A year in review: Access to choice after Bill C-7

On Thursday, December 16, 2021, CEO Helen Long presented a year in review – the last webinar of the year! During this webinar, audience members learned about Dying With Dignity Canada’s accomplishments in 2021 and the challenges and opportunities that lie ahead in 2022.

What were the major accomplishments in 2021?

Ensuring eligibility and access to assisted dying through legislation that complies with the Canadian Constitution and the Charter of Rights and Freedoms.

The passage of Bill C-7 on March 17, 2021, was a huge step forward for end-of-life rights in Canada.

Included in Bill C-7 was the removal of the ‘reasonably foreseeable death’ clause lead by both Nicole Gladu and Jean Truchon in the ruling by the Quebec Superior Court in 2019.

Another significant change in Bill C-7 was the addition of the waiver of final consent, also known as Audrey’s Amendment, prompted by Nova Scotia’s Audrey Parker who set the date for her MAID provision earlier than she wanted because of the fear of losing capacity and the ability to consent on her final day.

Bill C-7 also included the following important changes:

• A second track for those whose death is not reasonably foreseeable.
• Witnesses reduced from two to one and a witness can be a personal or health care worker
• Mental illness as a sole underlying condition excluded until 2024.

Supporting people, their families, caregivers and health care providers as they explore end-of-life options.

At Dying With Dignity Canada, we saw an increase in the need for our support services including inquiries about MAID support, witnessing and navigation. We anticipate this trend will continue with the changes we plan to advocate for in the near future.

Leading education on Advance Care Planning, patient education and end-of-life options including medical assistance in dying.

We stepped up our online education, due to COVID, and we saw an overall 25% increase in attendees to our webinars at both the national level and locally through our Chapters.

You can view many of our webinars from 2021 on our website here.

We released an updated version of our Advance Care Planning Kit, which is available, for free to everyone, on our website here.

Operational excellence

• Enhancing relationships and collaborating with Chapters
• Improving our stewardship and development activities to ensure sustainability
• Marketing and communications efforts that promote and support our activities
• Proactively engaging with media on the topics of assisted dying and end-of-life options.

What did we hear most from DWDC supporters in 2021?

Can I make an advance request for MAID?

The short answer is no, but this issue will be considered in the Parliamentary Review of MAID that we anticipate will be reconstituted in 2022.

Can a person with a severe mental illness access MAID?

If your sole underlying medical condition is a mental illness, you are not eligible to receive medical assistance in dying. This exclusion will remain in effect until March 17, 2024; in that time an Expert Panel on MAID and Mental Illness will review this issue and recommend protocols, guidance and safeguards. The exclusion was put in place to allow the government the opportunity to prepare and make sure the right measures are in place when the exclusion is repealed. Neurocognitive conditions, including dementia, are not included in the exclusion for MAID. The exclusion refers primarily to psychiatric conditions.

Can a person with dementia access MAID?

Some people with dementia can access assisted dying as long as they satisfy all the requirements laid out in the federal law. This includes the legal requirement that MAID assessors would determine whether or not they meet the criteria.

What will DWDC be working on in 2022?

1. We will continue to focus advocacy efforts on the Parliamentary Review including advance requests, mature minors and those with a mental illness.
2. We will work to reduce or remove exemptions for publicly-funded healthcare facilities who opt-out of providing MAID on their premises.
3. We plan to expand both our support and education efforts including to create new online, digital and print resources.
4. We will continue to collaborate with our local Chapters on education and support activities, as well as reinvigorate and initiate new Advisory Councils to help shape our work and advocacy efforts.
5. We will improve our stewardship efforts and supporter recognition.
6. Our new website will launch in early 2022. This site will be more accessible and bilingual to bolster our efforts to be more inclusive.
7. We will respond to and engage with the media more proactively and work to regularly correct any misinformation we see about end-of-life choice.

In summary, we are feeling optimistic about the future based on the accomplishments of the past year and the plans we have for the year to come. We would like to thank everyone who contributed to our work in 2021.

