In a June 11, 2020 email blast to CPA members, the CPA writes that the deliberately time-limited, now sunset CPA “task force, which was chaired by Dr. Gaind, did not deliver on the key part of its mandate - to produce a guidance document on MAiD”. In fact, the Task Force was the last group at CPA that engaged members and sought consultation on MAiD, and it did produce a guidance document. With delivery of the guidance document, the time-limited task force was wound down in 2018, and the CPA did not engage membership in nearly two years since then in development of the current Position Statement.

In terms of the previous CPA member engagement cited in the June 11 CPA e-blast regarding MAiD, the CPA email neglects to mention that it was in fact the aforementioned Task Force that surveyed all CPA members in 2016 and published the survey results, and that the Task Force presented symposia and workshops on MAiD at CPA Annual Conferences in 2016 and 2017.

Regarding a guidance document, the time-limited Task Force was intentionally not meant to duplicate the work of the Council of Canadian Academies Expert Panel that commenced in 2017 (on which Dr. Gaind also sat). The Task Force *did* develop an Interim Guidance document for psychiatrists, a draft of which was broadly and openly made available to all CPA members, plus to other external stakeholder groups and experts, for feedback, prior to anticipated publication. The last draft of that document, version 9, is provided for reference (please see note below regarding document). After this work was done by the Task Force, a final version was never approved by the Board once the Task Force was sunset nearly 2 years ago, the CPA did not get that guidance document translated into French and a finalized version was never distributed to CPA members.

It is unfortunate the CPA is now choosing to characterize all this as somehow the time-limited Task Force “not delivering” on its mandate.

In any case, the CPA and the PSP committee that developed the current 2020 CPA Position Statement of concern, years later, did not engage membership, internal groups like the CPA Research Committee, or other expert groups in developing the current CPA Position Statement. That Statement was developed without any member input, consultation or even awareness, and lacks evidence-based recommendations. Despite weighing in with its Position Statement that “patients with a psychiatric illness….should have available the same options regarding MAiD as available to all patients”, and knowing that MAiD is meant for irremediable conditions, the CPA remarkably acknowledges in its June 11 email blast that the Statement was “never intended to….examine whether psychiatric conditions are irremediable and if so, how this should be assessed.” In other words, with its Statement, the CPA has taken the position that patients with psychiatric illness “should have available the same options regarding MAiD” as patients with other medical illnesses, without any consideration of whether psychiatric conditions can be assessed as irremediable, and if so how.

In addition, while in its June 11 member email the CPA now states that their “statement supports…availability of, and access to, appropriate treatments, supports and services to ensure that MAiD is not requested as a means to escape social exclusion or a dearth of appropriate clinical and community support”, and that “In situations where mental illness is the sole underlying condition, access to MAiD should not be permitted until appropriate safeguards are in place”, none of this is in the actual Position Statement (click to read actual Statement). Regarding safeguards, the only comment in the actual Position Statement is that “The CPA will advocate for the inclusion of appropriate safeguards in processes, protocols, procedures and legislation pertaining to provision of MAiD”, which is quite different in terms of a Position and potential impact on unfolding policy. If the above comments are the CPA position, that needs to be clearly articulated in the actual Position Statement.

The Statement has been characterized by Drs. Sinyor and Schaffer, in the CPA's own peer-reviewed medical journal, as reflecting “an abdication” of CPA's responsibility (see “Perspective in CJP” article a few links above).