540 concerns about

00:38:02.620 that category?

00:38:04.280 It's very similar

00:38:05.580 to the last

00:38:06.220 question you

00:38:06.900 asked about,

00:38:08.140 well, if

00:38:08.900 somebody in

00:38:10.020 that moment is

00:38:11.660 deemed to have

00:38:12.620 capacity, shouldn't

00:38:14.060 we respect

00:38:14.720 we respect

00:38:14.840 their wish

00:38:15.600 and their

00:38:16.300 autonomy.

00:38:17.280 And that

00:38:17.560 argument has

00:38:18.360 been extended

00:38:19.220 to mature

00:38:20.840 minors to

00:38:21.520 say, well, it

00:38:22.420 shouldn't matter

00:38:23.840 what age they

00:38:24.500 are.

00:38:24.960 If you've got a

00:38:25.580 12-year-old who

00:38:26.880 understands what

00:38:28.580 they are asking

00:38:29.960 for and we

00:38:31.280 deem them to

00:38:31.780 have legal

00:38:32.800 capacity or

00:38:33.480 competency, they

00:38:34.740 should be able

00:38:35.160 to get it.

00:38:35.980 There are made

00:38:37.100 expansion activists

00:38:38.500 who are seeking

00:38:39.520 precisely that.

00:38:41.520 I am highly

00:38:42.580 concerned about

00:38:43.260 that because,

00:38:44.040 once again, I

00:38:44.540 think what it

00:38:45.180 does is in a

00:38:46.600 very, I would

00:38:48.720 say this is an

00:38:49.360 artificial, this

00:38:50.440 entire thing is

00:38:51.780 often an

00:38:52.880 artificially narrow

00:38:54.440 focus on, oh,

00:38:56.560 it's just that

00:38:57.160 person's individual

00:38:58.360 autonomy and it

00:38:59.680 excludes everything

00:39:00.460 else.

00:39:00.980 So let's look at

00:39:01.660 youth for a

00:39:02.100 second.

00:39:02.740 We know that

00:39:04.440 the brain, the

00:39:06.200 human brain

00:39:06.920 continues to

00:39:08.060 develop in

00:39:09.300 terms of

00:39:10.300 specific things

00:39:11.920 that are

00:39:12.280 necessary for

00:39:13.000 decision-making

00:39:13.740 into our

00:39:15.200 third decade.

00:39:16.800 So by the

00:39:18.260 age of even

00:39:18.920 25, it may

00:39:20.260 not be fully

00:39:21.280 the frontal

00:39:22.540 cortex and

00:39:23.360 other key

00:39:24.080 parts of our

00:39:24.760 brains that

00:39:25.800 are involved in

00:39:26.800 decision-making

00:39:27.420 are not

00:39:28.480 actually fully

00:39:29.760 developed in

00:39:30.700 terms of where

00:39:31.340 they eventually

00:39:32.160 will be going.

00:39:34.000 I remember

00:39:34.880 that was a

00:39:35.260 concern around

00:39:36.020 legalizing

00:39:36.740 marijuana, the

00:39:37.560 concerns that's

00:39:38.360 18 to 25

00:39:39.440 bracket there.

00:39:40.740 That's exactly,

00:39:41.360 I was actually

00:39:42.240 going to go

00:39:43.120 exactly there,

00:39:43.920 that, you

00:39:44.200 know, I find

00:39:44.620 it striking

00:39:45.220 that in

00:39:47.260 our society,

00:39:48.580 I don't have a

00:39:49.840 problem with this

00:39:50.460 other stuff I'm

00:39:51.000 talking about.

00:39:51.500 When I say

00:39:51.880 striking, I'm

00:39:52.360 talking about

00:39:52.640 the contrast.

