Kiran Rabheru is a Full Professor of Psychiatry at the University of Ottawa and Geriatric Psychiatrist at The Ottawa Hospital. He serves as Medical Director of the Geriatric Psychiatry, Electroconvulsive Therapy, and the Behavioral Support Programs at TOH. He obtained his medical degree from the University of Western Ontario. He is a Certificant and Fellow of the College of Family Physicians of Canada (CCFP, FCFP). He went on to complete his specialty training in Psychiatry, subspecializing in Geriatric Psychiatry, in which he is Board Certified in Canada (FRCP) and the United States (DABPN).
He is designated as a Founder of the subspecialty of Geriatric Psychiatry by the Royal College of Physicians and Surgeons of Canada. He is recipient of the Outstanding Achievements in Geriatric Psychiatry in Canada award by the Canadian Academy of Geriatric Psychiatry (www.cagp.ca) and has served as its President of the CAGP He serves as Chair of the Board of the International Longevity Centre (www.ilccanada.org), Board member of the International Psychogeriatric Association (www.ipa-online.org ), and Chair of the Section of Positive Psychiatry of the World Psychiatric Association (https://www.wpanet.org/). Dr. Rabheru was honoured to be elected as Chair of the Steering Committee for the Global Alliance for the Rights of Older People (https://rightsofolderpeople.org), a network of over 380 members from over 80 counties worldwide, united in the work to strengthen and promote the rights and the voice of older persons globally.
Prof. Cees Hertogh is professor of geriatric medicine & ethics of care at the VU Free University medical center in Amsterdam. He is also a member of the Task Force Antimicrobial Resistance at RIVM National Institute for Health and Environment. He studied Medicine and Philosophy of Medical Sciences at the VU University in Amsterdam. He obtained his doctorate there in 1986. Cees has been a registered specialist in geriatric medicine since 1991. In 2009 he was appointed professor of ‘ethics of care’, and in 2012 as professor of ‘geriatric medicine & ethics of care’. Cees is head of the departm ent of geriatric medicine of the department of family medicine & geriatric medicine, as well as vice -chairman of this department. In addition, he heads the research department of geriatric medicine and teaches at the medical faculty and in the training for specialist geriatric medicine (GERION). His research focuses on dementia, gerontopalliative care, geriatric rehabilitation and ethical issues in the care and treatment of vulnerable elderly people with multimorbidity. He is currently supervising 18 PhD students. Cees is a member of the Ethics steering group of Alzheimer Europe and of the INTERDEM group on early diagnosis and intervention in dementia. Cees is also one of the founders of the VUmc center for competence questions Free University Medical Center Amsterdam
Prof. Daniel Tsai, D.F.C., M.D., Ph.D., is a family physician and bioethicist. He graduated from National Taiwan University College of Medicine in 1989 and earned his PhD in bioethics from the University of Manchester, U.K. in 1999. He is Professor in the Graduate Institute of Medical Education & Bioethics, and jointly appointed in the Department of Family Medicine, the Institute of Medical Device and Imaging, and the Graduate Institute of Clinical Medicine in National Taiwan University College of Medicine. He is attending physician in the Department of Medical Research and chairman of the research ethics committee at National Taiwan University Hospital. He is also the Director of the Center for Biomedical Ethics at National Taiwan University. He is formerly the Vice President of the International Association of Bioethics (2016-7) and currently the President of Taiwan Association of Institutional Review Boards (2018~21). In the Covid -19 pandemic, he is a member of the Expert Advisory Committee to the Central Command Center of the Taiwan government. He has publications in Journal of Medical Ethics, Hastings Center Report, American Journal of Bioethics… etc. and has published books on subject of bioethics, informed consent, clinical ethics committee, case-analysis in medical ethics, research ethics, big data research, and family medicine, and another 100 papers published in Chinese language journals, and 20 papers collected in 20 books. His special research interests include: cross-cultural bioethics, genetic ethics, transplantation ethics, clinical ethics and ethics consultation, research ethics, and medical ethics education.
