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Peace of mind requires planning ahead. That’s why patients should have the right to make advance requests for assisted dying that will be honoured when the time comes.

For decades, Canada’s federal ban on assisted dying forced an impossibly cruel set of choices on desperately ill patients looking to die on their own terms.

“A person with [a grievous and irremediable medical condition] has two options,” wrote the justices on the Supreme Court of Canada in the February 2015 decision to strike down the old law. She can take her own life prematurely, often by violent or dangerous means, or she can suffer until she dies from natural causes. The choice is cruel.”

The Supreme Court’s landmark ruling on assisted dying opened the door for a future Canada in which horrific suffering is no longer a life sentence. But unless we act to ensure good legislation, many Canadians will still be forced to choose between ending their lives too early and suffering for far too long.

The details matter

When it comes into effect in June, the ruling will decriminalize physician assisted dying for competent adults who are suffering intolerably because of a grievous or irremediable illness and clearly consent to the termination of life. However, the decision is silent on when consent must be given, leaving the finer details up to legislators and bureaucrats.

Medical regulators in some provinces have proposed rules that, if fully adopted, will require a patient to be competent from the moment she makes her first request until the second she receives compassionate assistance to die. Though well-intentioned, these provisions threaten the choice of Canadians who receive approval for assisted death but lose competency before their wishes can be carried out.

Whose choice is at stake?

Consider the following scenario: Janice has terminal cancer and is bedridden at home. Knowing her condition is only going to get worse, she repeatedly asks to end her life with the help of her doctor, and the request is approved.

However, days before she’s scheduled to undergo life-ending treatment, Janice suffers a stroke, leaving her temporarily incapacitated but still very much alive. If she were conscious, she would still want a doctor to help her achieve a peaceful death. But at the moment, she has no way of making her wishes known.

And then there’s Arvin: Semi-retired and in his mid-60s, Arvin has just learned the most alarming news of his life: he has early dementia. He often has trouble remembering coworkers’ names and occasionally leaves the milk jug in peculiar places. Otherwise, life is still good. In fact, Arvin and his wife are planning to sneak in a couple of big overseas trips before travelling becomes too much of a challenge.

What worries Arvin more are his prospects for the long road ahead. He is terrified of spending his final days unresponsive and incontinent in the confines of a nursing home, and wants to access physician assisted dying before he finds himself in that position.

“But what if I lose competence before I’m ready to die?” Arvin sometimes asks himself. “I don’t want to feel pressure to end my life too early — while I can still enjoy the company of my grandchildren — to ensure that my wishes are carried out before it’s too late.”

Voice Your Choice for peace of mind

Patients like Janice and Arvin deserve the comfort of knowing that their wishes for a peaceful death will be honoured even after they lose the ability to express themselves. Offering Canadians the right to consent now, while they are still sound of mind, to life-ending treatment later will help ensure that patients with progressive or terminal illnesses won’t have to choose between a premature death and enduring months or years of unwanted suffering and indignity.

Winning the right to request an assisted death ahead of time is anything but assured. Not one of the North American jurisdictions where assisted dying is legal allows patients to consent to life-ending treatment in advance. If we don’t raise a strong voice now, we risk living with bad federal laws — those that restrict choice — for decades to come.

That’s why we need your support while this unprecedented window of opportunity is still open. Voice Your Choice today for the right to make an advance request for physician assisted dying.

(Header photo: Adobe Stock/Daxiao Productions)