Medically-assisted dying: the discussion in Saskatchewan

In order to be eligible for MAID, Canadians must:

be eligible to receive health services funded by the federal government, or a province or territory
be mentally competent and at least 18 years old
have a grievous and irremediable medical condition
voluntarily request MAID without outside pressure or influence
consent to MAID after receiving all information needed to make their decision

The Court declared the “reasonable foreseeability of natural death” criterion in the grievous and irremediable medical condition portion of the criteria to be unconstitutional.

In response, the federal government decided not to appeal the Quebec Supreme Court’s ruling and distribute the survey to adjust MAID in Canada. The court ruling will come into effect on March 11, 2020.

The numbers: federally and provincially

According to the Department of Justice, nearly 300,000 Canadians participated in the MAID survey.

While a summary report on the public consultations will be made available once the feedback has been analyzed, a survey from Leger – a polling firm – found that 86 per cent of the 1,552 Canadians polled agreed someone with a serious, degenerative and incurable disease should be able to request and obtain medical assistance in dying.

The poll stated Saskatchewan is tied with Manitoba for the lowest support for MAID, with only 66 per cent agreeing.

In the Prince Albert riding, an assistant for MP Randy Hoback said they’ve received a few emails regarding MAID, but “it’s been pretty quiet.”

MAID in Saskatchewan

Since Bill C-14 became law in June 2016, Saskatchewan has seen 248 cases of MAID, with each year growing. The Saskatchewan Health Authority said there were 11 cases of MAID in 2016, 57 in 2017, 84 in 2018, and 96 in 2019.

Her life was unbearable, and she had no life _{– David Dunn}

However, not all applicants for MAID in Saskatchewan were eligible.

David Dunn’s wife Cecilia suffered from fibromyalgia – a chronic condition that causes rotating pain in the muscles or bones, areas of tenderness, general fatigue, and sleep disturbances – for over 20 years.

“It got so bad she was bed-bound,” Dunn said. “She applied for MAID so that she could have an assisted death. They rejected that because she wasn’t within six months of imminent death. Her life was unbearable, and she had no life, according to her.

“She took matters into her own hands and took her own life.”

Cecilia passed away in her and Dunn’s apartment in January 2018.

“It was excruciating,” Dunn said. “She was under doctor’s care, she tried drugs that included morphine, meditation; everything. Nothing worked. She was at the end of her rope and she figured the only way out was to take her own life.”

The arguments: pro and against

One of the largest lobby groups for MAID – Dying with Dignity Canada – was started 40 years ago by a nurse who provided end-of-life support to various people. It became a national organization that advocates for the rights of individuals to choose an end of life, so “they don’t have to endure unnecessary suffering.”

We believe in caring for people, not killing them _{– Alex Schadenberg}

Susan Desjardins, a board member for Dying with Dignity Canada, told northeastNOW they feel people should have the choice to make a request for MAID or not.

“If it’s not something they believe in or feel they would want to pursue, then they simply don’t even think about it and they take another course of action,” Desjardins said. “Canadians recognize we have rights as individuals and each of us has the right to exercise our own choice.”

On the opposite end, Alex Schadenberg is the executive director of the Euthanasia Prevention Coalition (EPC), an organization that opposes euthanasia and assisted suicide.

“We believe in caring for people, not killing them,” Schadenberg said. “As someone is entering the final stages of life, they shouldn’t be in a situation where they’re thinking they’re afraid of the type of symptoms they might experience. Therefore, they’re going to consider euthanasia instead so they can avoid those symptoms.”

Response to the survey’s response

Desjardins said she’s not surprised to see nearly 300,000 Canadians participate in the federal government’s survey or the 86 per cent who in favour of MAID being accessible in Leger’s poll. She believes Canadians have been made more aware of MAID in the previous three plus years since its inception.

