Track 2 MAID cases: Insight from Dr. Eric Thomas 

News & Updates | February 9, 2024 | Sarah Dobec

Home / News & Updates / Track 2 MAID cases: Insight from Dr. Eric Thomas 

Dr. Eric Thomas is a former family physician and now a full-time MAID assessor and provider in Stratford, Ontario. We spoke to Eric about his experience with Track 2 MAID cases and some of the misconceptions and misunderstandings that are associated with them.

“I’ve always been interested in the subject of death and dying and palliative care; I followed stories about Jack Kevorkian, Sue Rodriguez, whose case was widely publicized in 1993 until her death in February of 1994, and eventually the Carter case. When the law changed in 2016 to include assisted dying, I made myself available for MAID assessments and provisions, recognizing that there wasn’t much structure in place at the time.” 

Track 2 refers to the procedural safeguards applicable to a request for MAID made by a person whose natural death is not reasonably foreseeable. Previous to the passage of Bill C-7 in 2021, MAID was only available to those whose death was reasonably foreseeable. The changes to the law came about because of advocacy and legal challenges in Quebec by people with disabilities, specifically Nicole Gladu, who lived with an incurable degenerative disease called post‐poliomyelitis syndrome, and Jean Truchon, who lived with cerebral palsy. In the end, Quebec Justice Christine Baudouin ruled that the law violated the right to life, liberty and security of the person, and discriminated against people with disabilities who aren’t near death. The federal law was amended in 2021, and this gave people who suffered intolerably but whose death was not reasonably foreseeable access to apply for MAID. 

There are an additional set of safeguards for Track 2 MAID cases including: 

“Before Bill C-7, I did see a few cases where people were credibly suffering but their deaths were not reasonably foreseeable, so they were not eligible. The addition of Track 2 and the waiver of final consent were important changes to MAID legislation. I’ve made myself available to do consults where there is complex chronic pain for which I have expertise, and these are most often Track 2. These cases are not necessarily more difficult, but they do take more time namely because of the 90-day assessment period and the time needed to gather the full health history and any additional information you need from the appropriate people – physicians, occupational therapists. 

When I do assessments, I approach them in a similar way. I focus on what I call ‘the present disability’ and have an extended dialogue about symptoms using the Edmonton Symptom Assessment Tool, a tool intended to capture what symptoms a person is having and how severe, so we can identify them and understand the individual’s current circumstances.” 

With the introduction of Track 2 MAID cases, there have been concerns that people who do not have adequate social supports are choosing MAID and that their suffering is tied to inadequate services. People are complex and a part of the MAID assessment is to understand the health conditions but also to learn as much about the individual’s circumstances and determine the best course of action. 

“I have certainly assessed people who are disadvantaged, and their circumstances are always a major consideration. I ask questions about what can be done to address their needs from a social point of view, and we do communicate with the agencies if we think there is more that can be done. If a person is found eligible based on the criteria and their irremediable medical condition, then we need to be cautious about not being too paternalistic and allowing them to make their own decision about what’s best for them. To be clear, you cannot be found eligible because of a lack of social services, but this will be part of the individual’s full story. You can’t undervalue the importance of the individual being autonomous and making their own decisions.” 

Misinformation about MAID is common in the media and among the general population. It is improving, but there is work to do. This is why DWDC has a Get the Facts on MAID and a Myths and Facts on MAID page on our website.

“Knowledge about MAID law has certainly come a long way since 2016 especially with more care coordination services across the country. What I would say to people is if they don’t know MAID law, then don’t talk about it. There are plenty of people, professionals and organizations that can offer facts about MAID in most regions.” 

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