In Case You Missed It: February 2018

In Case You Missed It is a monthly round-up of news articles and commentaries featuring Dying With Dignity Canada speakers and stories. Did you miss these stories in February?

Less than half of the Nova Scotians who requested medical assistance in dying (MAID) in the last six months actually accessed an assisted death. DWDC Nova Scotia Chapter Chair Sheilia Sperry spoke to CTV Atlantic about the importance of knowing why patients were unable to move forward:

“We'd like to know how many of each, because if some of them lost capacity, why did they lose capacity? What was wrong with the timeframe that meant that they lost capacity?”

Jane Gerster of the Winnipeg Free Press wrote about the anguish patients and families experience when their assisted dying wishes are denied because of a care facility’s religious beliefs. DWDC’s Communications Officer Cory Ruf and Dr. Ellen Wiebe, member of our Clinicians Advisory Council, both commented:

“They’re saying if you want MAID, go somewhere else… but that’s not how we deal with human rights," Wiebe says. "If you’re a publicly funded facility and this is a legal medical procedure, then you have to be able to offer it or allow it.”

Patricia Craig’s biggest fight was to die. Her experience demonstrates how difficult it can be for desperately ill Canadians to exercise their right to MAID. Patricia, who was incapacitated from five chronic diseases and confined to her bed, spoke with The Edmonton Journal:

“[…] if I can help just one person and make the process easier for them, then it’s worth it. Because you have to have an iron will to go through this. And I honestly don’t think that should be necessary.”

Art Grant, constitutional lawyer and member of DWDC’s Legal Advisory Committee, writes about an Ontario court ruling that upheld provincial regulations requiring doctors who oppose assisted dying to make effective referrals.

You can read Art’s analysis of the decision on his blog.

Four lawyers from the firm Borden Ladner Gervais LLP also wrote about the decision and a physician’s duty to provide effective referrals in a Lexology article:

“The Court stressed the importance of the role that physicians play as 'gatekeepers' to health-care services in Ontario, stating that they have an obligation to ensure that their moral and religious beliefs do not hinder their patients’ ability to receive health-care services. The role of physicians as gatekeepers, together with their obligations of non-abandonment and to put the interests of their patients ahead of their own, were significant factors in the Court’s decision.”

Palliative care physician, Dr. Alain Naud, also responded to the Ontario court decision. He wrote an opinion piece for Le Devoir on a physician’s duty to put patients first. (His column is in French, but you can translate the page using this online tool.)

“Medicine is not a religion. Individuals do not embrace this profession to impose on the sick their own faith, values ​​and beliefs, but to listen, understand and respect those of their patients, and to put themselves at their service. The interests of the sick must prevail over personal beliefs.”

Dr. Matt Kutcher, a doctor from Prince Edward Island, spoke to CBC News about his role in providing MAID, which he calls a “profound experience.” Dr. Kutcher’s first involvement with MAID was with Paul Couvrette, who was the first person to access assisted dying on P.E.I. 

“I don't want this to be something that's whispered about, that's hidden behind doors," said Kutcher. "We have a law that governs it. It's regulated carefully. It's done with great care by the people involved in it.”

(You can read more about Paul’s story here, as written by his widow and DWDC volunteer, Liana Brittain.)

Dr. Jonathan Reggler, chair of our Clinicians Advisory Council, wrote a letter to The BMJ about why assisted dying should be legal in the United Kingdom. In his response, Dr. Reggler provides valuable insights from his experience as a MAID provider in Canada:

“There is the belief that patients will distrust their physicians because we are supposed only to help prolong life; in fact, most patients are pleased to learn that we are more interested in their well-being and their autonomy than in our own rather narrow view of the role of the physician at the end of life. I get thanked on a weekly basis for being involved in providing MAID.”

John Schreurs did not qualify for a medically assisted death under Canada’s assisted dying law. As a result, John and his family had to go to incredible lengths to ensure he had control over his own death. His wife, Erin, spoke to CBC Radio’s Out in the Open about her husband’s choice to travel to Switzerland to access MAID:

“He didn’t want to die. But he didn’t want to live with Huntington’s more.”

DWDC’s former CEO Wanda Morris wrote about her friendship with Katherine, a DWDC volunteer who was forced to access her assisted dying wish in Switzerland because she did not qualify at home.

“I still mourn her loss. But mostly I regret that she died too soon, and that she died, alone, in a foreign country. Katherine’s last act was to travel to Switzerland for an assisted death. Even though Medical Aid in Dying had been legalized in Canada, it didn’t protect her.”

The Fraser Health Authority in British Columbia has taken a strong stance on medical assistance in dying in response to the Delta Hospice Society’s refusal to allow MAID in its hospices. As reported by Global News, Fraser Health’s board chair Jim Sinclair said hospices are obligated under the Canada Health Act to provide MAID if a person requests it.

“The right to a medically-assisted death is a step forward, not a step backwards.”

An Ontario woman, Sonia Perna, spoke to the Ottawa Citizen about her father’s life and end-of-life choice. While initially against her father’s MAID choice, Sonia had a change of heart when she saw her father’s rapid decline. Now, she looks back at his decision with pride.

“I’m proud of him. I think it’s beautiful that he allowed me to be there with him going through this, and I think that’s a father’s true love.”

This Hamilton Spectator piece on one woman’s journey with grief after her mother’s medically assisted death is incredibly insightful.

"In some cases, family members may have difficulty with their loved one's choice. So there is some distress with supporting it, but it is the same distress as when a loved one decides to stop chemotherapy or to go off dialysis. Any decision to shorten a life, family members often struggle with."

A psychiatrist wrote about depression and MAID for Healthy Debate. While terminally ill patients are often depressed, he wrote, that doesn’t mean they’re incompetent.

“Depression does bias a person’s outlook, but bias is not the same as mental incompetence. Doctors have to balance the need to protect patients in vulnerable mental states from exercising poor judgment against the need to respect their autonomy.”

Doctors who provide assisted dying in Quebec say a new initiative by the province’s Commission on End-of-Life Care will create heavy administrative burdens for them. Le Devoir reports:

“It’s almost an inquisition. It ends up having a deterrent effect.”

(Article is in French)

In this Letter to the Coast Reporter Editor, a woman whose husband accessed MAID writes about the “amazing right” of assisted dying.

There is no turning back the clock on certain diseases. The time is here to open the door wide for discussion about this gift of MAID that we have for ourselves and for our loved ones when it’s our turn to go from incurable and devastating conditions. "

This Letter to the Rocky Mountain Outlook Editor was written in response to a local hospital refusing to allow assisted dying on-site.

“This isn’t a matter of hoping no one asks. It’s a matter of when. And when a patient cannot be transferred for this procedure, we are denying them their wish to die with dignity.”

Alain Michaud, 56, was diagnosed with ALS last April and chose to end his suffering with MAID in January. His wife spoke to Le Journal de Québec about his choice. (Article is in French.)

“It went so smoothly. I would be inclined to say that it is the ideal death.”

Missed January's In Case You Missed It? Click here.

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