My mum was the sunshine. She was compassionate and kind, resilient and intentional. A cardiac ICU nurse for over 30 years, she devoted her life to caring for others. My mum lived fully, accepting what she could not change and having the courage to change that which she could.

In April 2025, at age 62, mum was diagnosed with early-onset Alzheimer’s disease. Unlike many people with dementia, she was painfully aware of her decline. She had supported her dad through his final years living with dementia. She helped her sister move into a nursing home when she could no longer care for herself. She led patients through devastating illnesses and saw the impact on their loved ones. She wholeheartedly understood what the path ahead looked like and was resolute that this would not be her own. In February 2026, mum died on her own terms with medical assistance in dying (MAID). For her, death was the less frightening option. She faced a merciless diagnosis with acceptance and grace.

Her pathway to MAID, however, was not linear. Between April 2025 and February 2026, my family navigated two vastly different experiences. Soon after her diagnosis, mum requested a MAID assessment. Consistent with her long-standing wish, she said that she did not want to die now but before she lost her ability to consent. The assessing physician ultimately offered her a two-week window for receiving MAID which mum responded was too soon. The physician affirmed that she would not have the capacity to consent in a few months and that this would likely be her only opportunity. With unsettling reassurance, she offered that mum may soon forget that she has Alzheimer’s and live on peacefully. While true for some, it was never mum’s vision of peace. She had spent years articulating her wishes and in that assessment, those wishes were dismissed.

By December, my parents had relocated to another province to be closer to family. Once settled, mum again asserted her wish to explore MAID. The contrast was immediate. The team approached her not as a case to be disqualified, but as a person to be heard. They acknowledged her professional background as a nurse and her insight into her prognosis. They accommodated their questions to someone living with dementia. Within two months, she died on her own terms. The process was coordinated and compassionate.

The legislation was the same in both provinces, yet one system upheld her autonomy, and the other obstructed it. This disparity highlights a critical gap in Canada’s MAID framework: the lack of advance requests for individuals at risk of losing capacity to consent.

MAID in Canada operates under a federal framework, yet access remains inequitable, shaped by provincial policies, institutional restrictions, and the subjective judgement of individual providers. While Bill C-7 expanded eligibility beyond “reasonably foreseeable death”, it stopped short of allowing advance requests for those who anticipate losing decision-making capacity, such as people with dementia.

Many organizations are advocating to correct this gap. A recent survey found that 84% of Canadians support advance requests for MAID for a person who has a diagnosis of a capacity-impairing grievous and irremediable condition. Dying with Dignity Canada is advocating to change the federal Criminal Code to allow advance requests. The Federal Government is conducting ongoing public consultation following a 2023 Parliamentary Committee recommendation to legalize advance requests. Countless families are sharing their stories to demand change.

My mum did not seek death. She sought to shape her end with dignity and grace. Stoicism teaches that we must make it our aim to have already lived long enough. My mum embodied this, facing her death as she did her life: with courage and acceptance. I balance my grief with deep gratitude – for the life she gave us, and for the privilege that her voice was heard and her choice honoured. Not everyone is granted that opportunity. In one province, mum’s autonomy was met with hesitation and her foresight dismissed. In another, that same autonomy was respected and realized. Canada’s MAID legislation remains conditional on timing, geography, and the influence of individual providers. True equity requires a national commitment to advance requests. A person facing irreversible cognitive decline has lost so much, and denying them this final act of self-determination is not protection; it is abandonment. It overlooks the fundamental importance of quality of life.

We often think about fighting illness as finding a cure or prolonging life. But for my mum, dying was inevitable. Her fight was for control. To allow those who loved her to remember her as she was. Alzheimer’s stole my mum’s future. Her choice for MAID granted us ours.

My mum’s story is not unique. It is a call to ensure that the next person who says, “I want to die before I lose my mind,” is met not with doubt but with humanity – and the legislation to back it up.

 

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Advance requests

An advance request would allow a competent person to make a written request for MAID that could be honoured later, after they lose the capacity to make medical decisions for themselves. An advance request could save a person from having to endure years — perhaps even decades — of unwanted suffering. 

In DWDC’s most recent polling, 82% of Canadians stated that they support advance requests for MAID for a person who has a diagnosis of a grievous and irremediable medical condition. It’s time for us to join our voices and tell the government to make advance requests legal. 

Join the conversation

If you think it is time to make advance requests as part of federal MAID legislation, we invite you to join the conversation. Your voice matters. Tell your MP and the Ministers of Health and Justice that you want to see advance requests as part of federal MAID legislation. Or consider calling or meeting with your elected official to have an even bigger impact. Find our action toolkit and more information on the advance request advocacy page on our website. For more frequent updates on our advocacy issues, as well as easy access to our educational materials, please consider signing up for our e-newsletter.

 If you have questions about MAID or any other end-of-life care option, please visit  www.WeCanChoose.ca. We Can Choose is a new initiative from Dying With Dignity Canada that provides clear information about end-of-life planning and care options, including MAID. Visit www.WeCanChoose.ca to learn more.