Lukas Radbruch is the chair of the Board of Directors of the International Association for Hospice and Palliative Care (IAHPC), and have been president of the German Association for Palliative Medicine until February this year. Before this he was the founding Director of the Department of Palliative Medicine at University Hospital, in Aachen. He has been President of the German Association for Palliative Medicine since 2014. Professor Radbruch completed his Habilitation (the German equivalent of a P hD) in 2000, which was the first thesis in anesthesiology and palliative care in Germany. He has published extensively, his main research interests being symptom assessment, opioid treatment, fatigue, cachexia and ethical issues in palliative care. He is co-author of the new edition of the German textbook on palliative medicine (Lehrbuch der Palliativmedizin, Schattauer Verlag) and of the regular editions of the German hospice guide. He has been editor of ‘Der Schmerz’ since 2004, a member of the Drug Commi ssion of the German Medical Board since 2004, and a member of the Expert Commission of the German Narcotic Control Agency since 2004. His contribution topalliative care in Germany has resulted in the following awards: Förderpreis Palliativ medizin of the German Association for Palliative Medicine in 2000, 2nd Förderpreis Palliativmedizin of the German Association for Palliative Medicine in 2009, 1st Annerkennungs- und Förderpreis “Ambulante Palliativversorgung“in 2009, TOM Medien- Sonderpreis of the German Children’s Hospice Foundation in 2014. Professor Radbruch coordinated the project, Access to Opioid Medication in Europe (ATOME), which was funded by the 7th Framework of the European Commission. He has played a very active role in the European Association for Palliative Care (EAPC) of which he was President from 2007 to 2011. He has been a member of the Steering Committee of the EAPC Research Network since 1996, chaired the EAPC’s first Research Forum in 2000 and three EAPC World Congresses: in 2005, 2011 and 2013.
He has also played a leading role in helping to develop the EAPC’s social media activities, in particular the EAPC online blog. He has worked with Liliana De Lima on the (successful) application for essential palliative care medicines to the World Health Organization (WHO) essential medicines list and is a member of the WHO Technical Advisory Group initiat ed in November 2014. His main activity in this group will be focused on the development of WHO guidelines on palliative care. Outside of work, Professor Radbruch enjoys horse riding in the countryside, and being with his family. His two sons are grown up, one working as a veterinarian in Berlin, the other doing his Master’s in engineering in Aachen. He also enjoys salsa dancing with his wife.
Dr. Mark Lachmann is the Medical Director of Bridgepoint Health, the 465-bed rehabilitation hospital campus of Sinai Health, in Toronto, Canada. He is a geriatric psychiatrist working in community home visiting, long term care, rehabilitation, and acute hospital settings. Particular interests include community care, cross -cultural cognitive assessment, and complex capacity assessments. Dr. Lachmann also serves as a Coroner in Toronto, and sits on the Geriatric and Long -term Care Death Review Committee of the Coroner’s Office. He is the Geriatric Psychiatry Medical Director for the Provincial Geriatrics Leadership Office. He is an assistant professor in the Division of Geriatric Psychiatry at the University of Toronto. Dr. Lachmann served on the Board of Casey House for nine years, Canada’s only stand alone HIV hospital, three of those years as Chair. Prior to geriatric psychiatry, Dr. Lachmann worked as a family physician for ten years on James Bay and Baffin Island.
Dr. Naik is the R.S. McLaughlin Professor of Medical Education and Professor of Anesthesiology and Pain Medicine at the university of Ottawa and The Ottawa Hospital.
He is the Director of Assessment for the Royal College of Physicians & Surgeons of Canada. He has 20 years of experience as an educator and oversees the credentialing of specialist training and the assessment, including examinations, for all medical specialties in Canada. In 2001, Dr. Naik obtained a Master of Education degree from the University of Toronto, and a Fellowship in Education from The Wilson Centre for Research inEducation. Following his training, Dr. Naik was recruited to St. Michael’s Hospital, where he started a Research Fellowship program in Simulation, and 3 years later, he was appointed Medical Director of the Allan Waters’ Family Patient Simulati on Centre. In 2009, he was recruited from the Universityof Toronto to establish the University of Ottawa Skills and Simulation Centre (uOSSC) as the inaugural Medical Director. Dr. Naik has focused his career on the integration of simulation into CanMEDS for postgraduate education and continuing professional development. He has over 100 peer reviewed publications and grants, and in 2007 and 2013, Dr. Naik received honour awards from the Canadian Anesthesiologists’ Society for his international contributions to education. As its Medical Director, Dr. Naik leads the Medical Assistance in Dying (MAiD) Program at The Ottawa Hospital and across eastern Ontario.