There was never one spot in any of the questions that allowed you to say you don’t agree with it _{– Alex Schadenberg}

“Individuals in their circle who have been suffering and perhaps have been receiving palatable care, and they have reached a point where it was no longer helpful to them,” she said. “It wasn’t addressing their pain needs and they decided to explore assisted dying as an alternative for them. I can speak from my own personal experience, when someone is suffering and they have the option of having a peaceful death and there aren’t really any other options that will alleviate the suffering, it is an amazing thing that they have that choice and have assistance to pass on in a peaceful way. I often heard people say they’re not afraid of dying, they’re afraid of the process of dying. They don’t want to suffer.”

Schadenberg criticized the federal government’s survey, calling the data “questionable at best.” He believes some of the questions weren’t asked in a neutral matter.

“They asked a question about the 10 day waiting period, but there was nothing in the questions that indicated whether you thought you wanted to eliminate the 10-day waiting period, have a longer period, or keep the period,” he said. “It was just ‘do you somewhat support’ or whatever. There’s no meaning to that.

“There was never one spot in any of the questions that allowed you to say you don’t agree with it. The assumption of the question was you support this and think this is a reasonable restriction or not.”

Schadenberg claimed the website hosting the survey allowed Canadians to vote numerous times, saying some of his supporters emailed him and said the website kicked them out or allowed them to vote twice.

Dunn said he filled out the survey. He said over 200,000 Canadians participating is great, but he’ll hold his breath when it comes to the federal government’s reaction.

“I don’t trust the government because the only reason they put regulation in to begin with was because it went through the Supreme Courts,” he said.

Final thoughts

Following review of the survey submissions, Desjardins hopes the federal government will include questions such as advanced requests when it’s time to review legislation.

She also had a message to those who may not support MAID.

“I think we try, as Canadians, to respect the beliefs of others and their views,” she said. “I recognize that’s their choice. Equally, I hope they would recognize, in my case, it’s my choice to feel that this should be an option for Canadians who wish. I personally would want to have that choice if I found myself in circumstances that are described in the law.”

…my death is foreseeable, because if you don’t do it I will_{– David Dunn on his wife’s plight}

Schadenberg said while the EPC is still against MAID and against providing endless treatment to patients, they recognize people need good end-of-life healthcare.

“We have to recognize as a human person, travelling and going through these situations alone is not a good option,” he said. “Excellent hospice programs have good systems of volunteers who spend time with people, or encourage family members to spend time with people, so they’re not going through these situations alone. We’re abandoning people to euthanasia, and we’re seeing that as a constant situation.

“There are a lot of situations where people lose hope; where they feel their life has lost value and they think that ending their life is the reasonable reaction to that situation. I would suggest a culture that cares and doesn’t kill its vulnerable citizens at a difficult time of their life. Find the right care for them and ensure their life is appreciated and valued until its natural time.”

Two years following Cecilia’s passing, Dunn hopes the changes coming to MAID make the legislation less vague. Citing one specific point that falls under grievous and irremediable medical condition in MAID’s eligibility criteria: “experience unbearable physical or mental suffering from your illness, disease, disability or state of decline that cannot be relieved under conditions that you consider acceptable.”

“In her eyes, she was definitely in a state of decline,” he said. “I wish they would make it more black and white. They’ve taken out the six months which is good, but again it says your natural death must be reasonably foreseeable. It affected my wife – at a point where your natural death becomes reasonable or foreseeable – as far as my wife was concerned, it was foreseeable.

“I remember when she got the phone call from her doctor saying she didn’t qualify. She just broke down sobbing, saying ‘my death is foreseeable, because if you don’t do it I will.’”

Another change Dunn hopes to see is giving consent immediately after medical assistance in dying is provided.

“For [Cecilia’s] part, that wasn’t a big deal because she was lucid right up until the end, otherwise she couldn’t take her own life,” he said. “It’s for other people that can’t make that decision. I think it’s an important part that you should be able to give consent before hand and in case you’re in a coma and you made arrangements beforehand to do that. You set up something with your lawyer; set something up if you can’t at bedside.”

The Department of Justice stated the federal government will launch the full review of MAID in summer 2020.

With files from The Canadian Press

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aaron.schulze@jpbg.ca

On Twitter: @SchulzePANow

by Aaron Schulze

Medically-assisted dying: the discussion in Saskatchewan

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