00:39:53.960 But I find it

00:39:54.720 striking that in

00:39:55.440 our society,

00:39:56.540 nobody raises

00:39:57.160 concerns, or I

00:39:58.820 won't say

00:39:59.300 nobody, but

00:39:59.920 people generally

00:40:00.820 accept that we

00:40:02.080 can have a

00:40:03.280 legal age for

00:40:05.100 drinking, we

00:40:06.900 can have a

00:40:07.360 legal age for

00:40:08.560 voting, we

00:40:10.200 can have a

00:40:10.700 legal age for

00:40:12.020 marijuana, but

00:40:13.800 we can't have a

00:40:14.840 legal age for

00:40:16.000 when we are

00:40:16.940 going to help a

00:40:18.120 non-dying teenager

00:40:19.820 or less end

00:40:22.400 their life.

00:40:23.020 I find that

00:40:23.920 remarkable.

00:40:26.160 And the science

00:40:27.520 and evidence

00:40:28.140 completely doesn't

00:40:29.560 support that, but

00:40:31.800 again, if the

00:40:33.700 only issue that

00:40:34.760 people are paying

00:40:35.800 attention to is,

00:40:36.760 oh, it's that

00:40:37.460 individual's autonomy,

00:40:38.900 let's provide them

00:40:39.880 what they're asking,

00:40:41.520 it's such an

00:40:42.100 artificial argument.

00:40:43.600 Dr. Gand, to

00:40:44.740 your point, there

00:40:45.200 are activists who

00:40:45.920 are pushing still

00:40:46.940 for further

00:40:47.580 expansion of this,

00:40:48.560 and also to one

00:40:49.500 of your very

00:40:50.360 beginning points,

00:40:51.500 a lot of Canadians

00:40:52.300 aren't even aware

00:40:53.200 of what's going

00:40:54.320 on now and

00:40:54.920 weren't even aware

00:40:55.560 of exactly what

00:40:56.460 the 2016 laws

00:40:58.100 brought about.

00:40:59.440 You've talked

00:41:00.020 about this being

00:41:00.800 beyond a slippery

00:41:01.600 slope, but are

00:41:02.320 we still falling?

00:41:04.440 Do we still

00:41:05.060 potentially have

00:41:06.380 more to go?

00:41:09.400 Well, I think

00:41:10.400 that opening it

00:41:11.160 up to mature

00:41:11.780 minors, opening

00:41:12.620 it up to sole

00:41:14.380 mental illness

00:41:15.200 conditions that

00:41:16.260 we are pretending

00:41:17.200 we can predict

00:41:18.460 to be irremediable

00:41:19.220 when we can't,

00:41:20.240 I think that

00:41:20.820 those are bridges

00:41:22.260 we should not

00:41:22.940 be crossing.

00:41:24.020 So we do have

00:41:25.620 ways more that

00:41:27.140 we could go,

00:41:28.180 but I don't

00:41:28.720 think we should.

00:41:29.380 You know,

00:41:30.620 this is actually

00:41:31.740 pretty unusual,

00:41:32.640 I'm pretty sure,

00:41:33.440 for a podcast,

00:41:34.380 but I wonder

00:41:36.160 if you would

00:41:36.820 bear with me

00:41:37.420 for me to

00:41:38.300 read you a

00:41:39.160 two-minute poem

00:41:40.200 that I wrote

00:41:41.200 the night that

00:41:42.000 Bill C-7 passed.

00:41:44.080 Yes, please.

00:41:45.160 Okay.

00:41:46.100 So this,

00:41:46.920 just to put this

00:41:47.980 in context,

00:41:48.460 this was in

00:41:49.160 March 2021,

00:41:51.580 March 11th,

00:41:52.680 and Bill C-7

00:41:54.580 passed with

00:41:56.080 what they

00:41:57.040 called the

00:41:57.500 sunset clause

00:41:58.400 that meant

00:41:59.220 that within

00:42:00.320 two years

00:42:00.960 made-for-soul

00:42:01.660 mental illness

00:42:02.300 will be provided.

00:42:04.360 And incidentally,

00:42:05.160 that sunset clause

00:42:06.000 remarkably,

00:42:06.900 you know,

00:42:07.080 for a year,

00:42:08.120 the government

00:42:09.320 had said

00:42:09.980 we're not

00:42:10.500 going to have

00:42:11.320 made-for-soul

00:42:12.600 mental illness.

