Canada and assisted suicide for mental illness?

breezy1985

https://www.boards.ie/discussion/comment/120057897#Comment_120057897

Dementia is a mental illness there is no coming back from and for some requires full time medical treatment in a dementia ward.

There are also people who will spend the rest of their lives in a mental home from something as simple as hitting their head and there is no coming back for them either.

Schizophrenia can lead to the same lifelong treatment in a mental home.

I would love to sign a piece of paper that would terminate my life rather than living through any of the above.

Mad_maxx

https://www.boards.ie/discussion/comment/120058115#Comment_120058115

I would never judge or take a harsh view of someone who died by their own hand but allowing the state to be involved in the suicide business is extremely dangerous to that extent, wishing that much power on the state is chilling

AndrewJRenko

https://www.boards.ie/discussion/comment/120058536#Comment_120058536

He didn’t say it was treatable. He said it was curable.

But if you want to talk about treatment, let’s talk about the availability and cost of CBT .

One eyed Jack

https://www.boards.ie/discussion/comment/120058653#Comment_120058653

it’s certainly a debate worth having here in Ireland

It’s a debate that’s long been had in Ireland ever since suicide was decriminalised in 1993 and the prohibition of assisted suicide was codified in Irish law at the same time -

2.—(1) Suicide shall cease to be a crime.

(2) A person who aids, abets, counsels or procures the suicide of another, or an attempt by another to commit suicide, shall be guilty of an offence and shall be liable on conviction on indictment to imprisonment for a term not exceeding fourteen years.

https://www.irishstatutebook.ie/eli/1993/act/11/section/2/enacted/en/html#sec2

Significant public debate was had around the issue during the time Marie Fleming was alive and campaigning for the right to die to be recognised in Irish law which would have permitted assisted suicide -

https://m.independent.ie/irish-news/news/garda-probe-launched-into-death-of-right-to-die-campaigner-marie-fleming-35160299.html

The first person who was actually charged with an offence was Gail O’ Rorke in 2015 after it was alleged she had assisted someone to die by suicide -

https://www.thejournal.ie/gail-orourke-3222621-Feb2017/

There’s always going to be significant debate about the issue because of the idea of who should be granted the authority to end another person’s life, and the circumstances under which they may be permitted to do so. There’s no significant demand for it in Ireland, and politicians understandably don’t want to touch the issue with a 20 foot barge pole!

AndrewJRenko

https://www.boards.ie/discussion/comment/120058692#Comment_120058692

Or maybe we could ensure that living in a mental home isn’t a fate worse than death?

Mad_maxx

https://www.boards.ie/discussion/comment/120058692#Comment_120058692

I probably would too but that’s different than depression

breezy1985

https://www.boards.ie/discussion/comment/120058735#Comment_120058735

It's not the condition of the home that I have the problem with whatsoever. Quality of care in state institutes is fantastic.

I don't want my family spending their days visiting a man child who doesn't even know who they are.

https://www.boards.ie/discussion/comment/120058738#Comment_120058738

I never said depression. The term thrown around is mental illness which these are and are not curable like is being claimed mental illness is.

crusd

https://www.boards.ie/discussion/comment/120058458#Comment_120058458

ECT is the equivalent of repairing a pothole with plastic explosive in the hope that the bits fall back into place by themselves.

Oscar_Madison

https://www.boards.ie/discussion/comment/120058731#Comment_120058731

I’ve heard it reported in 2022 that it’s a topic that might be handed to the citizens assembled for discussion- but whist some politicians will steer clear, such as those reliant on elderly Catholic voters in Kerry for example, it’s not the taboo topic it once was- personally if got a disease such as motor neuron or locked in body syndrome, I’d absolutely want to choose when I depart this planet and not be reliant on a crumbling health service

One eyed Jack

https://www.boards.ie/discussion/comment/120058727#Comment_120058727

I think posters (because I don’t want to single you out) who hopped on the word “curable” are being unnecessarily picky. It was clear from the context in which it was written, what the poster meant, given the rest of the post.

Therapies like CBT and EMDR are widely available and cheap as chips, and CBT in particular is widely regarded as being an effective treatment for mild cases of the conditions it is provided as a treatment for. Its effectiveness is in its use as an intervention therapy as part of the treatment of those conditions in order that the patient recovers from ill mental health. The jury is still out on it’s efficacy as part of a broader regimen in treating other conditions -

In sum, our review of meta-analytic studies examining the efficacy of CBT demonstrated that this treatment has been used for a wide range of psychological problems. In general, the evidence-base of CBT is very strong, and especially for treating anxiety disorders. However, despite the enormous literature base, there is still a clear need for high-quality studies examining the efficacy of CBT. Furthermore, the efficacy of CBT is questionable for some problems, which suggests that further improvements in CBT strategies are still needed. In addition, many of the meta-analytic studies included studies with small sample sizes or inadequate control groups. Moreover, except for children and elderly populations, no meta-analytic studies of CBT have been reported on particular subgroups, such as ethnic minorities and low income samples.

