On the front line: Q & A with DWDC’s Nino Sekopet

DWDC’s Personal Support Program manager reflects on how the legalization of assisted dying has affected the questions he receives from Canadians exploring their end-of-life options.

Medical assistance in dying (MAID) has been legal in Canada for more than a year now. Has the nature of the calls you receive changed much during that period of time?

I really don’t think so. Most of the calls are still about finding facts about the eligibility criteria and about the steps of the process.

What is noticeable is that, in some areas or within certain facilities, the process is much smoother than it used to be. But on the other hand, I’m also discovering how ill-prepared some other facilities can be.

What would you say are the biggest misconceptions that people who contact you have about the MAID rules in Canada?

I think people are often unaware that a diagnosis of mental illness, on its own, won’t qualify. They are also unaware that, [if they are diagnosed with dementia], they cannot consent to MAID through an advance request. On the other hand, lots of people still think that, in order to qualify, one must be terminally ill. 

How do you approach clearing up these misconceptions?

People who inquire about MAID because they have a mental illness or because they’ve been diagnosed with dementia, they are obviously disappointed. They very quickly go into the territory of explaining why the rules aren’t fair and why there is no logic in how the system is set up right now. And quite honestly, I agree with them. If you validate their logic, and if you validate their opinion, it will quite often defuse some of the frustration and aggravation that they have. But at the end of the conversation, they still feel disappointed, and I’m afraid that you can’t do anything to erase that.  

Increasingly, people are coming to us to ask what bereavement services are available in their communities for loved ones of individuals who accessed MAID. How would you say their needs differ from a family who is grieving the loss of someone who died without medical assistance?

The differences that do exist come from the fact that MAID is new in our society. Lots of people still feel that it’s a taboo or that something is not right about it. That is really the only difference. [Families whose loved ones accessed MAID] mourn as much as the people whose loved ones died with a natural death do. 

In fact, I would imagine that people whose loved ones died with MAID often have a certain advantage because they knew in advance when it was going to happen. That usually opens up a space and family members usually say goodbye and kind of wrap up the story to the degree that it can be wrapped up. 

What would you say is the most challenging part of your job?

What irritates me is the rigidity of the system and how little recognition the system has around the trauma that those people are going through. 

I’ve spoken with a couple people who had had their MAID date set and then literally a day before, or even on the day of, it got cancelled for administrative reasons, as if it was a hernia operation. I think that the system doesn’t recognize what those patients and their families are going through. My sense is that if they knew how complex and difficult a process it was, they’d never cancel it like that.

And what would you say is the most satisfying part?

The most satisfying part is when you get a call from somebody and you direct them to some resource, and you feel that the whole village stepped in and the whole process went smoothly for them. For me personally, that brings hope about humanity and about us really caring about each other.

To contact DWDC’s Personal Support Program, send an email to support@dyingwithdignity.ca or call us toll-free at 1-844-395-3640.


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