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Why public reaction toward legislation on medically assisted dying is divided

As the Liberal government seeks to pass its legislation on medically assisted dying before the Supreme Court's deadline of June 6, public reaction toward the bill is divided.

Some approve of its caution, while others argue it denies access to many who would seek assisted death, including individuals suffering from mental illness.

While Bill C-14 allows assisted death only to individuals suffering from a "grievous and irremediable medical condition," it doesn't specify that the condition must be physical. But those who support assisted death for the mentally ill say the criterion that "natural death" must be "reasonably foreseeable" may be interpreted as an exclusion of mental conditions.

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In addition, the bill's preamble, which states the government is committed to developing "non-legislative measures" for requests for medical assistance in dying by "mature minors, advance request and requests where mental illness is the sole underlying medical condition," suggests these cases are excluded in the proposed legislation, says Canadian psychiatrist Dr. Justine Dembo, who is temporarily working in the United States and is an advocate of granting access to medically assisted death for the mentally ill.

Excluding advance requests, in particular, would mean individuals with dementia would not be able to access assisted death, Dembo says.

"By the time they are closer to a reasonably foreseeable death, the dementia will have rendered them incapable with respect to those decisions. And so they're trapped in a place where they will not be offered aid in dying in any way."

Other countries, such as the Netherlands and Belgium, do allow assisted dying for mentally ill patients. Individuals there have sought assisted death for a range of chronic and severe conditions, including depression, anxiety, post-traumatic stress disorders and eating disorders. But, as an April, 2016, article in the journal JAMA Psychiatry noted, the practice is controversial. Doctors don't always agree on individual requests.

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