Despite these weaknesses in some areas, it is clear that the evidence-base of CBT is enormous. Given the high cost-effectiveness of the intervention, it is surprising that many countries, including many developed nations, have not yet adopted CBT as the first-line intervention for mental disorders. A notable exception is the Improving Access to Psychological Therapies initiative by the National Health Commissioning in the United Kingdom (Rachman & Wilson, 2008). We believe that it is time that others follow suit.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3584580/

Mad_maxx

https://www.boards.ie/discussion/comment/120058735#Comment_120058735

many people living on the streets today would have lived in psychiatric institutions back in the day, apparently the streets is progress ?

AndrewJRenko

https://www.boards.ie/discussion/comment/120058845#Comment_120058845

Where can I get “cheap as chips” CBT in Ireland please? Do your chips cost about €75-€100 a week?

One eyed Jack

https://www.boards.ie/discussion/comment/120058855#Comment_120058855

You can practice it in the comfort of your own home if you like completely free. I don’t own the concept either, it’s available to anyone, easily accessible. Like I said, one of its advantages is its cost-effectiveness in the treatment of mild cases of certain conditions. It’s not a suitable treatment for everyone, but there are alternative treatments which an individual may find more helpful in alleviating their discomfort.

One eyed Jack

https://www.boards.ie/discussion/comment/120058851#Comment_120058851

Given what we now know of the kind of behaviour patients In institutions were subjected to, living on the streets is a far less daunting prospect! At least on the streets they’re less likely to suffer physical, sexual, emotional, verbal and mental abuse perpetrated by people who purported to be caring for them.

One eyed Jack

https://www.boards.ie/discussion/comment/120058808#Comment_120058808

I’d absolutely want to choose when I depart this planet and not be reliant on a crumbling health service

The issue there isn’t your when you choose to depart, it’s that if assisted suicide were legislated for, you would be reliant on the same crumbling health service to assist in your departure.

Bit… awkward 😬

AndrewJRenko

https://www.boards.ie/discussion/comment/120058940#Comment_120058940

Therapy involves a therapist. "Go read a book" or "go watch this YouTube channel" isn't therapy.

Oscar_Madison

https://www.boards.ie/discussion/comment/120059053#Comment_120059053

Joking aside, in Canada the MAID system is actually seen as a money saver for the health service - so your post is not entirely without merit- the Canadian health service actually have a very good assisted dying programme in place and why wouldn’t they, if they can save millions of dollars every year as a result.

Apparently last year, something like 10.000 people chose MAID in Canada- on a per capita basis the equivalent in Ireland would be about 1600 people- not a huge amount when you consider the amount of people in Ireland at end of life, many with incurable diseases and great illness - in my view it’s just another way of dignified dying- it’s no different to pumping morphine into someone for a few days as I’ve witnessed all too often- let them go, they deserve it (assuming that they signed up for it)

Mad_maxx

https://www.boards.ie/discussion/comment/120058962#Comment_120058962

Those were a tiny minority of fringe cases , the reality is closing down the institutions was a disaster as the families of those unfortunate people were unfit to look after them and the result was a huge increase in homelessness and prison numbers

One eyed Jack

https://www.boards.ie/discussion/comment/120059083#Comment_120059083

CBT, as the acronym suggests, IS therapy. There is no requirement whatsoever that its practice requires a therapist. That’s your own criteria, which would explain why you think it should cost anyone between €70 - €100 to avail of, and why you think its availability is limited. Certainly if you wish to avail of a therapist’s services it’s going to cost, though whether it comes out of your pocket personally is dependent upon your individual circumstances, which I’m not privy to and I have no desire to be made aware of.

One eyed Jack

https://www.boards.ie/discussion/comment/120059118#Comment_120059118

That tiny minority of fringe cases was enough to demonstrate a much broader issue with institutionalised care, which is why it wasn’t a disaster at all for either people who were deemed unfit to look after themselves, or their families who were deemed unfit to look after them.

There hasn’t been any significant increase in homelessness or prison numbers as a consequence of shutting down institutionalised care in Ireland. The services provided in community care settings have improved, but as dealing with the pandemic showed, they’re still a long ways off ideal, and certainly there are still many people who are homeless and suffering ill mental health who consider living on the streets a far less daunting prospect than living in institutionalised care. From their perspective, you’d want to be mad to think homeless shelters are safer than living on the streets.

Mrs OBumble

https://www.boards.ie/discussion/comment/120058727#Comment_120058727

So you think it's better to just kill 'em off, rather than proving treatment.

Nice.

One eyed Jack

https://www.boards.ie/discussion/comment/120059352#Comment_120059352

That can’t be what Andrew meant, surely?

The cost to the State of providing for mental health services as a comparison to the cost of providing for assisted suicide doesn’t even begin to compare, let alone support the idea that it would be more cost efficient to provide for assisted suicide!

