MAiD in heaven

Judith MacLachlan knew what she wanted in her life and set out to get it. She sounds like the kind of woman I would have liked to have known.

Her son-in-law, Noah Richler, describes her as having lived a life of “deliberate choices,” and her death was no different. In his Globe and Mail opinion piece about the importance of medically assisted dying, he writes:

“I’ve seen what a good death looks like. I hope MAID’s future looks the same. My mother-in-law ended her life on her own terms, as the woman we knew and loved. There need to be safeguards so that no one forces such choices on others.”

Time to go

Judith had a terminal illness – multiple myeloma – and it was worsening. The drugs were no longer doing their job, and she wasn’t interested in more treatments. She qualified for a medically assisted death and had decided to have one. A fall that broke her hip speeded up her plans but didn’t change her mind. She died, as she wanted, at home, surrounded by family and friends, wearing her favourite blue turtleneck, having enjoyed her afternoon glass of sparkling wine until the end.

Richler’s ode to his mother-in-law is also a call to all of us to defend medically assisted dying.  He’s right to be worried. Already, we have seen the Liberals delay until after the next election implementation of an expansion of the legislation to allow those with a mental illness to choose MAiD. They claim it is to allow time for further study, but as there has been plenty of that already, the delay seems more about not losing votes.

A delay is as good as sending the proposed expansion to the legislative graveyard: Pierre Poilievre– likely to be the next prime minister — is opposed to expanding access to MAID and said, when the delay was announced in February that, if elected: “We will revoke an expansion entirely.”

The right to die

While feelings of Canadians about allowing access to MAID for people with mental illnesses are mixed, there seems to be a clear constitutional issue on the table. As Jocelyn Downie, professor emeritus in the faculties of law and medicine at Dalhousie University and an internationally recognized expert on MAiD, wrote last month:

“The current law limits the Charter rights of people with mental disorders. It restricts their ability to choose to end their enduring and intolerable suffering caused by a serious and incurable disorder with the assistance of a physician or nurse practitioner (violating their section 7 Charter rights to liberty and security of the person).”

Planning ahead

Those of us who hope for an expansion of MAiD to include advance requests should be paying attention. An advance request is how someone, while competent, can direct that they want a medically assisted death even if they are not competent at that time. In other words, with an advance request—which I have prepared, although it has no legal power at this time– I can say now that, even if I am incompetent later, I want a medically assisted death. (The present law requires people to be competent up to the moment of their medically assisted death, which rules it out for many people suffering from dementia.) Given the opposition of the Conservatives and their leader to allowing MAiD for people with a mental disorder, it seems unlikely they will support the addition of advance requests to the legislation.

As I’ve written here before, my mother has disappeared into her own very small world – a world she would never have chosen – because of dementia. She was horrified at the thought she might live on once her mind had left her, and I am horrified that the law forces her to live with the many indignities and losses of autonomy and privacy that come along with that. I can’t and won’t pretend to know what is going on in my mother’s mind, such as it is, but I do know that she told all of us she wanted us to make sure she didn’t have to live like this.

I also know that this is not how I want my life to end; for me or for the people who care about me. But, without an expansion of MAiD to include advance requests, this is how many of our lives may dribble on, ending not with a bang but a series of, often silent, whimpers.

Dying with Dignity Canada has produced a very helpful brochure about dementia and MAiD, which contains links to some of their webinars on this topic. It’s important reading for all of us.

As Noah Richler wrote:

“We have learned how to extend a life, but less so how to make it worth living. . . .At what point do we understand that a life is no longer worth conserving and what makes it so?“

Judith MacLachlan put it well in the days before her medically assisted death:

“I’ve had a wonderful life – I’m still having a wonderful life – but it’s over!”

That’s the way I want to exit this world.

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