Toronto lawyer Orlando Da Silva publicly opposes Canada’s proposed expansion of medical assistance in dying (MAID) for mental illness, warning that his own severe depression makes him an unreliable judge of his life’s value. According to his memoir Thank God I Failed, published in June, Da Silva fears his legal persuasion skills would enable him to convince doctors to approve his death during a severe depressive episode.
The Risk of MAID for Mental Illness in Canada
According to Orlando Da Silva, who has battled severe depression since the age of nine, expanding the eligibility criteria creates a profound danger for vulnerable patients experiencing temporary crises. Da Silva nearly died by suicide on December 18, 2008, after ingesting 180 sleeping pills and two liters of alcohol at age 40. Rescued and subsequently hospitalized in psychiatric care, he later realized his absolute conviction that he was a burden was a symptom of his illness rather than an objective reality.
According to Trudo Lemmens, the Scholl Chair in Health Law and Policy at the University of Toronto, offering MAID to individuals experiencing profound despair directly contradicts the core therapeutic foundation of psychiatry, which relies entirely on the hope of recovery. Lemmens warns that presenting medical assistance in dying as a valid clinical option during a psychiatric crisis risks creating a self-fulfilling prophecy where treatment fails because the clinician has signaled there is no way out.
Medical Consensus and Systemic Failures in Mental Healthcare
Opponents of the expansion argue that psychiatric disorders cannot be measured with the same objective metrics as physical illnesses. Da Silva notes in his book that depression is not a detectable tumor or a failing organ, but rather a narrative generated by the brain that the patient mistakes for absolute truth. Many psychiatrists and psychologists oppose the legislative change precisely because clinicians cannot reliably distinguish a treatable depressive crisis from an irremediable condition.
Furthermore, critics point to the rapid acceleration of MAID cases across Canada since the practice was legalized in 2015. According to Lemmens, what was initially promised as an exceptional procedure has rapidly normalized, raising concerns that struggling patients are receiving death as a solution instead of adequate medical care. Da Silva argues that a society failing to provide accessible, sustainable mental health support lacks the moral authority to offer death as a treatment option, concluding that patients need medical assistance to live rather than to die.