… everyone for being here today. Let’s get right into it. And we’re going to start; Helen, thank you for coming. So, to start, can you give us a brief recap on the last year and what stood out for you in terms of major accomplishments? 

Yeah, for sure. Thanks Nicole. And thanks every everyone for being with us today. We did get a number of questions in advance, so we went… I went to the… took the time to put a few slides together. So in some cases we’re going to run you through a few slides as well as just answer the questions. So, 2021, I think, as we all know, there were a lot of really great accomplishments this year. And when I say, for all of us at Dying With Dignity Canada, I mean all of you; our supporters, our volunteers, our stakeholders, our team, our board members, everyone who’s been involved the work we do. And I want to recognize each and every one of you for the time and effort and resources that you commit to our cause. So I think we all would recognize most significant accomplishment in 2021 was the passage of bill C-7 on March 17th. 

And I know if you were with me, you would all be clapping and sharing. So what drives that kind of change and what drives almost all of the work we do is the people that we hear from and support and the people who are at the heart of this issue. So I want to recognize a couple of individuals who are really instrumental in making bill C-7 a reality, helping to ensure eligibility and access to assisted dying through legislation that continues to comply with the Canadian constitution and the charter of rights and freedoms. So, first off, this is Jean Truchon and Nicole Gladu. 

In 2019, Quebec superior court justice, Christine Baudouin struck down bill C-14’s reasonably foreseeable rule restricting access only to those who are at end of life. And these restrictions were ruled to infringe Jean Truchon and Nicole GLadu’s section seven charter right to life, liberty and security, and also to violate their section 15 right to equal treatment. So here’s what Nicole Gladu had to say following the announcement of the court ruling. 

… myself. May I rely on you to take advantage of this federal election campaign to ask, not the government, this is an abstract concept, but the parties, the leaders and the candidates of all party to commit themself to change the law that Justice Baudouin just label as unconstitutional, the constitution… 

So thanks in no small part to the commitment of Jean Truchon and Nicole Gladu, and to all of you who heard this request and this call for action and engaged with MPs and candidates in 2019. C-17 was passed or C-7 was passed, sorry, removing that reasonable foreseeability clause. Many of you will recognize Audrey Parker. The other significant change that came out of bill C-7 was not driven by that court decision. It was actually driven by the courage and determination of Audrey, the support of people like you and the compassionate commitment of parliament. And here’s what Audrey had to say to Canadians. 

I’m asking you to speak out for the rights of suffering Canadians, who like me have already been assessed and approved for medical assistance IN dying, or we call it MAID. I am grateful to live in Canada, a country where I can choose my death, but the law has forced me to play a cruel game of chicken. I would like nothing more than to make it to Christmas, but if I become incompetent along the way, I will lose out on my choice of a beautiful, peaceful, and best of all, pain free death. That is why I’ve decided to leave this week on November 1st. No one should have to face a decision like this. People like me who’ve already been assessed and approved are dying earlier than necessary because of this poorly thought out law. 

So, thanks to Audrey, and again, to the Canadians people like you who rallied to speak to their members of parliament. Bill C-7 included Audrey’s amendment, and that allows Canadians who have been assessed and approved and have set a date for their MAID provision to proceed, even if they lose capacity in the meantime. So in addition to those two major changes, bill C-7 also brought in a few additional changes to the MAID process that I think it’s important to note and recognize. I’m not going to read through them, but changes around witnessing and the process. 

So, the success of bill C-17 also led to increased inquiries and interactions with our support team. So Kelsey and her team, Nicole and Samantha, within the year following bill C-7, the nine months, we doubled the number of people that we supported, both patients and loved ones. And that was both individuals calling us, but also the number of interactions we had with them. So with the change that we’re going to continue to advocate for in the years ahead, we anticipate that this trend will continue. Because of some of those changes to the witnessing requirements, we actually had volunteers who were required to witness less frequently, but the number of requests was actually slightly increased from 2020. 

