The Current - MAID for mental illness: Ottawa continues the debate

Episode Date: May 8, 2026

Claire Brosseau says after decades of mental illness and treatment, she wants to die by MAID. Ottawa will soon decide whether to allow medically-assisted death for those whose sole condition is mental illness or to postpone access, perhaps indefinitely.

Okay, three songs. You guess who there by. Three little birds, one love, and jamming. Yeah, that was a really hard quiz. These are all, of course, by Bob Marley. A whole lot of the world felt close to Bob and his music before and after his passing. But the guy who really knew him best was his son, Ziggy. On Q, Ziggy Marley will tell you about his new record and about the song he says, connect him to his late father, Bob Marley.

You can hear that conversation now. Just search Q with Tom Power wherever you get your podcasts. This is a CBC podcast. Hello, I'm Matt Galloway, and this is the current podcast. Thousands of Canadians with a severe and incurable illness die each year with the help of doctors, but some people do not have access to me, including those who want to die because of the suffering caused by their mental illness. Ottawa is again considering whether to allow access to medical assistant death to those whose sole underlying condition is mental illness, or to postpone the expansion of Maid once more.

This week, the Parliamentary Committee drafting recommendations heard its final witness testimony and will soon publish a report to the government, a report that the Prime Minister, Mark Carney, says he will wait to see before taking any position on this matter. The temporary pause on the expansion of Maid expires in March of next year, but the government is expected to act in the coming months. And that means more waiting for those hoping to access

Maid for their mental illness, people like Claire Brasso. Claire is suing Ottawa over the maid exclusion along with the advocacy group dying with dignity. She also went to an Ottawa, an Ontario court, pardon me, this week to ask for an exemption to that exclusion so that she can receive maid. Claire Brasso joins us from Toronto. Claire, good morning. Hi, good morning. I really appreciate you being here. This is difficult to talk about, so thank you for doing this. No, I mean, I got through the night because I knew someone was listening. Well, we're glad you're here.

Thank you. Why do you want to access a medical assisted death? Well, I mean, I personally am functionally terminal. I do not leave my 600 square foot apartment. I've lived with suicidal ideation and suicidality pretty much my entire life. I have diaries from when I was little, you know, scribbling that I want to die. I had attempts in high school, you know, in and out of psychiatric wards and hospitals and rehabs and 12 steps in Toronto, Montreal, New York City and L.A. And this has been for 35 years with psychiatrists, psychologists, counselors.

And I've tried every medication, you know, antidepressants, mood stabilizers. antipsychotics, benzos, Z drugs, stimulants. I mean, oh, electroconvulsive therapy, you know, sound baths, sensory deprivation, tank therapy, Reiki, Tai Chi. I mean, you know, there's only so much, I don't know exactly, it's been 35 years. I've lost everything. I'm very grateful for the roof over my head and my bed. But yeah, that's what's been happening for 35 years.

And so you believe that there isn't a treatment out there that could help that could make you want to live? When they say things like that, I'm just wondering because I have disordered eating and I don't speak to a person because I had to take myself out of the world. And I'm not exaggerating about that. the only time is I walk my dog. But I'm sorry, I have a compromised memory. So if I go on a jazz solo, you can rain me in. I'm really sorry. I guess that's okay.

It's just the question about whether there might be a treatment in the future that you haven't tried yet that might put you in a different place. Well, I mean, we wouldn't ask cancer patients to wait until there's like a theoretical cure. right so when they say that i just need to know are they going to fix all the slashes and burns on my body or everything else inside my body that i've ruined are they going to fix my relationships my bank account my career my reputation you know it's only been 300,000 years that they haven't been able to figure it out so you know i mean obviously we're a lot closer and i have a lot of hope for psychiatry.

