Rachel Hislop-Hook, MEd

Dear CPSA, I am medical student with a Master's in Counselling Psychology, I am very concerned by the idea of the medical profession to allow MAID to patients whose a sole condition is a mental illness. In the counselling profession, we are trained to think about suicidal ideation or a desire to die in much different way. We don't think that the mental illness is a CAUSE for desire to die - instead we collaborate with the client to get the real driving factor for why they want to die - which is often relational or occupational. These are matters of purpose/meaning, social inclusion and relationship. There could also be issues of untreated trauma (there often is) that impairs self-worth. We work on these things, and use a variety of other strategies that consider the client as a whole person. Once we do so successfully, the suicidal desire takes care of itself. I think we need to be very cautious when it comes to thinking about mental illness as a 'cause' for wanting to die. I think instead as medical professionals we need to borrow from the expertise of counselling to get to the bottom of why someone wants to die. A purely 'medical model' doesn't work when we are taking about issues of purpose, meaning, occupational opportunities, social inclusion, trauma and relationships. At the very least, I think all patients who are considering MAiD should be provided with at least 6 sessions of counselling using a model like CAMS-Care (the gold standard for suicide prevention) which gets to the bottom of why a patient wants to die and works to treat their actual drivers in order to create a life the patient thinks is worth living (which can be possible even if the mental illness itself doesn't resolve). We need to remember the basics of what medicine is here for: we are here to promote restoration and health first. This still needs to be the primary goal. We also need to not lose sight of the fact that we are treating human beings, not only mental illnesses.

Comments for this post are now closed. If you would like to share your feedback on this topic, please email support@cpsa.ca.

« Previous EntryNext Entry »