On the education front, we continue to deliver both nationally and at the chapter level. So with COVID continuing to limit in-person opportunities, we stepped up our online presence and we had a resulting 25% increase in attendees to webinars across the country. The chapters also provided a wide range of webinars on a variety of topics. And you can view many of the webinars from 2021 on our website, dyingwithdignity.ca. Just click on the education tab. We also released very early this year an updated version of our advanced care planning kit, which is also available online or by contacting the office. 

We continue to focus efforts on improving our overall organizational excellence. So this included developing and providing chapter policies, processes, resources and supports for our volunteers, continuing to maintain financial growth and stability despite the pandemic and the impacts on the economy, and creating a revitalized and, but still recognizable DWC brand. So, improving marketing and communications materials and continuing to proactively engage with media on the topics of assisted dying and end of life. We’re always moved by the engagement of people and the stories that they tell and all of the supporters we have in various areas. 

So this slide really just shows the tens of thousands of Canadians that were involved and engaged in our work this year, and the many, many stories that we shared, how many of those were personal stories, stories that speak to Canadians and sent them to really get involved to with our cause. So, thank you to all of you, thank you for the work you do and the support you give us and for these accomplishments, which only come about because we have so many wonderful people behind us. 

Thanks Helen for that detailed overview. So our next question for you is what word or words would you use to describe this past year? 

Yeah, that’s a good one. Challenging, busy, grateful, frustrating, successful, heartwarming, fun, sad and joyful. We always struggle, I think, internally, and I’m sure many of you do as well with the balance between the serious and sadness of what we do, versus the relief and compassion and care that it provides to people. So, I think the most important word as we’re leaving 2021 is optimistic; how we’re feeling about where we’ve got to this year, how successful we’ve been and how much we have to look forward to achieving in the days ahead. 

Thank you. Next question for you is what challenges, if any, did we, the organization, face this year in 2021? 

Yeah. Certainly like everyone, COVID. I think, as many of you know, I’ve been here almost two years now. Time flies. But many of our team were new and I was new to this space. So, just getting to know each other and remaining connected virtually. Everyone’s a little tired of zoom these days, so that’s been a challenge. I think making our voice heard in a competitive landscape, there’s a lot going on in the world. COVID inflation, climate change, just to name a couple. So, continuing to keep the attention, not only of Canadians, but also parliamentarians at times can be challenging. I think this year, more than ever, being inclusive. 

Continuing to make intentional steps that ensure that the voice and perspectives of all Canadians and all communities are included in the work we do. And finally, always volume. There’s so many aspects to end of life choice that can be looked at and worked on. It’s really important to remain focused and I think a challenge is making sure that you stay focused on what you’re doing and don’t go off into all of the other areas that are interesting and exciting and provide opportunities. 

Thanks. Yeah. It is hard to stay focused sometimes, but I think we did a good job. Okay. The next question I have for you is, what did you hear most from Dying With Dignity Canada supporters in 2021? 

Yeah. So we hear a pretty wide range of questions and concerns and suggestions and ideas. We picked a few themes that I think really stood out this year that I’ll share with you. So, the number one question, the thing we get asked most often is, can I make an advanced request for MAID? An advanced request is a request that can be honored at a later date, given a specific health state, and after the capacity to make medical decisions is lost. And the short answer to that question is, no, you cannot. So currently in Canada, advanced requests are not legal. This is the number one issue I would say of importance as well for our supporters, in particular from those who have a family history of dementia, or similar conditions. 

Advanced requests are something that we’ll be setting during the parliamentary review, and I would speculate that that will begin sometime in February or March following parliaments resuming after the holiday break. Important to note, and we’ve shared this image on social media a few times, it’s on our website, but an advanced request is not advanced consent, which is currently part of the self administered MAID process, and it’s also not the waiver of final consent or Audrey’s amendment, which is part of bill C-7, and we’ve talked about a bit. So, advanced request, no, hopefully in the future, I’ll be able to tell you the answer is yes. 