00:42:13.440 In the initial

00:42:14.060 draft of that

00:42:14.880 bill,

00:42:15.600 the Attorney

00:42:16.020 General,

00:42:16.820 Minister Lamedi,

00:42:17.980 was giving

00:42:18.740 those assurances

00:42:19.540 repeatedly.

00:42:20.120 And then

00:42:21.620 less than

00:42:22.360 a month

00:42:22.980 before this

00:42:24.340 date,

00:42:24.720 in March,

00:42:25.420 the government

00:42:26.040 changed its

00:42:27.200 mind.

00:42:28.300 They put in

00:42:29.180 the sunset

00:42:29.600 clause that

00:42:30.760 had been

00:42:31.060 recommended

00:42:31.540 then by

00:42:31.940 the Senate

00:42:32.400 Committee.

00:42:33.660 And after

00:42:33.960 one evening

00:42:34.660 of debate

00:42:35.300 that the

00:42:36.920 government

00:42:37.280 foreshortened

00:42:38.020 with,

00:42:38.380 I believe,

00:42:38.800 what they

00:42:39.020 call a

00:42:39.420 closure motion

00:42:40.760 or something

00:42:41.160 like this,

00:42:41.660 so literally

00:42:42.180 one evening

00:42:42.840 of debate,

00:42:44.100 this bill

00:42:45.240 with sunset

00:42:45.800 clause

00:42:46.240 passes.

00:42:46.900 The political

00:42:49.580 background is

00:42:50.200 interesting because

00:42:51.180 the vote

00:42:53.020 was largely

00:42:53.600 along party

00:42:54.240 lines.

00:42:54.720 Almost all

00:42:55.260 the liberals

00:42:55.660 voted for

00:42:56.280 it.

00:42:56.840 The bloc

00:42:57.300 voted for

00:42:57.840 it.

00:42:59.180 But the

00:43:00.240 people who

00:43:00.700 voted against

00:43:01.260 it, it

00:43:01.520 was actually

00:43:02.280 left and

00:43:02.840 right united

00:43:03.500 in voting

00:43:03.880 against it.

00:43:04.760 So the

00:43:05.400 NDP and

00:43:06.700 conservatives

00:43:07.180 and Greens,

00:43:07.980 independents,

00:43:08.660 and a

00:43:09.040 smattering of

00:43:09.700 liberals

00:43:09.960 voted against

00:43:10.600 it.

00:43:11.320 And I was

00:43:11.960 very disturbed

00:43:13.080 that, I

00:43:13.580 have to say,

00:43:14.380 and I was

00:43:15.140 really upset

00:43:15.700 because I

00:43:16.040 could see

00:43:16.400 where things

00:43:16.820 were going

00:43:17.240 to be

00:43:17.400 going.

00:43:17.780 And I

00:43:18.540 could picture

00:43:19.640 the headlines

00:43:20.300 that we're

00:43:20.980 now seeing

00:43:21.560 about I

00:43:22.180 die when

00:43:23.100 I run

00:43:23.400 out of

00:43:23.680 money.

00:43:24.560 And so I

00:43:24.940 wrote this

00:43:25.280 that night,

00:43:25.860 and it's

00:43:26.340 called Last

00:43:26.960 Rites,

00:43:27.940 Ode to

00:43:28.540 C7.

00:43:29.680 So,

00:43:30.140 O Canada,

00:43:31.000 my brave

00:43:31.620 new world,

00:43:32.760 glorious and

00:43:33.560 gore-free,

00:43:34.940 will soon

00:43:35.640 become the

00:43:36.160 land of

00:43:36.800 death on

00:43:37.400 demand,

00:43:38.260 full autonomy,

00:43:39.500 at least

00:43:39.960 for me.

00:43:41.340 I've been

00:43:42.020 granted good

00:43:42.680 life, good

00:43:43.660 friends, good

00:43:44.680 wealth.