The only obvious advantage of assisted suicide doesn’t overcome the cost of providing for mental health services - the idea that there would be no complaints whatsoever from users who avail of the service.

Mad_maxx

https://www.boards.ie/discussion/comment/120059209#Comment_120059209

Community care is a bad joke for those who are seriously unwell

as for you’re claim that closing down the old institutions hasn’t resulted in a significant increase in homelessness or imprisonment, only an ideologue could believe such nonsense

One eyed Jack

https://www.boards.ie/discussion/comment/120059504#Comment_120059504

True, but it’s still far superior to the alternative being discussed in this thread of assisted suicide. Community care services can always be improved, whereas feedback about assisted suicide services is far more difficult to obtain, for obvious reasons.

Oscar_Madison

https://www.boards.ie/discussion/comment/120059352#Comment_120059352

No one is killing anyone “off” so stop with the exaggeration- the MAID. System in Canada is one you yourself must sign up to - its completely voluntary

Oscar_Madison

https://www.boards.ie/discussion/comment/120059522#Comment_120059522

If someone wants to die due to serious medical issues why not let them? It gives them control and dignity.

AndrewJRenko

https://www.boards.ie/discussion/comment/120059352#Comment_120059352

I never said or even hinted at any such position. Please withdraw your claim and apologise.

https://www.boards.ie/discussion/comment/120059504#Comment_120059504

What institutions were closed down?

https://www.boards.ie/discussion/comment/120059161#Comment_120059161

Seems a bit strange to know that we have all this BPD in the world that can be fixed by apparently giving people a book or a YouTube video. Is there any particular reason why BPD is such a huge issue in Ireland and all over the world given that you have some cheapo solution there? Every definition of CBT that I can find (five examples below) refers to it as a 'talking therapy', so unless we're advising people with BPD to be talking to themselves, we need therapists.

Your 'see no evil' approach to the costs of therapists doesn't make the problem go away. People still face into costs of €100 per session, typically weekly initially in the early stages. HSE may provide access to group therapy, but not to 1:1 therapy. Those with private health insurance can get some costs covered, and can get tax relief, creating yet another inequality in our health system.

https://en.wikipedia.org/wiki/Cognitive_behavioral_therapy

https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/talking-therapies-and-counselling/cognitive-behavioural-therapy-cbt/overview/

https://www.hse.ie/eng/services/list/4/mental-health-services/dsc/communityservices/cbt.html

https://www.mayoclinic.org/tests-procedures/cognitive-behavioral-therapy/about/pac-20384610

https://my.clevelandclinic.org/health/treatments/21208-cognitive-behavioral-therapy-cbt

One eyed Jack

https://www.boards.ie/discussion/comment/120059613#Comment_120059613

Seems a bit strange to know that we have all this BPD in the world that can be fixed by apparently giving people a book or a YouTube video.

What’s even more strange is your bringing CBT into the conversation at all when its effectiveness is limited to generalised anxiety disorders, and nowhere did I suggest it was effective in the treatment of bipolar disorder, or that it involved simply giving people a book (although I know of at least one therapist under contract to the HSE who suggested the good book to a patient who was non-religious. You can imagine how that went down 😒).

The rest of your invented argument is just that, about as useful as a prostitute suggesting the only way for people to have access to great sex is to pay for it. Completely disregards the idea of indulging in a bit of self-love… religious beliefs permitting 😬

Or the idea of availing of assisted suicide, as opposed to suicide - if you want someone else to do it, there’s a cost involved, and the same issues you point out with regard to access to mental health services in this country would undoubtedly be exactly the same issues with access to assisted suicide - unless one is wealthy and willing to pay for the services privately, they’re reliant on public services provided for by the State.

It’s not a question of seeing or not seeing evil, it’s a question of ethics. Evil is for people who are religious.

Girl Geraldine

I would be against it. You see it would only suit the state and the civil/public service all too well if it came in as it would mean they would be literally doing away with having to pay for the life-long care of the seriously mentally ill.

On the other hand, i would be in favour of assisted suicide for those terminally ill and in pain but only in principle. I would be against it in practice because it would be something wide open to being abused by greedy or unscrupulous family members who want to get the deceased assets, or be freed from the obligation of caring for the ill person. You'd have greedy/uncaring people grooming the person to convince them to go for assisted suicide.

There would be huge potential for grooming of the seriously ill in this way.

The poor will be groomed into it so someone or the state doesn't have to pay for their care.

The wealthy will be groomed into it by someone wanting to inherit their wealth.

Girl Geraldine

https://www.boards.ie/discussion/comment/120059582#Comment_120059582

Voluntary sign up for assisted suicide, whether for mental or physical illness, doesn't count for much if you've spent months or years being subtly groomed into believing it was the best thing for you.

In that situation it is only the appearance of being voluntary, but really it is a consent that is carefully engineered out of you by some other person who has something to gain from your death - either inheritance, or being freed from the obligation and cost of your care.