So another question we hear regularly, and I think in large part because of bill C-7 is, can a person with a severe mental illness access MAID? The answer to that question is, if your sole underlying medical condition is a mental illness, you are not currently able to access MAID. And this exclusion will remain in effect until March 17th of 2023 at which point it will be automatically repealed. There’s currently an expert panel on MAID in mental illness that was formed coming out of bill C-7, and that panel is looking at protocols, guidance and safeguards for MAID for those with a mental illness. The review and the temporary exclusion is intended to allow the government the time to prepare and ensure that the right measures are in place prior to that March 2023 deadline. 

Helen, can you tell us what will happen in March of 2023 regarding choice for mental health issues as a basis for MAID? So, will, the main question is, will it be available? 

Yeah. So, unfortunately, we can’t really say for sure. We know that something will be available. That’s what the work of the expert panel is going to help to inform. It could be a legislative change, it could be practical safeguards. It could be a combination of the two. It could be something else. It’s really premature for us to comment on what that might look like. And while I understand that this is frustrating for those who have an interest in this space, it is a very sensitive area. And I think we want to take a lot of care with it. We’re looking forward to seeing the expert panels’ conclusions around MAID requests, which we hope to see later this spring, so that we have some sense of what they’re recommending for that very, very small number of Canadians who may be able to apply for MAID under this criteria in the future. 

Thank you for clarifying that. And then so what about dementia? Have any legislative changes been made to include demand patients in MAID? 

Yeah, so that’s a great question, Nicole, and that’s also one we hear pretty frequently. It’s really important to be clear that neurocognitive disorders, including dementia are not included in that exclusion from MAID. The exclusion relates primarily to psychiatric conditions such as depression or personality disorders. So, no legislative changes have been made or are required to include individuals with dementia who have capacity to make decisions; make medical decisions in regards to MAID. 

Okay. But what about now, can someone with dementia qualify for assisted dying? 

Yeah, so some people with dementia can access assisted dying. The eligibility criteria might limit the circumstances in which you could be eligible. A person with a capacity eroding conditions such as dementia might lose capacity before they satisfy one or more of the eligibility criteria. So for example, they may lose capacity before their suffering becomes intolerable, and as such, they would not be eligible for MAID. By the time the person reaches that state, they may no longer have capacity to provide consent. So, while the waiver of final consent does provide some room for individuals with dementia to have an assisted death, and there are assisted… there are people who will meet the criteria. Not every person today will be eligible for an assisted death. 

Thanks Helen. So, thanks for clarifying those areas. They are our most common questions we get from supporters. I know from talking to so many of you all the time, and if you ever need clarifications about advanced requests or MAID in mental illness or anything that we’ve talked about or just highlighted, you can always reach out to support@dyingwithdignity.ca, and Samantha can throw that email address in the chat for everyone. So, let’s switch gears a little bit. Can you talk to us about what Dying With Dignity Canada will be working on in 2022? 

So many things. We’ve got a lot of plans for a full year ahead of us. So, building a lot on our work in 2021, obviously. We’re going to continue to focus advocacy efforts on the parliamentary review. And in particular, as we’ve talked about, advanced requests and MAID for those with a mental illness. Those are two of your top priorities. We’ll can continue to ask you to write letters, to meet with your MP, to communicate about how you feel and what you want to see as this, the process evolves for those. We’ll also be doing some more work to ensure access for Canadians specifically around reducing or removing the current exemptions that allows some publicly funded healthcare facilities to opt out of providing MAID. Our chapters in BC started a program about six weeks or so ago in British Columbia to start that ball rolling. 

And we’ll be launching a bigger plan early in 2022 to speak specifically to that issue. We’re going to continue to expand both of our support and education efforts, so more Canadians are able to access the information and supports that they need at end of life, not just around medical assistance in dying, I know because of the legislative change that’s really become the big thing that we talk about and people ask us about, but we are looking at a broader range of end of life choices. We’re going to continue to work closely and even more collaboratively with our chapters and volunteers across Canada, and we’ll be reinvigorating and creating some new advisory councils in early 2022. 

