Should Canada introduce advance requests for MAID?


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15 comments

  1. Carmen Allan

    I Also support,this Fully.
    I know I have,Spoken on this to a Few Ppl. In the end,it should be patients first signature on Form that stays as such.

  2. Susan Greenfield

    This is so incredibly thought provoking. Thank you for these insights and the thoughts to consider.

  3. Sandy Buchman

    There is another viewpoint to consider here – and that is the perspective of the physician or nurse practitioner who is administering MAID. I completely understand, am sympathetic and totally supportive of the reasons for wanting advance requests. But I do not think that I, as a MAID provider, would be able to administer MAID to a patient with advanced dementia who could not tell me (with capacity) at the very last moment that they wanted to receive MAID. I need certainty in the moment to do this. To me, it is qualitatively different from other medical procedures where a substitute decision maker can make the decision to proceed. I also know that many other providers (although not all for sure) feel the way I do. Therefore fewer providers will be available to provide MAID in the context of advance requests, and this sadly further limits the already limited access to MAID.

    • Maureen Taylor

      Sandy, thanks for your comments, and obviously we have discussed this together before and I agree that the willingness of providers to provide MAID for patients with dementia is going to be a huge barrier. But why do you say fewer providers would be available to provide MAID if advance requests were permitted? Wouldn’t you continue to provide those that you were comfortable with in the context of your own morality, and refuse those requests you felt you couldn’t fulfill?

      On the subject of advance requests for MAID in cases of dementia, I am of course a supporter, but then I am not a healthcare provider legally allowed to provide MAID. All I know, is that if I ever get a diagnosis of dementia, I will have to hope the “reasonably foreseeable death” clause has been struck from the law so that I can have MAID before my dementia takes away my capacity, as I do not want to live out my days in that manner.

    • Margaret Killin

      I agree with your opinion. One way to manage late decisions I think is through a proxy who has guardianship or power of attorney. Personally, I think there are too many contingencies that influence doctor-patient decision making to make any consent a fully reliable choice.

  4. JAMES LEONARD PARK

    PROXY AFFIRMATION
    OF LIFE-ENDING DECISIONS:
    EXTENDING THE RIGHT-TO-DIE IN CANADA

    Canada is now considering expanding its right-to-die law
    to embrace three situations not originally included:

    1. Final informed consent for a patient
    already assessed and qualified for MAiD.

    2. Informed consent for life-ending decisions
    for patients who have lost mental capacity
    due to Alzheimer’s disease or other mental problems.

    3. Making life-ending decision for children.

    Read how carefully chosen PROXIES
    can solve all three of these problems:

    https://www.facebook.com/permalink.php?story_fbid=2248562628507478&id=105267556170340

  5. Margaret Piton

    I am opposed to medical assistance in dying under any conditions. I realise it is now the law, but that does not make it right. And yes, I am old enough that I have witnessed some very difficult deaths from heart disease in my own family. Just as we do not bring ourselves into existence, we do not have the right to determine when our life ends.

    • Christian

      Agree– God is our Creator and the one who should make the decision

  6. Jeffrey Fruitman

    this is a very important issue. As medical intervention become more, and more advanced, it is feasible to think that many of these patients will be able to be kept alive for longer periods of time. Speaking, not only as a strong advocate for MAID, I have experienced the decline of one parent, who ultimately has passed away, with the consent of my family agreeing to stop any intervention. I am now dealing with an 86 year old father who has the early stages of dementia. His situation, is further complicated, because he does not speak, due to a laryngectomy performed 12 years ago for tongue cancer. He also receives his medication and food via a G-tube. At this point, he is able to write his thoughts and wishes down on paper. That is how he communicates. I am dreading the time when he may not be able to write for whatever reason, and basically, we will not know what he is thinking, or what his wishes may be at any one time. I know he would definitely be in favour of MAID.

  7. Renee Fine

    Well written paper on MAID covering all aspects of this very important issue. Common sense tells us that it is unreasonable to expect a person with Alzheimer’s to give knowledgeable consent nor is it right for anyone to have to end their life before their time because they have to be in a position to consent. Doctors can opt out of performing MAID and allow patients to access help from those doctors who are respectful of patients’ wishes. To watch a human being lose cognizance and waste away is inhumane and cruel.

  8. Margaret Killin

    Personally, and professionally too, I think the bill should be reversed. As it stands, we have euthanasia and assisted suicide practiced in Canada without federal regulations or legislation. We don’t have enough terminal and palliative care units to offer patients a real choice. We don’t have enough, or equitable, resources for chronic and long term care patients, to offer real choices.
    In these conditions, physicians and hospitals have been, still are, and will continue to set the rules about hastening death.
    For the record, I would love to know how many hospital in-patients in general feel they control what happens to them from the emergency room, to admission to discharge and after care! I would love to know how many in patients leave with their dignity intact! I just do not believe that MAID is honestly about choice .
    Is it, for example, a real choice if the offer is 4 weeks in palliative care, but if you don’t die by then you will be discharged because we need the bed, OR a MAID can come clean your room? That is a true scenario.
    I think MAID is a consequence of the erosion of Canadian medicare.
    A good analysis can be found in the book The Cult of Efficiency. For online line research concerning patients’ motivation for hastening death you can also search the National Association of Social Workers web site. (American).

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