Dr. William Reichman, President of the International Psychogeriatric Association and President and Chief Executive Officer of Baycrest, Canada
Kiran Rabheru, International Psychogeriatric Association (IPA), Global Alliance for the Rights of Older People (GAROP), ILC-Canada, Professor of Geriatric Psychiatry, University of Ottawa, Canada
Cees Hertogh, Chair, department of Medicine for Older People Amsterdam University Medical Centers, Netherlands
Daniel Fu-ChangTsai, Professor in the Graduate Institute of Medical Education & Bioethics, and Director of the Center for Biomedical Ethics at National Taiwan University, Taiwan
Lukas Radbruch, Chair of Palliative Medicine at the University of Bonn, and President of the German Association for Palliative Medicine, Germany
Mark Lachmann, Medical Director of Bridgepoint Health, and Geriatric Psychiatry Medical Director for the Provincial Geriatrics Leadership Office, Canada
Viren (Vern) N. Naik, R.S. McLaughlin Professor of Medical Education and Professor of Anesthesiology and Pain Medicine at the university of Ottawa and The Ottawa Hospital, and Director of Assessment for the Royal College of Physicians & Surgeons of Canada, Canada
The word “euthanasia” comes from the Greek euthanatos, which means “easy death”. Euthanasia, assisted suicide and medical assistance in dying (MAiD) will be used interchangeably in this symposium. This has long been a controversial and emotional topic, with recent societal opinions leaning in favor of it, accounting for between 0.3 and 4.6 % of deaths in countries where it is legalized. This debate will use an ageism and human rights lens to focus on the complex factors in offering MAiD to older persons with mental health conditions or psychosocial disability.
MAiD has been accessible to eligible Canadians since June 2016. 5,631 Canadians (average age 75.2 years) accessed MAiD in 2019 of which 80% were age 65 or older. Persons with mental illness alone do not currently have access to MAiD, but this is about to change. On March 17, 2021, the laws governing MAiD were amended to open access to MAiD for persons with mental illness alone. The potential impact of this is that suicidal, non-dying, marginalized people suffering from life distress, psychosocial disability, and mental health conditions, with potential to recover with care or treatment may have access to MAiD in Canada.
This controversy has sparked a huge debate.
Many persons with disabilities and human rights advocates have been deeply disturbed on social media. They have expressed strong sentiments about this change.
For example, while Canada cannot guarantee life with dignity e.g. by not providing adequate supports for independent living, which can in turn lead to suicidal desire, Canada can then, under the new proposed legislation, provide the person guaranteed “death with dignity” with MAiD! Even the Office of the United Nations High Commissioner for Human Rights has raised the alarm that Canada’s pending MAiD policy will prematurely end vulnerable lives. The Centre for Addiction and Mental Health has concluded: “There is simply not enough evidence available in the mental health field … to ascertain whether a particular individual has an irremediable mental illness.” After 15 months of studying global evidence, the Council of Canadian Academies came to the same conclusion, as did the Expert Advisory Group on MAiD. Both the American Psychiatric Association (APA) and Royal Australian and New Zealand College of Psychiatrists (RANZCP) have also concluded that there is no evidence to support providing MAiD solely for mental illness. Those who advocate expanding access to MAiD propose mitigating this reality with “safeguards.” This ignores the fact that irremediability is itself the primary safeguard built into the MAiD framework, and bypassing it renders all other supposed “safeguards” meaningless. The debate rages on with the Canadian Psychiatric Association releasing its position statement in 2020 that “patients with a psychiatric illness … should have available the same options regarding MAID as available to all patients.”
Many countries in the world have far more experience offering MAiD to persons with mental illness. In the Netherlands, 110 people were euthanized for psychiatric suffering between 2011 and 2014, with numbers growing fast. 66 of these cases were analyzed. Approximately 70 % were women, suffering with personality disorders, social isolation and loneliness, who had never been hospitalized or received treatment. One woman was euthanized because she complained of a life without love and, therefore, had no right to exist. In Belgium, many disturbingly young persons have been euthanized because they were suffering from depression, eating disorders or post-traumatic stress disorder. The highest court in the Netherlands has ruled that physicians can end the lives of dementia sufferers who had chosen euthanasia before they fell ill.
This symposium will examine the arguments put forth on the question of MAiD for older persons with mental health conditions or psychosocial disability. Please join the contentious debate with renowned global experts on MAiD including a Canadian Senator involved in the legislation which will be moderated by Mr. Craig Mokhiber, an iconic international human rights expert and Director of the United Nations New York Office of the High Commissioner for Human Rights.