"The Case Against Legalizing Assisted Death for Psychiatric Disorders"

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Abstract
This chapter examines whether euthanasia and assisted suicide for psychiatric disorders (pEAS) should be legalized. While proponents often rely on parity arguments, claiming that psychiatric suffering should be treated the same as physical suffering in jurisdictions that permit assisted dying, we argue that such conceptual ethical reasoning is insufficient to justify legalization. Legalization requires careful policy analysis that considers empirical evidence, implementation challenges, and broader societal consequences. Using Canada’s planned expansion of Medical Assistance in Dying (MAID) for mental illness as a case study, and drawing on developments in Belgium and the Netherlands, we analyze concerns related to the scale of pEAS, the difficulty of reliably assessing irremediability and decision-making capacity, the risk of premature and preventable deaths, and the impact on vulnerable populations. We further examine effects on stigma, suicide prevention, mental health care, and the integrity of medicine. We conclude that the current evidence does not support the claim that pEAS can be implemented safely and reliably, and that its legalization risks serious long-term harms for individuals, mental health care systems, and society. Therefore, pEAS should not be legalized.

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