The doctor’s parents opt for MAID 

Soon after my own 2016 diagnosis of advanced lung cancer, I enquired about MAID for myself – a General Practitioner at the time. Never did I imagine that my parents would precede me down that road. Fortunately, I have been stable so far on a non-curative targeted therapy, allowing me to accompany my parents on their final journeys.    

In 2018, my dad was diagnosed with metastatic esophageal cancer. A stent was placed to help him swallow during a scope exam and biopsy, and a referral to the Cancer Agency was made. At 86, and after suffering terribly with post-shingles pain for over five years, he told me that he didn’t want any further treatment such as radiation or chemotherapy, as it would only prolong the inevitable. He was already tired of suffering and had no desire to lose his independence in the few months he was likely to live. 

None of the professionals that he encountered had discussed the option of MAID, despite it having been available for about two years for those with a foreseeable death. Knowing how my dad felt about his situation, I gently put it out there that he was likely a candidate for an assisted death. His immediate response was, “Let’s get it done.” Luckily, we lived in a major center where there were MAID providers, and the locum for his GP was comfortable being the second assessor. Not knowing how his friends felt about MAID, he elected to have his lawyer and staff witness his application. Although he was weakened from his condition, he soldiered on through the appointments with the support of my mom and myself. As this took some time, he was quite concerned that he would progress to a point where he no longer had capacity to give consent on the day of his assisted death, which was still a requirement at that time. He did have his peaceful death in his favourite recliner in his retirement home, with my mom and myself at his side. 

Fast forward to August 2021, when my mom has a first fall. At first it was thought to be a new medication issue, but the falls continued after the issue was resolved. She soon required a walker and was initially diagnosed with Parkinson’s Disease. The ambulance service attended the retirement home many times to pick her up off the floor or to transfer her to the hospital if there were injuries. She had a poor response to the Parkinson’s medications. It got to the point where she was needing extra help with lunch preparation and bathing and could barely use the washroom despite installing mobility aids. She would soon have to transfer to an assisted living situation. She told me that she wished each night that she would not wake up, as she had no wish to lose her independence and especially not to “lose her marbles,” a possibility with her diagnosis.  

I knew that there was now a second track to MAID for some individuals with a severe condition for which there was no remedy, where the death was not foreseeable within the time frame of a few months. Like my dad, my mom was keen to see if she was a candidate for MAID. We saw the same caring MAID provider who looked after my dad, and my mom was so relieved to hear that she qualified. She also had a GP willing to complete the second assessment. With this second MAID track, applicants must wait at least three months from their date of application to have MAID, must be seen by a specialist in the field for which they are applying, and must remain competent to consent on the day of the procedure (no longer required for track 1). We happen to be in a city that had a neurologist with a special interest in movement disorders, but we were told initially that it could be a 9-12 month wait to be seen. We learned later that the doctor had been working additional days to catch up, and to say that my mom was ecstatic to get an appointment after only four and half months would be an understatement. We had also learned that the assisted living facility that she was planning to go to if she could not remain her retirement home did not allow MAID at their site due to religious reasons. The specialist changed my mom’s diagnosis to Progressive Supranuclear Palsy, an even more aggressive degenerative neurological condition that generally doesn’t significantly respond to any treatments. Two weeks later (a year after her first fall), after some family time with myself and her grandsons and saying goodbye to her buddies, she passed peacefully in her armchair in her retirement home with all her “marbles.”

I am so grateful to those who got us to this point with MAID as an end-of-life option, and those who support and provide MAID. I look forward to the day when advance requests can be honoured, so that patients on track 2 who lose capacity to consent after their application, and any competent person who develops a condition in the future for which they would have wanted MAID if they were capable of consent for MAID, can have that choice. I hope that health care providers initiate more conversations with patients about MAID, and that people have the information they need to talk about it, preferably before there is a pressing need.