They’re Severely Mentally Ill. Is It Ethical to Help Them Die?

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Hosted by Lulu Garcia-Navarro

Produced by Rhiannon Corby

Edited by Anabel Bacon and Kaari Pitkin

Engineered by Carole Sabouraud

Original music by Isaac Jones, Pat McCusker and Carole Sabouraud

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Next year, Canada’s health care system is set to undergo a controversial change, when people struggling with severe mental illness will gain the legal right to request help from a doctor in ending their lives. Until now, medical assistance in dying — or MAID, as it’s often called — has been available in North America primarily to patients with terminal physical illnesses. The introduction of psychiatric MAID will present difficult, and different, ethical questions, especially for the doctors responsible for helping patients through this choice.

But a handful of other countries have been wrestling with these questions for years. Dr. Sisco van Veen is a psychiatrist working in the Netherlands, where psychiatric MAID has been legal since 2002. As an ethicist and a clinician at Amsterdam Medical University, Dr. van Veen has thought deeply about the thorny ethics of psychiatric MAID. But even now, after years of studying it, he’s still conflicted over what he sees as the central question of his work: When patients express a wish to die, when is it a doctor’s responsibility to guide them to another treatment — and when is it to let them go?

If you are having thoughts of suicide, call or text 988 to reach the Suicide and Crisis Lifeline or go to SpeakingOfSuicide.com/resources for a list of additional resources.

(A full transcript of the episode will be available midday on the Times website.)

Credit…Glasshouse Images/Getty Images

Thoughts? Email us at firstperson@nytimes.com. Follow Lulu Garcia-Navarro on Twitter: @lourdesgnavarro

“First Person” was produced this week by Rhiannon Corby. It was edited by Anabel Bacon and Kaari Pitkin. Mixing by Carole Sabouraud. Original music by Isaac Jones, Pat McCusker and Carole Sabouraud. Fact-checking by Mary Marge Locker. The rest of the “First Person” team includes Stephanie Joyce, Olivia Natt, Wyatt Orme, Sophia Alvarez Boyd, Derek Arthur and Jillian Weinberger. Special thanks to Scott Kim, Kristina Samulewski, Shannon Busta, Allison Benedikt, Annie-Rose Strasser and Katie Kingsbury.

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