I mean, with the exception of the ones that are trying very hard to make it look like a pseudoscience, beyond that, I think it's, I have hope. It's very scary when you hear psychiatrists say ridiculous things, but... What has it been like for you to watch these committee hearings on Parliament Hill about the potential expansion of access to made for people like yourself who, who the sole underlying condition is a mental illness. What's it been like to watch that? I get spikes in my messages from people who want to harm themselves and end their lives. I got a full-blown suicide note. Watching them, I mean, Polowski, the chair, flat out telling the media that he and the co-chair

were both against it. The people that they saw just this year, they handpicked, right? So when Kowalski, again, shamelessly said to the press that politicians will hear who they want to hear, that there was too much lived experience to make it worth it, because what it would mean is that they wouldn't be able to hear a Dutch psychiatrist who's against it. They picked him, who lives in a country where it's legal. So I feel like a lot of psychiatrists in the Netherlands might have weighed in, but, you know, they had to hear him. And they, I'm sorry. I just wonder, in listening to that, it must be really difficult because you weren't, you weren't part of those hearings, right?

Oh, no. I wrote them a letter explaining that, you know, my credibility is only linked to the fact that I live with the reality of it. And I kind of gave them like all the stuff I've done, all of the work I've done. I wrote it in English and French because there's a French, like there's a bloc person in the committee. And I mean, to be fair, they've heard one person in five years. And this year out of 25, the one woman that they had with lived experience really represented us, I feel like, because she did four years of med school, four more years for psychiatry, practice psychiatry. practice psychiatry and is glad she lived and openly against me.

So I think that's a really great representation of what we all are. Are you kidding me? And then the other quote unquote lived experience was a woman who was, you know, devastated about her mother's death, which I think we all can agree is very sad. There was no, I won't get into her situation. But the only thing I can say is that because she's sad, and because people are like, whatever their reasons are,

some people need to write books and create a legacy for themselves about the vulnerable population. I mean, it's, they've heard, those were the two people. A dead person is not going to be affected by this law. So, you know, we can listen to her, but if you want to slap on a label about,

so that you can call them the vulnerable population, of whom you have interacted with zero of them. They're not inaccessible. I volunteered for two decades and two countries and four big cities directly along, quote unquote, vulnerable people,

homeless people and shelters. And I would, number one, argue that they perhaps are the most resilient group of people. In general, you know, mental illness is not exclusive to poverty. You know, you wouldn't believe this. There are people who are genuinely worried that this will go too far

and that there won't be those guardrails there to protect vulnerable people. I'm sorry to cut you off. No, that's okay. I just wonder what you say to those who are genuinely concerned about ensuring that some guardrails exist in this. I mean, obviously there are already. And again, I mean, I know this one psychiatrist who they had to hear instead of someone,

who actually lived it. You know, there is actual factual data from the Benelux countries. And I think one of the reasons people are still nervous is because when you're against made, what some physicians are doing that are openly against it, who have little, well, certainly no objectivity and little conscientiousness, they mix together the number of requests with completions. So if they say something like five times the amount of it's like, yeah, was that were they all approved or did five times the amount of people apply? Because the applying, so they're mixing those two numbers and it, of course that would terrify people like, oh no, oh no.

Because like an actual poll that like an actual poll that's real, 80% of Canadians are okay with it. 80% of Canadians. This was a poll that was commissioned by dying with dignity that came out of recently. Yes. Do you understand why the government might want to be cautious when it comes to this in terms of setting policy here? After five years, which is longer than med school, it's hard to say. I think it's about optics, which I think is ridiculous at this point, because Mark Carney is

clearly winning at prime ministering. And nobody's going to be like, wait, I know I'm a much. might lose my house, but he did say yes to equal rights. So I'm not voting for him. Like, it's going to make no difference beyond the fact that conservatives might use it to smear him for a little bit, but it means nothing. It's about optics. And it's honestly, if I may, it's about money. Because for five years, all of those people who make more in a day than people who are on disability make in a month for five years sitting around and doing that for months and months a year, all of them openly against made, stacking the deck admittedly, and then when a mostly old white guys,

and then when a woman asks a legitimate question, they cut off the mic. They're like, what? And they give the floor to someone. It's sickening to watch. And Polowski especially should be ashamed of himself. I have to let you go. But let me ask you just briefly a couple of questions. And this is just about you. Yeah. This is your life that you're talking about. And as you said, the life that you're living right now, you say you're functionally terminal and that it's a nightmare. You've asked for this exemption. You went to the court asking for an exemption that would allow you to seek maid while. the pause continues. If you don't get that exemption, what's going to happen? I mean, you should ask the committee because I'm left with two options. I'm left with two options.

