Dr. Eric Kelleher:

My colleagues may want to come in as well. What we have really tried to convey here today is the complex interplay between the mind and the body. Even something as simple as fatigue or motivation can be a consequence of physical illness but can be also a consequence of a co-morbid or co-existing mental illness. It is very difficult in clinical practice to separate out those two things. We do our best and we endeavour to do so, and we provide the wraparound supports that we can for individuals who we see in acute settings in hospitals and emergency departments and then translate that care into care in the community. However, as the evidence has shown in other jurisdictions, it is always open to challenge in terms of who we limit these groups to, and that would be a huge concern of ours.

I do not think anybody here is supporting mental illness alone as a qualifying factor; nobody is saying that and we are not saying that either. We want to highlight the high rates of co-existing mental illness and the overlap there is with those with physical illnesses. No jurisdiction has actually identified that and, as my colleague, Dr. Ambikapathy has said, we examine capacity but not co-morbid mental illness. As I said earlier, this reframes how we view patients with physical illness who express suicidal ideation, and my colleagues will want to come in on this, as will those in the National Suicide Research Foundation. Therefore, I imagine there will be a certain proportion of patients who will not get access to care because of how we as a society - because it is a societal issue, as the Deputy is highlighting - reframe somebody with a chronic illness or terminal illness who is expressing a wish to die, for whatever reason.