00:43:45.760 Thank you,

00:43:46.300 C7, for

00:43:47.200 dealing me

00:43:47.760 good, easy

00:43:48.580 death.

00:43:50.220 My last

00:43:51.160 rites, my

00:43:52.160 last rite,

00:43:53.360 easing suffering

00:43:54.100 at my

00:43:54.640 choosing,

00:43:55.660 sanitized,

00:43:56.400 beautified,

00:43:57.340 the choice

00:43:57.800 will be

00:43:58.100 mine, my

00:43:59.100 death so

00:43:59.600 peaceful, ready

00:44:00.860 for prime

00:44:01.420 time.

00:44:02.640 I hear

00:44:03.320 whispers in

00:44:04.120 the background,

00:44:04.880 warnings, to

00:44:06.040 not short the

00:44:06.960 price of

00:44:07.480 tomorrow's

00:44:08.180 mornings, that

00:44:09.800 the cost of

00:44:10.540 my saving

00:44:11.200 grief will

00:44:12.380 be those

00:44:12.820 seeking relief

00:44:13.660 from a

00:44:14.420 life lived

00:44:15.020 without my

00:44:16.000 privilege, not

00:44:17.440 dying but

00:44:18.300 only trying to

00:44:19.240 get by in

00:44:19.900 life, those

00:44:21.400 we won't

00:44:21.920 help live but

00:44:23.020 will now

00:44:23.480 give enticed

00:44:24.760 escape from

00:44:25.960 strife.

00:44:27.580 But whispers I

00:44:28.960 can ignore if

00:44:30.240 they fall on the

00:44:31.080 shores of those

00:44:32.320 who whisper

00:44:32.880 louder, experts

00:44:35.180 reassuring me

00:44:36.500 prouder.

00:44:37.180 it's their

00:44:38.720 task to

00:44:39.620 know full

00:44:40.200 well, but

00:44:41.360 I don't ask

00:44:42.380 and they

00:44:43.140 don't tell.

00:44:45.260 And besides,

00:44:46.300 it's not

00:44:46.680 entitlement,

00:44:47.860 consider the

00:44:48.500 enlightenment

00:44:49.160 of those

00:44:50.200 non-white,

00:44:51.180 non-wealthy,

00:44:52.100 and wise,

00:44:53.200 of those

00:44:53.760 marginalized,

00:44:55.080 to finally

00:44:55.780 have a choice

00:44:56.420 to die

00:44:57.000 well, when

00:44:58.100 in life they

00:44:58.700 had no

00:44:59.160 voice, their

00:45:00.320 only choice

00:45:01.120 was living

00:45:02.000 hell.

00:45:03.100 So thank

00:45:03.800 you Canada,

00:45:04.500 powers that

00:45:05.000 be, for

00:45:05.860 ensuring that

00:45:06.560 our smooth

00:45:07.140 passings will

00:45:08.600 reflect the

00:45:09.160 privilege of

00:45:10.260 our life

00:45:10.780 trappings.

00:45:12.000 I will soon

00:45:13.040 be free,

00:45:13.880 without anxiety,

00:45:15.480 knowing that

00:45:16.520 with ease I

00:45:17.160 can choose the

00:45:17.800 time of my

00:45:18.480 going, and

00:45:19.600 any poor

00:45:20.280 souls sacrificed

00:45:21.580 on this

00:45:22.620 altar of my

00:45:23.800 choice, my

00:45:24.940 voice, there

00:45:26.020 will be no

00:45:26.540 way of

00:45:27.140 knowing.

00:45:29.280 Wow.

00:45:31.820 Those would

00:45:32.500 be powerful

00:45:32.940 words to end

00:45:33.660 by, but I

00:45:34.700 want to talk

00:45:35.220 about a couple

00:45:35.920 more issues

00:45:37.440 before we

00:45:37.980 go, Dr.

00:45:39.620 Gand, and

00:45:40.720 one of them

00:45:41.680 relates to

00:45:42.200 what you

00:45:42.520 said about

00:45:43.180 the vote

00:45:45.000 on all of

00:45:45.580 this, the

00:45:46.540 legislation

00:45:47.200 being a bit

00:45:48.500 more aggressive

00:45:49.000 than it

00:45:49.380 needed to

00:45:49.820 be.

