An Ethical-Legal Analysis of Medical Assistance in Dying for Those with Mental Illness

This article considers sources of opposition to allowing access to medical assistance in dying for individuals with mental illness. It originated with an observation by members of the University of Toronto Joint Centre for Bioethics that in mainstream Canadian culture — as well as in political, academic, and professional circles — such opposition remains widespread (and often reflexive). This opposition exists even in light of broad support for access to assisted dying for individuals with illness manifesting in physical suffering. Most Canadians treat the prospect of assisted dying for those with mental illness with suspicion, and it is worth exploring why this opposition persists, what arguments can be leveled to support it, and whether those arguments can be sustained. To that end, I identify five objections to assisted dying for the mentally ill that seem to characterize the public debate, and argue that none are sustainable. They either rely on false premises or otherwise fail to secure the conclusion that assisted dying should be off limits to people suffering from mental illness, even when such mental illness is their sole underlying condition.