So look for those opportunities early in the year if that’s something that is of interest to you. On the development or fundraising front, we’re going to continue to improve our stewardship efforts and our turnaround times. We’re so grateful for your contributions. We really are, and obviously they help us do the work we need to do. So we want to make sure that we’re demonstrating that appropriately and in a timely manner. 

So really making some steps to improve our work in that space. We’ve got a great new website coming in early 2022. I think we’re all pretty excited about that, much more functional, clean, easy to access, and lined up with our new brand. So excited to see that come to fruition. And we’ll also be increasing and improving our efforts to produce more accessible, more diverse, and more inclusive materials, including more materials in French this year. And of course we’ll continue to work with the media. So being more proactive, responding to inaccurate or misinformation whenever we can. And that’s somewhere where we’re always happy to have your help. A letter to the editor from a community supporter is often impactful. There’s a lot on the list and it’s going to be another busy year, I think. 

Thanks, Helen. Yeah, it looks like a busy year ahead. I’m excited. And I think you are too. So now we’re going to open it up quickly to some audience questions. So anyone who has a question please feel free to pop it in the Q and A function at the bottom of your screen. And while we get some questions coming in, Helen, we got one about the expert panel. And if you can explain who sits on the expert panel for MAID and mental illness. 

Yeah, so the expert panel was formed as I said, coming out of Bill C-17. It was pretty much, it’s a responsibility under the Minister of Health and they had gone through a pretty extensive process. I don’t know all the details, but I know that we were asked to make recommendations of people that we thought might be appropriate. And I’m sure other agencies were asked that as well. And they ended up with a group of I believe there’s about 13 or 14 experts, a number of psychiatrists, people who have experience with MAID specifically at least one individual, some academics, a pretty broad range, but a great level of expertise. So I don’t know, Nicole, if we can find the link. If you Google expert panel on MAID and Mental Illness, the website will come up and there is a full listing with biographies of all of the members of that committee. 

Thanks, Helen. And if anybody wants that, Sam is maybe looking for the link. Maybe Kelsey can look for the link if you don’t find it on Google. Again, our email address is in the chat, support@dyingwithdignity.ca, so feel free to shoot us a quick email and we can send you the link to that expert panel if you’re interested. Okay. Let me see if we have any more questions, oh, Kelsey popped that in the chat. So thank you, Kelsey, for that. 

Yeah. Maybe just to add, Nicole, while you’re looking for questions. So that panel did continue to meet because that is not a parliamentary panel. It did continue to meet over the break and through the election and is still meeting now. And it’s my understanding that we should see something from them, hopefully in line with the original March 22 deadline. But if not, I think it will still be next spring. So, that’s where they’re at. 

Thanks. Okay. We have a question here, are there enough providers across the country to meet the needs and requests for MAID? And it’s kind of a part two. And the second part is, how can we help to ensure access to providers? 

Yeah. So that’s a little bit of what I like to call a, how long is a piece of string, question. Could we use more? Absolutely. I think that the assessors and providers that we have in Canada, the doctors and nurse practitioners, they’re amazing individuals who go above and beyond and they will do literally anything they have to do in order to make sure that people are assessed and provided for appropriately and in a reasonable timeframe. That said, are there times when a specific geographic area may have a challenge with having someone available or having enough people available at a point in time? Yeah, absolutely. That has come up. It’s our hope and we held a webinar earlier this year as a bit of a introduction to MAID for practitioners. 

It’s our hope that more assessors and providers will continue to step forward. I think as awareness of medical assistance and dying increases, I had a personal experience recently where an individual went and wanted to find about MAID, and he talked to his general practitioner and the general practitioner said, well, I’ve never done that, but I think I could be an assessor. I’ve been your doctor and let me look into it. So I think the work of CAMAP, the Canadian Association for MAID Assessors and Providers and our work around education and just general knowledge expansion, hopefully will continue to see those numbers rise and to see people be available. 

