BACKGROUND CONTEXT FOR PROPOSALS

Canadian Psychiatric Association (CPA) leadership released its controversial 2020 Position Statement on Medical Assistance in Dying (MAiD) in March 2020, after nearly two years with no membership engagement or consultation on the issue. Since then, Canadian psychiatrists have continued to express concerns about flaws in process, content, and lack of evidence related to the CPA Statement; and most importantly about its continued negative impact on evolving MAiD policies, as outlined in the 2020 Open Letter from two past CPA presidents and elsewhere.

Following criticism from members the CPA struck a select working group on MAiD, yet even this group failed to ask whether members agreed with the known to be controversial CPA Position Statement when it surveyed members in October 2020.

After refusing to properly engage members on its Position on MAiD for a year an a half, less than two weeks before Member Proposals on MAiD would be heard that CPA could not block from its upcoming AGM (including one to rescind the 2020 Position Statement), CPA leadership released an updated Position Statement on November 12. Remarkably, despite 20 months of concern expressed by members regarding the lack of evidence-based guidance (including lack of any comments regarding evidence of predictability of irremediability of mental illnesses, or of mental illness related suicide risks), the updated CPA Position Statement continues to fail to address any of these key issues, and in some ways is worse than the initial 2020 Statement.

To date, a year and a half after releasing its flawed 2020 Position Statement, CPA leadership has failed to once ask members whether they agree with their Position. Yet CPA leadership has continued to use their Position as a basis for informing CPA public advocacy, claiming it has taken “no position” while knowing full well that its public messaging has led policy makers and the public to view CPA as supporting MAiD for mental illness.

Predicting that a condition is irremediable is the fundamental safeguard for MAiD in Canada. Despite acknowledging in June 2020 that “our (position) statement was never intended to….examine whether psychiatric conditions are irremediable and if so, how this should be assessed”, the CPA Position (including the November 2021 updated Position) continues to be that “Patients with a psychiatric illness … should have available the same options regarding MAiD as available to all patients”.

Through consultations on Bill C7, despite claiming that it has taken “no position” on MAiD for mental illness, CPA leadership repeatedly stated in Senate and other consultations that the exclusion of MAiD for sole mental illness was “inaccurate and stigmatizing”, “vague, arbitrary and overbroad”, “discriminatory”, and “unconstitutional”. The CPA never once mentioned mental illness related suicide risk or suicide prevention, indeed never once even used the words “suicide”, “suicidal”, “suicidality”, etc, throughout these consultations on mental illness and death. Instead, in November 2020 Senate testimony when asked “Do you [the CPA] agree with the other experts, including the Council of Canadian Academies, who say the knowledge is not certain about mental disorders, and we need more research about it? Does that call for precautions? Unless we have more information, should we prevent people suffering from mental disorders as the sole condition to access the second track to MAID as a matter of precaution?”, CPA president Grainne Neilson responded “I guess that is a legislative decision.”

Psychiatrists across the country, including past presidents, members, and ex-members who have resigned from CPA over this issue, have continued to have significant concerns about the lack of proper engagement and lack of expert evidence CPA leadership is contributing on this important issue. Public quantitative results of a recent psychiatrist survey done by the Ontario Medical Association Section on Psychiatry showed that most respondents did not agree with the planned expansion of MAiD for mental illness that CPA input facilitated, nor did most psychiatrists agree with positions that CPA leadership has taken.

While CPA refused to allow member submitted MAiD Proposals on the agenda at the 2020 AGM, three Member Proposals have been successfully submitted that CPA is legally obligated to allow be heard at the 2021 AGM, to comply with federal legislation and regulations.

If anything, the still deeply flawed ‘updated’ CPA Position Statement released November 12 emphasizes the importance of these Member Proposals. Click on links below to review these Proposals.

Most importantly, if you are a CPA member, plan to attend the upcoming AGM on November 25, scheduled 16:30-18:00 ET, and vote (to participate, you will have to register for the AGM *in advance*. Click here to see how to register for the 2021 AGM). CPA is a member association, it is supposed to be representing you, and this is a chance for your voice to be heard…and encourage your colleagues likewise to participate and attend the CPA AGM.

If you want to stay informed of developing issues, send a message on the ‘contact’ page.

Thank you again for taking the time to engage in this important and nuanced issue, and to advocate for the patients we entered the profession to help.

CLICK HERE FOR ADDITIONAL CONTEXT AND KEY FAQs SUPPORTING THE AGM PROPOSALS