00:45:50.400 I know we

00:45:51.340 haven't invited

00:45:51.820 you on as

00:45:52.380 a political

00:45:53.660 analyst, but

00:45:55.180 what is your

00:45:56.360 sense of what

00:45:57.840 people think

00:45:59.020 they're trying

00:45:59.580 to accomplish

00:46:00.240 in bringing

00:46:01.680 in these

00:46:02.080 laws?

00:46:02.460 Because to

00:46:03.080 your point,

00:46:03.460 we're not just

00:46:04.000 following best

00:46:04.600 practices, getting

00:46:05.380 up to global

00:46:05.900 standard.

00:46:06.560 We're now

00:46:06.920 the cutting

00:46:07.920 edge, if you

00:46:08.700 can call it

00:46:09.200 that, for

00:46:09.920 most jurisdictions.

00:46:12.380 It's not

00:46:13.080 something that

00:46:13.680 everybody out

00:46:14.460 there is

00:46:14.780 saying, we

00:46:15.060 need this, we

00:46:15.680 need this.

00:46:16.320 Do they

00:46:17.620 think that

00:46:18.340 this is

00:46:19.000 following social

00:46:20.840 progress and

00:46:21.720 just something

00:46:22.300 that inevitably

00:46:23.300 must be done?

00:46:24.120 Is this

00:46:24.520 catering to

00:46:25.160 some special

00:46:25.800 interest groups?

00:46:26.620 I mean, how

00:46:27.580 did this all

00:46:28.020 come about?

00:46:28.540 I appreciate

00:46:28.960 the technicalities

00:46:29.880 or a Supreme

00:46:30.420 Court ruling

00:46:31.020 five years ago,

00:46:32.000 but more

00:46:32.780 broadly, how

00:46:34.340 did we get

00:46:35.220 to this point?

00:46:36.720 Again, you

00:46:37.380 know, I think

00:46:38.060 that's a really

00:46:39.740 important question

00:46:40.620 because when we

00:46:42.000 get to this

00:46:42.660 point, when any

00:46:43.320 country gets to

00:46:44.360 a point like

00:46:44.940 this on issues

00:46:46.180 of national

00:46:46.960 importance, you

00:46:48.900 kind of hope that

00:46:49.920 due diligence has

00:46:50.820 been done and

00:46:51.760 that different

00:46:52.240 things have been

00:46:52.880 looked at and

00:46:53.900 weighed before

00:46:55.220 decisions are

00:46:56.020 made.

00:46:56.600 That hasn't

00:46:57.400 happened here,

00:46:58.160 so I can't

00:46:58.800 speak to the

00:46:59.460 reasons why, but

00:47:00.400 I can tell you

00:47:01.120 what has

00:47:01.540 happened.

00:47:02.840 And, you

00:47:03.440 know, I

00:47:03.600 think there

00:47:04.220 are a couple

00:47:04.520 of important

00:47:06.000 points along

00:47:07.920 this path.

00:47:09.080 You know, when

00:47:09.380 the initial law

00:47:10.760 came in, and

00:47:11.720 keep in mind,

00:47:12.200 that was through

00:47:12.640 a different

00:47:13.180 attorney general,

00:47:14.840 right?

00:47:15.040 That was back

00:47:15.520 when it was

00:47:16.160 Minister Jody

00:47:17.840 Wilson-Raybould

00:47:18.540 who brought

00:47:19.640 in the initial

00:47:20.120 law.

00:47:21.080 So when the

00:47:21.580 initial law

00:47:22.200 came in that

00:47:22.840 had reasonably

00:47:23.620 foreseeable

00:47:24.140 natural death

00:47:24.960 as a

00:47:25.300 safeguard in

00:47:26.740 2016, and

00:47:28.260 then that was

00:47:28.900 challenged in

00:47:29.600 2019, in

00:47:30.940 what was

00:47:31.360 called the

00:47:31.760 Truchon

00:47:32.160 ruling in

00:47:33.060 Quebec.

