Dying with dignity through MAiD

Experts discuss medical assistance in dying at RIH

Margaret Hall, an associate professor here at TRU, spoke at length about the legal implications of the MAiD legislation. (Wade Tomko/The Omega)

Last Wednesday, members of the Kamloops community were invited to sit in on a panel discussion regarding medically assisted death. The session was the third part in a speaker series focused on health care decisions and hosted by the Royal Inland Hospital.

The discussion follows a Supreme Court decision from 2016 which amended the criminal code to make medical assistance in dying (MAiD) available to all Canadians. Four experts from various professions in medicine and law spoke at the event.

The panel included Jill Calder, the clinical director of Rehabilitation Service for Interior Health (IH) West, an expert in palliative care strategies, Eric Haywood-Farmer, an emergency physician at RIH and a MAiD provider, Lori Seeley, the IH manager for Kamloops South Home Health and Margaret Hall, an associate professor in TRU’s law school who has published extensively on issues relating to law and age.

Hall, who began the discussion, noted that while the MAiD legislation does not create the right to die in Canada, it does create a limited exception for homicide in the most grievous of cases.

“The legislation does not create a right to die, which is important because MAiD gets talked a lot about on television as a right to die,” Hall said. “What the legislation actually does is create a limited exception to the crime of homicide for medically assisted dying where these conditions are met.”

In order to be eligible for MAiD, you must be over the age of 18, be capable of making decisions in respect to your health, must have a grievous and irremediable medical condition, in an advanced state of condition causing intolerable pain and your death must be reasonably foreseeable.

However, perhaps most importantly, MAiD can’t be consented to by another person on your behalf and you have to make a voluntary request without any outside pressure.

“The patient must request MAiD, not a substitute. They have to have a grievous illness and their death has to be reasonably foreseeable,” Haywood-Farmer said. “I can’t tell you the tens of hours I’ve spent in my basement trying to decide if someone’s death is reasonably foreseeable. That is by far the most difficult part of the process as far as decision making goes.”

Despite MAiD being legal in Canada, Haywood-Farmer noted that decisions regarding who should be allowed to end their life are still very difficult, adding that there haven’t been enough court cases to fully guide the system.

Shortly after MAiD was made legal, a B.C. woman, Julia Lamb challenged the legislation’s requirement that says the disease or disability must be incurable. While only 25 and with an intolerable, but not life-threatening illness, spinal muscular atrophy, Lamb claimed not allowing her to end her own life violated her right to civil liberty.

The panel explained that while Lamb’s case is still ongoing it will no doubt set the precedent for similar cases for years to come.

While MAiD is still a contentious issue in Canada, the practice is becoming more normalized as it is often seen as the patient’s right to decide. Both Haywood-Farmer and Seeley noted that MAiD provisions were often a positive experience for all involved. For both the patient and their family, as well as the practitioner, MAiD marked an end to suffering.

“Part of what I enjoyed about being a MAiD provider is that the patient is in the driver’s seat,” Haywood-Farmer said. “Part of that is because the patient likely hasn’t been in the driver’s seat for a long time, undergoing various treatments like chemotherapy and pain they can’t control. This gives them a modicum of control.”

MAiD also gives patients a time and place for when they want to end their life as well.

“One patient I had wanted to sit out on his deck while it happened and watch the sun go down,” Seeley said. “It was a very positive experience for him and because of that it was a positive experience for the nurse involved as well.”

Calder added that while it is important to offer your patient a full spectrum of care, palliative or otherwise, doctors must always be their patient’s advocate and note that MAiD is an option.

“It is important to offer a full spectrum of care, but also not to be afraid to talk about MAiD,” Calder said. “It’s just another tool in your toolbox. I don’t have any issues with it, it’s the patients personal choice.”