The Debate Over Assisted Suicide and Mental Illness: Where Do We Draw the Line?

A recent op-ed by journalist David Heitz raises one of the most complex and ethically challenging questions in the debate over assisted suicide: Should people with severe mental illness be allowed to access medical aid in dying (MAiD)?

The conversation around assisted suicide in New Hampshire has long been framed around terminal illness—patients facing suffering with little hope of recovery. But as laws in some countries expand to include individuals with chronic mental illness, the debate takes on new urgency. Heitz’s article examines both sides of the issue, exploring the risks, moral dilemmas, and the potential consequences of allowing individuals with psychiatric conditions to legally end their lives.

The Risks of Expanding MAiD to Mental Illness

One of the greatest concerns in broadening access to assisted suicide is ensuring that vulnerable individuals are not steered toward death when they could still recover or receive meaningful treatment. Mental health conditions can be severe and debilitating, but they are often treatable—especially with access to therapy, medication, and social support. Experts argue that allowing assisted suicide for psychiatric patients would send a dangerous message: that their lives are less valuable or that suicide is a "solution" rather than an avoidable tragedy.

There is also the question of capacity and consent. Unlike physical illnesses, mental health disorders can impair decision-making, making it difficult to determine whether someone is truly making a rational, informed choice to end their life—or whether their illness is driving that decision. Suicide prevention efforts exist precisely because many people who experience suicidal thoughts eventually find relief and stability with time and treatment.

The Argument for Expanding MAiD

Countries like Canada and the Netherlands have already taken steps to allow people with chronic psychiatric illnesses to access assisted suicide under specific circumstances. But even in these nations, the practice remains highly controversial and heavily debated.

The conversation about assisted suicide and mental illness is far from over, and Heitz’s op-ed highlights the difficult ethical terrain we must navigate. How do we protect the most vulnerable while respecting personal autonomy? What safeguards are necessary to ensure that no one is making an irreversible decision based on temporary despair? Palliative care is one valuable pathway that significantly improves the quality of life for patients facing serious illnesses by actively managing their pain and other symptoms, providing emotional and spiritual support, and empowering patients and their families to make informed decisions about their care, ultimately leading to a better overall experience while reducing unnecessary medical interventions and associated costs. Death is natural, and the Pandora’s box of suicide is not opened.

As this issue continues to unfold, one thing is clear: The debate is not just about policy—it’s about how we, as a society, define compassion, dignity, and the value of human life.