“I’m good to go”

Seventy-one year old Joan Williams had a medically assisted death in late September, after living with a degenerative neurological disorder for more than 20 years. She died in her home, with her family by her side.

In a conversation with CBC Radio shortly before her death, she reflected on her rich and full life, even during her illness. However, in the past year, her condition had deteriorated significantly, and by September she decided she was, in her words, “good to go.” The migraine headaches,  neuropathic pain, double vision, muscular weakness and problems with balance and coordination had become too much, especially once she developed difficulties swallowing and was limited to a liquid diet.

Her son admits his mother’s wish for MAiD was initially difficult, “but, as I thought more about it , , , it became clear that it was really in her best interest. . . .”

Joan wanted people to know that she had no doubts:

“I want people in the community to know that medical assistance in dying is a wonderful thing. That if you’re struggling at the end of your life, you can take MAiD and put MaiD into effect and shorten the agony of your disease.”

Not such dignified final days

Katherine’s husband is not in such a fortunate situation. (Both Katherine’s last name and her husband’s full name are protected by court order to maintain their privacy.) The husband sought MAiD because he has a number of serious, ongoing health conditions, including end-stage obstructive pulmonary disease. He met the criteria set out in the Criminal Code and was approved: he has a “serious and irremediable medical condition,” his death is “reasonably foreseeable,” and he had the capacity to provide informed consent.

However, his wife did not agree with his decision and sought an injunction to prevent her husband from accessing MAiD on the basis that he is a hypochondriac and lacks the mental capacity to make this decision.

There have been a number of court proceedings, the most recent of which refused Katherine’s application, thus clearing the way for her husband to proceed with his medically assisted death. However, Katherine is determined to stop her husband from making this choice and appealed this decision to the Nova Scotia Court of Appeal. The case has been argued, and the Court has reserved its decision. In the meantime, her husband waits.

“He won’t talk to me”

Among the arguments put forward by her lawyers was the claim that medical opinions about the man’s health differed and that “there is a serious risk that a man could effectively [be] put to death in circumstances where he lacks capacity.”

The husband’s lawyers argued that Katherine has no standing in the case and that adequate safeguards exist in the legislation.

While the Court of Appeal has committed to making its decision as quickly as possible, Katherine’s husband is forced to remain alive, in pain as well as in a terrible conflict with his wife of many decades, from whom he has now separated. It is hard to imagine anything more tragic.

Autonomy and freedom of choice

It is to be expected, even though Canada’s MAiD legislation is now four years old, that court cases will continue to be part of shaping and refining what the words of the law mean.

Such was the case when federal Justice Minister David Lametti introduced Bill C-7 to Parliament in late February, in response to a Quebec case that sought to broaden the availability of MAiD.

Bill C-7 seemed to address the issues raised by that case and to reflect the opinions of more than 300,000 people who responded to an online government survey about MAiD.

However, first the pandemic and then the Prime Minister’s prorogation of Parliament have slowed and then stopped Bill C-7.

Happily, Lametti reintroduced Bill C-7 on October 5th. The changes proposed in the Bill would remove the requirement that the person’s death be reasonably foreseeable and allow MAiD for those whose death is foreseeable but whose medical condition might mean they lose the capacity to consent before their medically assisted death can be carried out.

In a statement, Minister Lametti noted:

“The COVID-19 pandemic has posed unprecedented challenges for all Canadians. This includes the disruption of the legislative process to review the proposed changes to Canada’s MAiD legislation. We understand MAiD is a deeply personal issue that touches individuals and families. The government of Canada remains committed to making the necessary changes to the federal MAiD legislation. This is why we have reintroduced these important proposed amendments, which aim to reduce suffering while also supporting individual autonomy and freedom of choice.”

Bill C-7 will not fix all of the problems with the current MAiD legislation, but it will be an important step forward and, regardless of what the Nova Scotia Court of Appeal decision may be, should ensure that people like Katherine’s husband have true autonomy and freedom of choice when making end of life decisions.

Show your support for Bill C-7 by signing Dying with Dignity’s letter.

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