00:47:33.660 So this was

00:47:34.200 a provincial

00:47:35.340 court, and

00:47:36.860 in that ruling,

00:47:37.940 ruled on by

00:47:38.560 one single

00:47:39.900 judge, she

00:47:42.260 overturned or

00:47:43.360 said that the

00:47:44.240 naturally

00:47:44.880 foreseeable

00:47:45.480 reasonable

00:47:45.940 death

00:47:46.400 safeguard is

00:47:48.700 overly

00:47:48.980 restrictive, and

00:47:50.700 the country has

00:47:51.360 to eliminate

00:47:51.860 it.

00:47:52.180 now, very

00:47:54.180 unusually, the

00:47:56.420 government did

00:47:57.200 not appeal that.

00:47:58.120 By then, the

00:47:58.640 attorney general

00:47:59.240 had changed.

00:48:00.840 But it's

00:48:01.820 pretty unusual,

00:48:02.740 I'm not a

00:48:03.160 lawyer, but my

00:48:04.240 understanding is

00:48:05.000 that it's pretty

00:48:05.560 unusual for the

00:48:07.180 government not to

00:48:08.340 appeal such

00:48:09.120 provincial rulings

00:48:10.260 to the Supreme

00:48:11.380 Court, and they

00:48:12.160 did not do that.

00:48:13.920 You know, it's

00:48:14.320 ironic, I don't

00:48:14.940 even know what

00:48:15.500 this was on, but

00:48:16.300 two days ago, I

00:48:17.760 think it was,

00:48:18.260 yesterday or two

00:48:18.700 years ago, driving

00:48:19.780 home, I heard on

00:48:20.880 the radio that

00:48:21.700 there was some

00:48:23.080 provincial ruling

00:48:23.720 on some other

00:48:24.300 issue, and

00:48:24.800 immediately, the

00:48:26.080 government has

00:48:26.660 said, we're

00:48:27.100 appealing to

00:48:27.580 Supreme Court.

00:48:28.560 In this case, they

00:48:29.720 didn't even appeal

00:48:30.300 it.

00:48:30.860 So it never went

00:48:31.640 through that.

00:48:32.100 The government

00:48:32.520 did not do a

00:48:34.020 five-year review

00:48:35.180 that it was

00:48:35.940 supposed to, and

00:48:37.600 that mandated

00:48:38.960 review was also

00:48:39.740 bypassed.

00:48:41.020 And so in that

00:48:41.720 sense, due

00:48:43.720 process hasn't

00:48:45.140 been done, I

00:48:46.960 think.

00:48:48.080 And I will

00:48:49.860 also say that

00:48:50.860 and I regret

00:48:52.540 saying this, but

00:48:53.320 I honestly

00:48:54.280 believe it's

00:48:54.880 true.

00:48:55.120 You know, I'm

00:48:55.420 a past

00:48:56.160 president of

00:48:56.880 our National

00:48:57.360 Psychiatric

00:48:57.980 Association.

00:48:58.980 I'm a past

00:48:59.460 president of the

00:49:00.180 Canadian

00:49:00.480 Psychiatric

00:49:01.160 Association.

00:49:03.020 And I've

00:49:04.040 had significant

00:49:05.800 concerns about

00:49:06.780 the input of my

00:49:08.220 own association

00:49:08.920 in this, because

00:49:09.900 I don't think

00:49:10.440 it's contributed

00:49:11.080 necessary evidence

00:49:12.360 in making these

00:49:13.240 decisions.

00:49:14.300 And I say

00:49:14.920 this as a

00:49:15.360 past president.

00:49:17.180 So unlike the

00:49:18.280 American Psychiatric

00:49:19.140 Association, or the

00:49:20.300 Irish one, or the

00:49:21.320 Australian and New

00:49:22.200 Zealand one, the

00:49:23.760 Canadian Psychiatric

00:49:24.860 Association's input,

00:49:26.480 they basically framed

00:49:27.700 it purely as an

00:49:28.900 issue of

00:49:29.820 discrimination, in

00:49:32.000 my mind.

