Calgary’s Carewest Hospice performed their first medical assisted death a month after the program’s legalization in June 2016.
David Sawatzky, director of operations at Carewest, says that they “worked with each staff member to respect their individual perspectives and provide support and education.”
But not everyone is pleased with the legislation, including patients with mental health issues, long-term illness and diseases that will make them unable to consent on the day of death.
“The individual must experience physical or mental suffering from illness that cannot be relieved under conditions that they consider acceptable, and they must be at a point where their natural death has become reasonably foreseeable.”
Unfortunately the term, ‘reasonably foreseeable’ is subjective and difficult to define for many.
More than 3,714 Canadians have opted to use the program since its inception, saving them much pain and suffering.
Dr. Jim Silvius, Alberta Health Services’ lead coordinator for Medical Assistance in Dying, has found that reactions toward the program are more than positive.
“One sentiment that we have heard repeatedly is that the system … in Alberta with the [MAID program] has gone further to meet the needs of both individuals seeking an assisted death and providers on all sides of the issue than other jurisdictions and has been well received.”
In Alberta, there have been a total of 417 medically assisted deaths, 148 of which were in Calgary between June 2016 and June 2018. The average age of those seeking the program is 70.
Both patients and workers in palliative care say MAID laws finally provide people with the ability to control the final stage of life.
Sarah Walker, executive director of Hospice Calgary, has experienced first-hand how this program changes families’ lives.
“[Alberta Health Services] has done an outstanding job so far —yes, it can still be tweaked here and there over time regarding some aspects but yes, it’s working as well as it can.”
This semblance of control lets people leave this world knowing that they are making the right choice for themselves.
However, the criteria exclude some from using MAID legislation, including:
- Patients with a non-foreseeable terminal illness or debilitating disease
- Patients under 18
- Patients with mental illnesses
There are many steps to take when applying to use the MAID program. Along with the signatures needed from various people, the program also demands that one of these signatures come from the patient on the day of death. This requires the patient to be of competent and sound mind.
Excluded from this program are individuals whose mental capacity to proceed through the process will diminish over time and will not be sufficient on the day in question.
“As they are then not able to reaffirm their desire and consent as required by the legislation,” says Dr. Silvius.
According to Dr. Silvius, there are changes that are looking to happen soon in regards to competency at the time of death.
The Council of Canadian Academies, a not-for-profit organization that convenes experts to discuss complex scientific topics, is writing a report of the Bill due in December.
The report focuses on how desirable it would be “to expand the criteria to include mature minors and those with mental illness as the sole underlying reason for seeking an assisted death,” says Dr. Silvius.
According to Dr. Silvius, Alberta has become an ideal place for the program because of the Care Coordination Service. With this service, Alberta Health Services (AHS) has the ability to support patients, their families and even care teams through the process, from beginning to end.
“We’ve made a promise to both patients and families stating that we are going to journey with them through the end of life and through grief for as long as they need us,” Walker says.
“The focus of our team in preparation for a MAID procedure is to ensure that all involved are focused on supporting the needs and wants of the patient.” – David Sawatzky
Seeking end-of-life care is a very personal decision but AHS strongly encourages those seeking treatment to share their decision with their family members and have them present for support.
Sawatzky says that, “The focus of our team in preparation for a MAID procedure is to ensure that all involved are focused on supporting the needs and wants of the patient.”
Carewest hospices ensure that they will do everything they can to make the families feel respected, cared for and that their wishes were treated with dignity in these final moments.
“Our philosophy is to work with the clients and families and try to make the process as smooth as possible during a very difficult time in their lives,” Sawatzky says.
Editor: Sam Nar | email@example.com