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Topic

Medical assistance in dying and mental illness: Perspectives from 2S/LGBTQ+ individuals in Atlantic Canada

Social Dimensions of Health

Date & location

• Wednesday, July 31, 2024
• 10:00 A.M.
• IAHL boardroom & Virtual

Examining Committee

Supervisory Committee

• Dr. Nathan Lachowsky, School of Public Health and Social Policy, ·¬ÇÑÉçÇø (Supervisor)
• Dr. Simon Carroll, School of Public Health and Social Policy, UVic (Co-Supervisor)

External Examiner

• Dr. Christy Simpson, Department of Bioethics, Dalhousie University

Chair of Oral Examination

• Dr. Kelli Stajduhar, School of Nursing, UVic

Abstract

In March 2027, medical assistance in dying (MAID, also referred to as physician-assisted suicide) in Canada will be available to those with mental illness (MI) as the sole underlying condition (MAID-MI). The literature surrounding MAID-MI rarely consults individuals with MI; consequently, there is urgent need to understand this population’s perspectives. A key intersecting/sub-population is 2S/LGBTQ+ (Two-Spirit, lesbian, gay, bisexual, transgender, queer) Atlantic Canadians with MI, who will be disproportionately affected by the change in MAID eligibility for several reasons. These include: 1) intersections of sexual/gender minority status with homelessness and poverty, and the impact of rising costs of living in Atlantic Canada; 2) associations between sexual/gender minority status and MI/suicidality, and the impact of barriers to accessing timely and competent healthcare in Atlantic Canada, specifically gender-affirming and mental health care; and 3) associations between homelessness, suicidality, and likelihood of seeking MAID. This study used an interpretive description methodology, informed by a feminist-of-colour disability framework, and community collaboration, and engaged 2S/LGBTQ+ Atlantic Canadians with mood disorders through qualitative one-on-one interviews to understand their perspectives on MAID-MI and how their experiences and identities impacted these perspectives. Of the 38 participants, 63% were white and the remaining 37% represented diverse races/ethnicities: Indigenous, First Nations, Métis, or Inuit; Black, East or Southeast Asian; Latino/Latina/Latine/Latinx; and South Asian. A minority (21%) identified as cisgender. A reflexive thematic analysis of the verbatim interview transcripts focused on the topic of autonomy in the context of MAID-MI within the Atlantic Canadian healthcare system. These results identify possible complications for MAID-MI implementation and highlight areas where additional safeguards could be enacted to ensure equity for and prevent abuse of power against 2S/LGBTQ+ or other marginalized communities.