Determining who gets to access Medical Assistance in Dying is all of our responsibility

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  • Kevin Reel says:

    Just a small point of clarification – Tom Koch is not a well known palliative care physician, nor is he a physician. He calls himself a gerontologist, which is easily mistaken for geriatrician.
    In my humble opinion, his G+M opinion column confuses supporting people to live with dignity and requiring some to continue to live despite the indignity and suffering they describe themselves.
    Extending access to MAiD need only make it a possibility for more people.
    Yes, concerns arise and safeguards are needed.
    It’s possible.

  • Kathleen Ahearn says:

    My husband and I responded to the GOC survey. Unfortunately, his father recently died a painful death at 97, due in large part to a physician (hospitalist) who did not listen. Everyone touts the benefits of palliative care, but he was not afforded this option until one day before he finally died. He spent weeks in agony….surely we can and must do better than this.

  • Paul says:

    My big worry is that MAiD could easily be used on all of us as a cost cutting measure, as when we get old and need pain medications to function because of our injuries, and those of us that need insulin and many other drugs to function so that we do not die. As something like that could be implicated where I live south of you in the USA. There are those that are always looking for ways to cut social programs, and using the definitions that are given it could easily apply to anyone that goes to doctors, and the only reason it has not happened yet is there are too many drug makers and doctors that benefit from keeping the majority of us alive. Also those companies have more of a pull than the military here in the USA, and the only thing bigger than those two are the banks. All of these entities have far more political power than most people think. Looking at the wording “reasonably foreseeable”, as this applies to all of us that are born into this world, as we are all going to die at some point, and a serious and incurable illness that can easily apply to many things as it did not say that it is untreatable, as there are many things that are treatable and incurable. I have had an incurable S. aureus infection for around 20 years or so and as long as I can get the correct antibiotics it does not develop into pneumonia. So here are 2 things that those in power could use to exterminate me and there are probably more. This is the problem with all of these laws as they do not say things such as can live without too much suffering with medications, as I did not read that. I can pick things out of a few paragraphs, but not enough to read the whole thing. Also if someone is in severe pain with medications such as Morphine, diamorphine, fentanyl, or any other strong pain medication in any amount that does not cause severe respiratory distress then I would say they can’t be helped, but not including that as a factor is a slippery slope that could easily be used as a cost cutting method.

    • Kieran says:

      Thank you for your comment, Paul.

      The most important aspect of MAiD is to protect our most vulnerable patients from receiving treatments not in line with their personal values and preferences. Many safeguards are currently in place to ensure this doesn’t happen.

      MAiD is a request made by the patient, not by anyone else. The criteria you outline (e.g. reasonably foreseeable death, serious and incurable illness) are to be applied to deem patients eligible/ineligible for their requests to undergo MAiD. These criteria are in place to ensure the we are using it as a tool to relieve intolerable suffering for the right patient (i.e. those who wish to receive the treatment and are eligible) at the right time.

  • Paul Anderson says:

    Thank you for this thoughtfully written article.

    The Bill in question, incidentally, is C-14. It is very difficult to imagine how legislation could successfully balance the demands of those who, like the group Dying With Dignity, favour completely unfettered and unconditional access to MAiD, on the one hand, with effective protection of vulnerable disabled or chronically ill people, on the other hand, who are immersed in a culture that progressively devalues their lives as MAiD access is expanded. It is especially disheartening to see how little effort is going into making improvements in the availability and quality of palliative care, community based care, and living conditions for chronically ill or disabled persons, as compared with the energy and publicity that is devoted to the expansion of the practice of MAiD.

    • Kieran Quinn says:

      Thank you for your comments, Paul. I agree that we should be doing more to improve access to home and palliative care – but there is hope.

      I sit on the Ontario Palliative Care Network as a Clinical Advisory Council member to advise our provincial government on the delivery of palliative care across Ontario. We are diligently working to address all of the issues you raise above, which we believe are equally as important.

      The continued advocacy from people like yourself are needed to help influence funding and policy decisions for our healthcare system.

    • Paul says:

      I agree Paul, as access to pain medications has been sharply curtailed here in the USA for many people and you are having the same problem in Canada. There is a big difference between psychological addiction and dependent on something to function or live. However there are many that feel that if Christ had to suffer on the Cross that all of us should be able to suffer as well. Also this war on drugs actually started as a way of destroying minority communities under the Nixon administration and has been creating more and more suffering ever since. Then it spread to nearly all other countries on this planet. Also there is this illusionary getting high and I have no clue as to what that could be, but there are a few drugs that are quite easy to get doctors to prescribed that make people stoned, and I hate being stoned. Amitriptyline, Nortriptyline, Celebrex, and a few others get me so stoned that I can’t safely do much of anything, but they are far easier to get than things that are far more effective as pain medications. Just because someone has a memory they want to forget does not mean they should be taking pain meds to help themselves, as that is not what most use them for. However that is exactly what those that abuse them use them for.

  • Jason says:

    My common-law partner fulfills the whole of the criteria for medical assistance in dying with the exception of the “reasonably foreseeable death” criteria point. Even so, she has been trying to access MAID for almost two years now. We continue to wait for change.


Kieran Quinn


Kieran Quinn is a general internist and palliative care physician at Sinai Health System and an early career health services researcher affiliated with the University of Toronto and the Institute for Clinical Evaluative Sciences (ICES).

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