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Northern psychiatrist pleased with delay in assisted dying law

Psychiatry chairs at NOSM University favour more time, more discussion and more clarity before enacting law on medically assisted dying for mentally ill patients

A Sudbury psychiatrist is pleased with the federal government's decision to delay medically assisted death for people whose sole medical condition is mental illness.

Dr. Rayuda Koka, a consulting psychiatrist and Medical Director of Mental Health & Addictions Program at Health Sciences North (Kirkwood), was commenting on the decision announced Thursday by federal justice minister David Lametti. The MAiD issue (Medical Assistance in Dying) has been pushed back to March of 2024.

"It was great,” Koka told in an interview. “That's what we were advocating for, because we're not ready. I don't want to push our patients when things are not really clear. So I want to make sure that people are safe and their doctors are safe, when they're deciding to do this very tough job."

Both Koka and Dr. John Haggarty jointly authored a letter last week calling for a pause in the legislation. Koka and Haggarty are the past and current Section Chairs of Psychiatry at NOSM University. Their letter spoke to concerns about improving suicide prevention initiatives, about gaps in MAiD standards and the issue of definition for  irremediability (determining the level of continual suffering).

Koka said when dealing with a physical illness, one can more easily define how serious it is. A physical illness is either going to be fatal or it isn’t, either a person will return to a satisfactory quality of life or they won’t. 

Mental illness, and how people respond to their illness, is more complex, he said, and often much less black and white.

"It could be just at that time people may feel” their only option is MAiD, Koka said, but protocols and procedures must be in place and robust to determine if a mental illness is truly intractable.

"We need to make sure that they may be getting better. There are different things that can be done," he added. 

With respect to gaps in the standards for MAiD, Koka said there are human resources staffing issues in psychiatry all across Canada. He said it is an issue that psychiatric departments in medical schools across Canada will also have to deal with.

Koka added that the government now has a year to work with the Academic Chairs in Psychiatry of Canada (ACPC) and others to try to find more clearly defined solutions.

"Well, we hope that things will be more clear with regard to definitions and the services and the availability of resources properly, clearly outlined, so that guidance is available for people who have been involved in doing this for the patients as well as the physicians," said Koka. 

"The most important thing is about the patients, to see that they get the proper assistance they need."

Len Gillis covers health care and mining for

Len Gillis

About the Author: Len Gillis

Graduating from the Journalism program at Canadore College in the 1970s, Gillis has spent most of his career reporting on news events across Northern Ontario with several radio, television and newspaper companies. He also spent time as a hardrock miner.
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