At the conclusion of this session, participants will be able to:

(i) Be aware of the scope of physician assisted death (PAD) frameworks, ranging from PAD for terminal illness to PAD outside near end-of-life conditions

(ii) Appreciate challenges assessing irremediability, intolerable suffering, capacity and decision making when considering potential requests for assisted dying in the context of mental illnesses

(iii) Understand proposed safeguards, and their limitations

(iv) Appreciate the tension between ‘overinclusion’ and ‘underinclusion’ in the context of potential assisted dying requests

Physician Assisted Death (PAD) has been legalized or decriminalized in well over a dozen jurisdictions around the world, and assisted dying policies continue to evolve rapidly. Many jurisdictions are exploring whether to introduce assisted dying laws, or expand existing laws. There is wide variation in how policies address potential applications for assisted dying for mental illness. PAD for sole criterion mental illness is available in the Netherlands, Belgium, Luxembourg and Switzerland, and recent Canadian legislation will permit psychiatric euthanasia by 2023.

This session will explore medicolegal, scientific, ethical and public policy issues related to PAD, focusing on the particular challenges posed with mental illnesses in the context of PAD, including challenges determining irremediability and the overlap between suicidality and psychiatric PAD. Dr. K. Sonu Gaind, a University of Toronto professor and psychiatrist, a past president of the Canadian Psychiatric Association and panelist from the Council of Canadian Academies Expert Panel reviewing psychiatric euthanasia, will review the Canadian experience with PAD, including recent policy developments expanding PAD to non-dying disabled. Issues that have driven Canada’s PAD expansion will be discussed. This session will also explore differences between groups who seek PAD for different reasons, and discuss potential impacts of expanding PAD laws on marginalized populations suffering from life distress.