All About Estates

Dementia and MAID

Medically assistance in dying (MAID= Bill C14) for eligible Canadians was passed by federal legislation in June 2016.  To recap, eligibility includes:

  • Being 18 years and older and mentally competent
  • Having a grievous and irremediable medical condition
  • Making a voluntary request for MAID that is not the result of outside pressure or influence
  • Providing informed consent.

Grievous and irremediable has been defined as:

  • Having a serious illness, disease or disability
  • Being in an advanced state of decline that cannot be reversed
  • Experiencing unbearable physical or mental suffering from your illness, disease, disability or state of decline that cannot be relieved under conditions that you consider acceptable
  • Being at a point where your natural death has become reasonably foreseeable which takes into account all of your medical circumstances and does not require a specific prognosis as to how long you have left to live

One does not have to a fatal or terminal condition to be eligible for medical assistance in dying.

Informed consent means receiving all of the information required to make a decision at the time of your request AND immediately before medical assistance in dying is provided.[1]

Given the above criteria, for those individuals who have been diagnosed with a dementia and have indicated that when in the future, they have declined to a point when they no longer (recognize family/ communicate/ feed themselves/ respond  to those around them/able to get out of bed/breath on their own) have not been eligible to request MAID.

This past August 2019, a Victoria man became one of the first Canadians with a dementia diagnosis to have received MAID.  Dr. Stefanie Green is the physician who provided the medical assistance.  In a recent interview she shared:  “His care ‘seemed very much on the edge….The risk of not meeting the eligibility criteria, or not being found to have done so properly, is a criminal offence, which leaves me liable to go to jail for up to 14 year.’”[2]

Dr. Green expressed: “This is not an expansion of our law….This is a maturing of the understanding of what we’re doing.”

This is a difficult and very important topic.  A team of Canadian experts recently authored a paper to provide guidance to clinicians who assess and provide MAID in Canada.  Their report is linked here  https://camapcanada.ca/wp-content/uploads/2019/05/CPG-dementia.pdf.

I found the examples in the Appendix reflected the medical status of many clients with whom I have worked over the years and I wonder how many wanted a different ending.

 

 

 

 

[1] https://www.canada.ca/en/health-canada/services/medical-assistance-dying.html

[2] https://www.cbc.ca/radio/thesundayedition/the-sunday-edition-for-october-27-2019-1.5335017/b-c-man-is-one-of-the-first-canadians-with-dementia-to-die-with-medical-assistance-1.5335025

About Audrey Miller
Email: amiller@eldercaring.ca About: Audrey Miller, Managing Director of Elder Caring Inc. has over 25 years social work and rehabilitation experience working with older individuals and their families. She advises the financial, insurance, legal and business communities regarding elder care issues. Audrey is a recognized expert in her field.

1 Comment

  1. Suzanne S.

    October 28, 2019 - 2:11 pm
    Reply

    Audrey, I always look forward to your informative write-ups expressed objectively yet with empathy. MAID was recently a route taken by a close family member – it was handled with professionalism and grace by the attendants. It can be a gift to the recipient and their family.
    Thank you for addressing this.

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