Live like this where I can't leave here, not even to pick up my own prescriptions. When I try, I like have an anxiety attack and start crying. I mean, so living here and staying a lot, this is not a life. I don't talk to one single person. person. The other option is that I have an extremely violent death surrounded by no one, possibly not working again. And the government has to justify violence to its citizens. So I would like them to justify that. And frankly, if people are coming at this in good faith, it's not anymore because seriously, it's not enough reason to deny me my constitutional rights. So Claire, I'm glad to talk to you about this this morning.

This is hard and it's raw and it's about your life in many ways. But I appreciate you being willing to speak with us about it. Absolutely. Thanks so much. Take care. Okay. Thank you. Claire Brasso, as you heard, is suing the federal government for access to maid for mental illness. She's gone to a court to file an exemption to be allowed to access medical assistance and dying. She was in Toronto.

Hello, I'm Emma from the Earth Rangers podcast. If you think that animals are amazing, then our podcast is the one for you. Join me as I travel the world to discover the wildest animal facts out there and solve nature's biggest mysteries. If you're a fan of animal expeditions like on PBS's Wildcrats and the BBC's planet Earth, or the mystery and intrigue of Carmen San Diego, then you'll love the Earth Rangers podcast. This is a journey you won't want to miss. Follow the Earth Rangers podcast on Apple Podcasts, and for more information, go to gzmshows.com.

See you soon. If you or someone you know are struggling, you can call or text the National Suicide Crisis Help Line. The number is 988. It's free, confidential available 24 hours a day, seven days a week in both English and French. This is an issue that is in front of this committee that will advise the federal government on what to do,

but it's also an issue that's being debated across this country. Dr. Sonugand is a psychiatrist and professor at the University of Toronto, former chief of psychiatry at two Toronto hospitals and co-editor of the book Unraveling Maid in Canada. He's told the Parliamentary Committee studying Maid that he believes eligibility should not be expanded to those with soul mental illness. And he's with me in our Toronto studio. Good morning to you. Good morning, Matt. When you hear Claire Brasso talk about why she's seeking maid saying that her life is a nightmare, that she is functionally terminal, why shouldn't she have access to medical assistance and dying?

So listen, I think your heart has to go out to anyone who is suffering like that. and it is sadly true that mental illness can cause terrible suffering. At the same time, this case actually illustrates why it would be so problematic to expand maid to mental illness. And I should say up front that I am not opposed to maid. I actually chaired my former hospital's maid team. What I'm opposed to is providing death under false pretenses. What does that mean false pretenses?

So what it means is that, you know, we have to remember that made, especially on track two, which is what made for mental illness would be provided on. In that we're providing death to people who are not otherwise dying, and it's an exemption to the criminal code. That is serious business, and we need to be honest what we're providing death for. Our made laws are supposed to be for when you're suffering from an illness and will never get better. And evidence shows we cannot make those predictions in any individual with mental illness.