00:49:32.800 And they said

00:49:33.660 patients with a

00:49:34.420 psychiatric illness

00:49:35.240 should not be

00:49:35.900 discriminated against,

00:49:37.340 and nobody wants to

00:49:37.960 discriminate.

00:49:38.800 But then they link it

00:49:39.780 to the assumption

00:49:40.720 that it would be

00:49:41.920 discrimination unless

00:49:43.840 they have the same

00:49:44.780 options available

00:49:45.680 regarding made as

00:49:47.080 available to everyone

00:49:47.900 else, and they

00:49:49.040 admitted that they

00:49:50.040 had not looked at

00:49:51.040 whether you could

00:49:51.680 predict whether

00:49:53.060 psychiatric conditions

00:49:54.460 could or could not

00:49:55.460 get better.

00:49:56.520 And most

00:49:57.180 concerningly to me,

00:49:59.180 you know, throughout

00:49:59.680 this whole process of

00:50:01.240 whatever it was, a

00:50:02.160 year before the C7

00:50:04.840 consultations, or

00:50:06.100 during that public

00:50:07.400 consultation process,

00:50:08.880 in all of that time,

00:50:10.380 in the written and

00:50:11.260 oral submissions from

00:50:12.420 my own expert group,

00:50:14.240 the number of times they

00:50:15.220 even mentioned mental

00:50:16.280 illness, suicide risk,

00:50:18.720 mental illness related

00:50:19.840 suicide risk, suicide

00:50:21.760 prevention, even said

00:50:23.280 the word suicide

00:50:23.940 literally was zero.

00:50:25.880 And to me, that's like

00:50:26.920 a respirology

00:50:27.960 association doing

00:50:29.460 public consultations on

00:50:31.620 lung health or lung

00:50:33.100 disease and never

00:50:34.280 mentioning smoking.

00:50:35.440 It's baffling.

00:50:36.740 But what it does mean is

00:50:38.240 that the necessary input

00:50:41.680 into making these

00:50:43.040 decisions wasn't made.

00:50:45.220 And, you know, you

00:50:45.860 made the comment

00:50:46.880 about, and I am

00:50:49.900 linking a thread here,

00:50:51.200 you made the comment

00:50:52.000 about, oh, we're at

00:50:53.540 the forefront, you

00:50:54.640 know, kind of whether

00:50:55.160 we want to be or not.

00:50:56.360 One other point I want

00:50:57.460 to make is that, unique

00:50:59.140 to Canada, nowhere else

00:51:00.380 in the world actually

00:51:01.160 has this.

00:51:02.300 We have a provision

00:51:03.480 that says that

00:51:05.520 somebody can get

00:51:07.160 made, they can apply

00:51:08.080 for and get made, even

00:51:09.580 if they've never had any

00:51:11.000 attempts at treatment.

00:51:13.200 Think about that,

00:51:14.160 especially in the context

00:51:15.340 of, say, mental

00:51:16.180 illness, but even in

00:51:18.020 general.

00:51:18.980 So, and the reason for

00:51:20.820 that is there's a

00:51:21.760 qualification in there

00:51:23.360 that things that could

00:51:25.220 make the situation

00:51:26.000 better, they need to be

00:51:26.940 acceptable to the person.

00:51:28.800 Now, nobody's talking

00:51:29.780 about forcing treatment.

00:51:30.740 I'm not saying that at

00:51:31.880 all.

00:51:32.840 But I am saying that if

00:51:34.560 we're now telling people,

00:51:37.060 oh, yeah, we know you're

00:51:37.820 not going to get better,

00:51:38.640 and they may have never

00:51:40.340 even had access to

00:51:41.380 treatment, that's pretty

00:51:42.720 shocking to me.