And what you can do, I think it’s just continuing to talk about MAID. And if you do know doctors or nurse practitioners, clinicians who might have an interest, be sure to point them to us, point them to CAMAP, it’s always great to have more. The healthcare system is as you all know, overburdened. But I have to say our assessors and providers have done an amazing job making sure that everyone’s been taken care of especially during the pandemic. 

I echo that as well. Okay. So now we have a question. This is more a point of clarification. So we talked about advanced requests as part of the ongoing parliamentary review. And then we talked about MAID and Mental Illness and the expert panel. So now we have a question, is an expert panel being formed for advanced requests? Can you just clarify how that works? 

Yeah, not that I’m aware of. Certainly something could be happening, but not that I’m aware of. And quite honestly I’m just speculating here, I don’t anticipate that that’s how they would make manage it. I think what will happen after the break is they will form hopefully another special joint committee. So a committee of both the House and the Senate and that committee will examine all of the areas under the parliamentary review. There’s actually five of them, including advanced requests and MAID for those with a mental illness as a sole underlying condition. And then through that process, I would anticipate that they will ask experts to come to committee and speak or provide submissions. They may form a panel or a group to talk about that specific area, but nothing, I haven’t even heard a rumor of that at this point. So I would expect that process will much more follow the, I would call it the regular process of a parliamentary committee much like Bill C-7 did. 

Thanks for clarifying that. Lots of questions coming in about MAID and Alzheimer’s and dementia, which is one of our most common topics that we hear about. So maybe we can just go back to that for one second. And folks are asking if you know, and I know that it’s hard to say because everyone’s situation is unique, but criteria around a person with a dementia diagnosis or Alzheimer’s diagnosis who wants to be able to access MAID. Do you want to just speak to that a little bit more? 

Yeah. Maybe a teeny bit, although Nicole, I would almost defer to you to some extent. I think, what I can tell you and I will remind people, there is a lot of information. We did a webinar specifically around this. We’ve got a list of FAQs that include some information on dementia, maybe in the follow up email we can send some of those links, but there is quite a bit of information on our website. Ultimately, anyone with dementia must still meet all of the eligibility requirements that are in the general MAID eligibility outline. 

So they have to be 18 or over, they have to have a disease or diagnosis or a condition that’s eroding. They have to have intolerable suffering. All of those criteria must be met, and they must have of the capacity to make medical decisions. So as Nicole pointed out, these are case by case by practitioners. I’m not a clinician, but you would have to meet both the MAID eligibility piece and you would have to retain your capacity to make a medical decision. That’s really the criteria. I don’t know, Nicole, anything to add to that? 

No, I’ll just echo what you said and that if anybody has a more personal question, I’m also not a medical professional, but I can help explain the law around this in more detail. If you want to email me, support@dyingwithdignity, or you can call us and I’m happy to have a conversation, but like Helen said, it does come down to everyone’s situation and their medical history and a full review of that when they meet with a doctor or nurse practitioner. So happy to explain what the law says around that in more detail for anyone who’s interested, but it is a case by case. But this is one of our most common questions. So I’m familiar with talking to people about it. So, if anybody wants to chat don’t hesitate to reach out. 

And I’m happy to chat with anybody who needs some more information. And the website also does have a lot, but I know sometimes that can be a lot. So one more question, Helen before we move on here and for anyone whose questions we didn’t get to live today reach out to us, support@dyingwithdignity.ca and I’m happy to answer any questions or connect with Helen to get your questions answered if we didn’t get to them today. So just a quick question. You had mentioned some improvements around French language on the website for next year and resources. And is there somewhere people can go now, is there a French counterpart to Dying with Dignity, Canada? I know we do get some French requests in, not too many, but do you know of anywhere that these folks can go if they have questions? I was thinking AQDMD. 

Yeah, there is an organization called AQDMD. They are based in Quebec. We refer to them as our French sister. So certainly if you are French speaking and you’re in Quebec, the information that they have would be very relevant for you. I know they’re also happy to speak to other French speaking Canadians, but the resources on their site are fairly specific to Quebec. So if you’re in New Brunswick, for example, and a French speaker, you may not be able to get as many details around the New Brunswick process in French from AQDMD, but certainly they’re happy to help and feel free to reach out to them. 