She says, and we just heard her say that, that we would not apply the same logic to somebody who is suffering through cancer, for example, saying maybe something will come on the horizon that will alleviate your suffering. Do you believe the people who are asking for this because their sole underlying condition is mental illness are being treated differently than those perhaps who are living with cancer? I think if we ignored the realities of the differences between mental illness and cancer for the purposes of made, then we'd be doing the ultimate discrimination and exposing people to wrongful death. I say that with my background clinically, as a

psychoancologist that spans both oncology and psychiatry. And I can tell you that there is a world of difference between providing made to somebody who is diagnosed with a cancer that's advanced and advancing versus any patient with mental illness. It's a fallacy to conflate the two. And as a small example, Matt, it's not just that we can't predict the course of mental illnesses. We don't know the underpinnings of why they occur. We don't know the biological underpinnings, unlike cancer, and all sorts of social things come into place. So once you have advanced cancer, for example, the best estimates are that it's probably a one in a hundred,

maybe a one in a million chance that it resolves spontaneously with advanced psychiatric illnesses, including treatment-resistant depression and other things. We actually have spontaneous resolutions of that, meaning even without treatment. So I'm not even talking about whether people have to be exposed to treatments they don't want. We just don't know what their futures will hold.

I guess the guidelines were made, and I ask that some part because the guidelines say that to be considered you have to have a serious illness, a disease or disability, be an advanced state of decline that cannot be reversed. And that's the part that I think you're disputing there, but also experience unbearable physical or mental suffering from your illness, disease, or disability or state of decline that cannot be relieved under conditions that you consider acceptable. And that there are people like Claire, but others, who would say that that's what they're living with right now. And so to that, I'd go back to what the guidelines and the law says and what the premise has been to the Canadian public, which is that we are providing this for suffering from an illness that will never get better. And what all of the evidence shows, so you're right, one of the key issues here is that we can't make those predictions. And in fact, those predictions are probably wrong more often than they're right. That's what the evidence shows.

I can honestly tell you, I would sooner trust a coin flip over an assessor's guess of irremediable. of mental illness for that. At least the coin does not have an ablest bias. But the second issue is we've been reassured that somehow assessors can filter out suicidality from other motivations for made requests for mental illness. And what the evidence tells us is that they can't. They think they can do it, but they can. What does that mean? What it means is that there's very same factors that we see exposing people to suicidality risk, things like loneliness, feeling a burden, social economic factors, those also, we are now seeing fueling, made requests on track two. In other words, when someone is not dying, what we're seeing is that the nature of suffering

shifts. When they're on track one and they're dying, that's the cancer examples you're talking about. And this is why it's so different. They're in the process of decline and we can predict they're dying. And the suffering is about that. So we are providing compassionate relief of end-of-life suffering. Whereas on track two and with Maid for Mental Illness expansion, all sorts of social suffering also comes into play. And we know that people with mental illness also face more than that.

Claire actually asked, can you fix my bank account? Can you fix these other relational things? And we can't separate that from what is motivating maid requests. And we know those are suicide risk factors that are merging on track two. We're almost at a time. Let me just ask you briefly. You have said that this is a cliff that we have fallen off, that, We know broadly the Canadians support medical assistance and dying,

but do you believe that this goes beyond what the policy was intended to achieve initially? I absolutely do because people support what they think is responsible policy when we're providing death to compassionately help somebody avoid suffering they will otherwise continue to have for the rest of their life. We can't do that with mental illnesses because we can't predict that. we can't filter out suicidality. And in particular, unfortunately, that risks the most marginalized populations. And, you know, getting back to this issue of the one policy, you know, there's that Anatoly France quote that he said that the law in its majestic equality forbids the rich as well as the poor to sleep under bridges to beg in the streets and to steal bread.

Just as there are different factors that might drive a poor person versus a rich person to beg in the streets or sleep under a bridge, there are different factors that might entice. marginalized people versus more privileged ones to seek death as an escape from life suffering. I need to let you go, but we'll leave it there and talk more about this as it unfolds. Dr. Thank you, Matt, so much for bringing this conversation to your listeners. Dr. Sonogand is a psychiatrist professor at the University of Toronto. He was with me in our Toronto studio. You've been listening to the current podcast. My name is Matt Galloway. Thanks for listening. I'll talk to you soon. For more CBC podcasts, go to cbc.ca slash podcasts.