Kate's story: My dad chose a medically assisted death. This is my celebration of his life and choice.

In late June, Mark Alexander died peacefully at his home, surrounded by his close family and friends. The British Columbia man was an avid outdoorsman, globe-trotter, and beer-league hockey player who loved all kinds of physical activity, but loved his family above all else. Despite his zest for life, Mark was always realistic about his prostate cancer diagnosis. After every treatment failed, he made the decision to access medical assistance in dying, and he did so with unwavering conviction. At his Celebration of Life reception, his daughter, Kate, presented a speech about his end-of-life choice. She has graciously allowed us to share her beautiful words on our blog.

Dear friends and family,

Thank you to all of you for coming out and to everyone near and far who have expressed your support and shared stories, anecdotes and photos with us over the last few weeks.

I was wondering what I would talk about that would add to all of the amazing tributes that many of you have made honouring dad’s life and accomplishments. So I thought I’d talk about a different topic, and the sad reason we are all gathered here today — his death and the way he chose to undergo it.

As I think all of you know, dad chose to undergo medical assistance in dying (MAID). For years, he felt preoccupied by the right for people to choose how they exit this life and was even involved in lobbying for the legislation to be introduced in Canada. As such, he was able to choose a specific date and time and could be surrounded by loved ones.

Although the days leading up to his death were sad, as we were in the unusual and novel predicament of knowing exactly how much time he had left, we were able to share many meals, gatherings, memories and stories. The phone seemed to ring constantly with close friends calling to offer their last respects, and dad exchanged innumerable messages and tearful goodbyes. Although emotional, it had a celebratory feel and it was a memorial that dad was able to fully participate in.

At the appointed time, he rose from the couch, hugged each and every one of us who was there and walked into his bedroom. His doctor placed a catheter, and my brother and I sat on the bed beside him, holding his hand and caressing his head while he received the injections. It was peaceful and powerful, and I felt overwhelming love and gratitude that I could be there to send him on his way.

Kate and her dad, Mark, in 2010 — a few years before his diagnosis.

As a veterinarian and animal lover, I have assisted many living beings through their final minutes and felt the relief of easing their suffering, but also the responsibility of making a very difficult decision. With my father, the responsibility was shouldered by him, which allowed me to feel only comfort and relief that he would not have to endure the increasing levels of pain and debilitation caused by widespread cancer.

The legislative process seems designed to reduce the responsibility on any individual doctor: both his oncologist and palliative care doctor needed to consent, and their decision required two witnesses. The request is only approved following a 10-day waiting period and dad had to sign a final consent minutes before the procedure. Dad was also fortunate that he fulfilled the somewhat narrow criteria for permission.

There are no words to express my gratitude to the Canadian government for passing legislation allowing MAID. A few days before he died, dad and I were discussing politics (no big shock there) and I was surprised to hear his positive accolades towards Justin Trudeau. It was only when I was writing this that it occurred to me that it is not Justin’s curly locks and boyish charm that won over dad, but the courage of the Liberal government to pass this legislation.

"Dad's final courageous and generous gift"

I also owe my respect to the doctors who are willing to perform MAID. It is not an act that can be taken lightly. My father was of completely sound mind, bantering back and forth with us up until his final moments, no doubt wanting to dispel any tension and make it easier for everyone. I think it must require the experience of having witnessed painful terminal disease for a doctor to see MAID as an act of incredible compassion. Randy, my father’s doctor said that, although it was sad for him to lose my father as a person, he felt that it was a privilege to be able to perform dad’s final wish.

I think that dad’s long-standing conviction made it easier for everyone to accept and participate in his decision. He prepared himself and us well, and I think this is important for anyone considering MAID. He was open about his prostate cancer diagnosis and about each treatment and its disappointing failure. He discussed his intention to undergo MAID well in advance with his doctors and family.

He did extensive research to understand the novel legislative procedure and any barriers to obtaining consent. With the tools provided through Dying With Dignity Canada, he prepared an advance directive and a Representation Agreement in case of incompetency. He filed a no CPR request with his doctor and the British Columbia Ministry of Health Services.

I understand that this might be difficult for some of you to hear. The right to choose to die might challenge your personal convictions and I respect that. Also, I am deeply sorry if you have lost a loved one in less caring, unexpected or even tragic circumstances. We are uncomfortable around death. It exposes our true vulnerability. I hope that my father’s experience can fuel some discussion and offer a perspective, and I am sure he would feel the same way. I also think it is important to know that MAID is not just a piece of legislation reported in the news. It is available, it is an option and it was dad’s final courageous and generous gift to all of us who he loved so dearly.

- Kate Alexander, August 9th, 2017 

Dying With Dignity Canada is immensely grateful to Kate for sharing this beautifully written celebration of her beloved father's choice. We are thankful Mark was able to have a peaceful, gentle death.


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