Canadian military veterans and advocates say the case of a Veterans Affairs Canada (VAC) employee discussing medical assistance in dying with a veteran should prompt an inquiry into the agency’s ability to address the mental health of former soldiers.
With many soldiers who served in the Afghanistan and Iraq conflicts suffering traumatic brain injuries — which can lead to suicidal thoughts — veterans say the need to provide proper care is more important than ever.
“(My fear is) can somebody who’s on a razor’s edge be pushed in the wrong direction or negatively impacted by a suggestion … of something like medical assistance in dying?” said retired Sgt. Tobias Miller, who was injured while serving in Afghanistan.
“When you have to fight daily against your own brain telling you things that you don’t want to hear, I sort of question how a department whose sole job is to care for us and to help us heal would step in and … make an offering that could see veterans harm themselves.”
Sources told Global News a VAC service agent brought up medical assistance in dying, or MAID, unprompted in a conversation with the combat veteran, who was seeking treatment for post-traumatic stress disorder and a traumatic brain injury. Global News is not identifying the veteran who was seeking treatment.
But multiple sources tell Global News the combat veteran never raised the issue, nor was he looking for MAID, and that he was deeply disturbed by the suggestion. Those sources and VAC have told Global News the discussion took place, with VAC confirming it is investigating the incident.
Sources close to the veteran say he and his family were disgusted by the conversation, and feel betrayed by the department mandated to assist veterans. The sources said the veteran was seeking services to recover from injuries suffered in the line of duty, and had been experiencing positive improvements in his mental and physical health. They say the unprompted offer of MAID disrupted his progress and has been harmful to the veteran’s progress and his family’s well-being.
Scott Maxwell, executive director of Wounded Warriors Canada — an organization focused on providing mental health services to veterans — said the “flat out wrong” discussion and its impact shows how fragile mental health care can be, particularly for former soldiers.
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“You get one chance at it,” he told Global News. “Every conversation matters, to the extent that they can be set back so they don’t go on to receive any further care, or don’t feel comfortable to reach out and access independent support.”
Although post-traumatic stress and other mental health impacts have always been a side effect of military service, traumatic brain injuries have been called a “signature injury” for veterans of the Afghanistan and Iraq conflicts due to the high number of improvised explosive devices (IEDs) used, including roadside bombs.
The number of soldiers who suffered a traumatic brain injury is not regularly tracked, but a 2010 military report suggested around six per cent of Canadians who served in the Middle East in the early years of the conflict were injured.
A year later, the Globe and Mail reported on a National Defence study that found Canadian soldiers in Afghanistan were hospitalized for traumatic brain injuries between 2006 and 2009 at almost three times the rate of Americans fighting there in earlier years.
Miller, who sustained a traumatic brain injury from a roadside bomb in Afghanistan and suffers from PTSD, says he personally experienced hearing negative and even suicidal “voices” in his head before learning how to “fight that voice and ignore it.”
Someone without those coping mechanisms could be more susceptible to suggestions like assisted dying, he adds — making it more alarming that such an offer could be made by a VAC worker.
“One of my thought processes was, is this department out of touch with modern veterans?” he said.
“I worry, and most of us (veterans) worry, was this done to anybody else? Is there anybody else out there who has had this suggestion made to them?”
The department did not answer Global News’ questions about how many times assisted dying has been offered to veterans through this particular VAC employee or others at Veterans Affairs, or what guidance employees have been given about providing such advice.
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VAC told Global News that providing advice about medical assistance in dying “is not a VAC service” and that employees have no mandate to make such a recommendation to clients.
The department did note, however, that it may offer assistance to veteran clients and their families after the veteran has already made the decision to pursue an assisted death with their primary care provider, who by law are the ones responsible for making such a recommendation.
In a statement released Tuesday following Global News’ report, Veterans Affairs Minister Lawrence MacAulay said he has asked Deputy Minister Paul Ledwell — who directly oversees the department — “to ensure this never happens again.”
“What happened to this veteran is completely unacceptable,” he said, adding the incident “never should have happened.”
MacAulay said he has been assured that the “appropriate administrative actions will be taken,” but did not elaborate on what that would mean. VAC would not discuss the nature of the ongoing investigation or specifics of what consequences the employee might face, citing privacy concerns.
Maxwell, with Wounded Warriors Canada, says VAC employees need to be better trained in helping veterans navigate their mental health struggles as they transition into civilian life.
He’s now concerned that this one veteran’s experience could deter others from seeking the benefits they are entitled to from the department.
“That’s just devastating, it’s unacceptable,” he said.
For his part, Miller says more transparency is needed to repair the relationship between VAC and veterans, who he says are in crucial need of support.
“We’re one year post the fall of Kabul,” he said. “There’s a lot of raw, raw emotion going on in the veteran community right now. There’s a lot of veterans questioning whether their sacrifice and their blood and treasure was worth it.
“To have a have a ministry whose responsibility is (to care for veterans) to say, ‘Well, maybe we could help you not be here,’ does that reinforce the feeling that it wasn’t worth it, that it was wasted?”
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