Okay. Thanks Helen. And sorry, I lied. We have one more before we move on. A lot of people wanting to know, okay, we know what’s happening with the law and what’s going on. As an organization specific to advanced requests, what are we doing to drive that forward? Is there anything you can speak to? I know you mentioned some of our plans for 2022, but anything specifically around advanced requests? 

Yeah, sure. So, yes, as people know, there is a parliamentary process, and I think we were fortunate last year to see Bill C-7, despite the stops and starts and the time it took, the process did work and we did see two hugely significant changes to the law that are helping Canadians. So when it comes to advanced requests, we’re kind of waiting for the committee to be formed, parliament resume. They have a lot of, I would call it housekeeping to do establishing the regular committees. I understand the prime minister has just released the mandate letters, things like that. So we do anticipate they’ll do that. In the interim, we are running a couple of letter writing campaigns. So asking you to tell parliamentarians as we did during the election, that advanced requests are what’s important to you. 

This is the work you want them to do. We’re having meetings. I’ve met recently with [Boseman] and Minister [Almedi] and Minister Qualtrough’s office to talk about what we’d like to see, when are we going to see that? What does that look like? Those meetings and meetings with other MPs are part of that bigger process. We’re preparing background materials. So when the committee is formed, we’ll be able to write in with our position statement, what we want to see, experts that we have both professional experts, but also lived experience experts. People who can speak at committee if necessary or contribute to a submission. We’re continuing to post blogs and social stories that again, raise awareness about this issue with people across Canada, so they can then write a letter or they can become part of the process. We’ve got a kit, I believe it’s posted on the website, or we’re just finishing up saving it from the election, but it’s a kit that you can use to have a meeting with your own MP if you want to do so. 

And talk to them about the changes you would like to see around advanced requests. And then continuing to work with like-minded organizations and individuals. Senator Wallin for example, was very engaged in the advanced request discussion. And we have an ongoing relationship with her. So continuing to talk about what else can organizations like ours and people like you be doing to move these forward. So, I would call it the big advocacy government relations wheel, it keeps turning, and we’re doing all of those things now, and in the next weeks and months ahead as we look to get to advanced requests. 

Thanks, Helen. And yeah, if anybody is ever wondering what they can do to drive our mission and our message forward, feel free to reach out and we’re happy to share links to those letter writing campaigns and contacts for MPs, all those things. So yeah, don’t hesitate to reach out. Again, if we didn’t get to your question, contact us offline and we’ll follow up with you individually. And just to close off our year in review session, Helen, I want to ask, what is the one thing that you are most proud of this year? 

Yeah, that’s one thing, it’s hard to say one thing. I think we had a really successful year and obviously Bill C-7 was huge, but for me personally, I think the thing I’m most proud of and most honored by is just the chance to be part of this organization and this community. The team that I work with is a small, but boy, fierce, committed, loyal, hardworking team who has put everything into the last year to make great achievements. We work with an amazing board of directors who are all personally driven by the work we do. And we get to talk to and work with volunteers, people with lived experience, storytellers, individuals who reach out to us and just become part of the family. So, if I had to say the thing that makes me most proud it’s just being part of this organization and the work that we do and the work that all of you are doing to support us and beside us, as we work to continue to advance Canada as a country that supports Canadians in assisted dying and other end of life choices. 

I think that’s a great way to end it on such a positive note. And thanks again, Helen for chatting with us today and answering all of our questions and thanks to everyone for coming, all of our supporters, not just to this session, but to all the sessions we held all year. And for being so involved with everything we do. I just want to send a quick reminder to sign up for the second half of our conference, Reflections on Death and Dying, which is beginning again in January. So hope to see you all there. And I just want to wish you all a very safe and happy holidays, and we will see you all again in 2022. Thanks everyone. 

Happy holidays everyone. 

Bye-bye.