00:51:43.800 In other countries that

00:51:46.460 have previously been

00:51:47.300 considered to be more

00:51:48.740 expansive with MAID, so

00:51:49.820 some of the European

00:51:50.480 countries, even there,

00:51:51.980 there's a requirement

00:51:52.840 that reasonable efforts

00:51:54.740 at treatment have been

00:51:56.060 made before you can say

00:51:57.340 that something won't get

00:51:58.560 better.

00:51:59.140 We don't even have that

00:52:00.220 here.

00:52:00.880 So, what that means is

00:52:02.120 rather than helping

00:52:04.340 people live dignified

00:52:05.460 lives in the community

00:52:06.480 and providing them the

00:52:07.540 supports that they may

00:52:08.960 need to do that, in a

00:52:11.400 state of immediate

00:52:12.640 suffering and immense

00:52:13.940 suffering, rather than

00:52:15.700 helping somebody live,

00:52:17.020 we might say, we're

00:52:18.120 going to, you know, help

00:52:19.300 you end your life.

00:52:20.520 And that obviously has

00:52:21.660 financial consequences.

00:52:23.600 You know, this has been

00:52:24.180 looked at pre-expansion

00:52:26.000 and estimates made

00:52:27.100 post-expansion.

00:52:27.960 The Parliamentary Budget

00:52:28.880 Office was tasked with

00:52:30.480 doing estimates on how

00:52:31.500 many hundreds of

00:52:32.220 millions of dollars,

00:52:33.760 actually less it costs

00:52:36.220 to provide MAID than to

00:52:37.800 provide medical care.

00:52:39.940 And that doesn't even

00:52:40.780 count the social

00:52:43.560 supports that are no

00:52:45.500 longer needed to help a

00:52:46.980 disabled person live in

00:52:48.240 the community with

00:52:49.040 dignity.

00:52:50.880 So, what I'm saying is

00:52:53.020 that whether people

00:52:55.420 consciously are thinking

00:52:57.660 about these levers or

00:52:58.820 not, they are all

00:53:00.320 there.

00:53:01.520 And in terms of even

00:53:04.040 these financial

00:53:04.840 implications on a

00:53:06.040 strained health care

00:53:07.560 system, I mean, you

00:53:10.180 can do the math

00:53:10.880 yourself.

00:53:11.560 Yeah.

00:53:12.380 Wow.

00:53:13.920 Dr. Gant, I have

00:53:15.060 learned so much during

00:53:16.980 this conversation right

00:53:18.580 now.

00:53:18.800 And it all goes back to

00:53:19.600 your original point that

00:53:20.440 perhaps we are not

00:53:22.340 having an informed

00:53:23.300 national conversation.

00:53:24.680 Canadians are not fully

00:53:25.700 apprised of what's going

00:53:27.020 on with this issue.

00:53:27.680 Whatever opinions they

00:53:28.480 have, whatever views they

00:53:29.980 end up holding about it,

00:53:30.900 that we need to probably

00:53:32.200 hash things out a bit

00:53:33.840 better as a nation.

00:53:35.240 So, I hope our

00:53:35.660 conversation today can at

00:53:36.780 least be helpful in some

00:53:38.120 small way in heading in

00:53:40.040 that direction.

00:53:41.020 Dr. Gant, thanks so much

00:53:42.060 for joining us today.

00:53:43.780 And thank you so much for

00:53:45.260 your kind of thoughtful

00:53:47.060 consideration of these

00:53:48.740 issues and openness to

00:53:50.500 thinking about the

00:53:51.620 various perspectives.

00:53:52.540 Thank you.

00:53:54.000 Full Comment is a

00:53:54.980 post-media podcast.

00:53:56.320 I'm Anthony Fury.

00:53:57.440 This episode was produced

00:53:58.500 by Andre Pru with theme

00:54:00.020 music by Bryce Hall.

00:54:01.420 Kevin Libin is the

00:54:02.380 executive producer.

00:54:03.900 You can subscribe to

00:54:04.700 Full Comment on Apple

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Full Comment - January 02, 2023

Best of 2022： Killing off the sad and the poor with MAID

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