Current approaches that define capacity in cognitive terms disregard concerns that emotional instability may disrupt capacity or that a person may be cognitively intact yet lack the capacity to give a valid consent. An alternative evaluative approach would be to view capacity holistically, as a combination of biological, psychological, and social (biopsychosocial) factors.
Medicine can do many things but at the end of life what matters most is not necessarily treatment but making peace with yourself on your terms. Atul Gawande, Being Mortal. Advanced care planning is an evolving process where individuals outline their wishes regarding their care and medical decision-making based on…
It’s Super Bowl Sunday as I write this, and in the lead-up to the game, football fans are debating what game changers may be possible to gain an advantage and win. Why not apply the same breakthrough analogy to address critical issues in managing care? What game changers can we…
The Caregiver Crisis in Canada Have you attended a social event lately with people aged 40 to 60? Often described as the ‘sandwich generation,’ they try to care for older family or friends while working full-time, coping with busy family lives, and raising children. No doubt the conversation will turn…
There appears to be a lack of consensus in the mental health field whether persons with a mental disorder-sole underlying medical condition can be adequately evaluated for capacity to consent to MAiD.
Today’s blog is co-written by Jennifer Campbell and Sandra Arsenault, Senior Law Clerks in the Private Client Services Group at Fasken. At the beginning of November, we were fortunate enough to attend the Institute of Law Clerks of Ontario (ILCO) annual conference in Niagara-on-the-Lake. This conference brings together law clerks…
I suggest “an appreciation of the impact MAiD will have on family members and friends” be included in fulfilling the proposed amendment of the appreciation test for consenting to MAiD. The proposed amendment would not mandate being bound by others’ opinions, but that that lack of ability to appreciate the views of one’s significant others would demonstrate a lack of ability to apply the relevant information to one’s circumstances.
In Canada, the law no longer restricts medical assistance in dying (MAiD) to people whose death is reasonably foreseeable: as of March 17, 2023, people with a mental disorder as a sole underlying medical condition (MD-SUMC) will be eligible for MAiD.
A Dead Give-Away Did you know that deathbed wills are the original will? In medieval Europe, for all but those in high society, will-making was synonymous with efforts right before death. Luckily, this type of estate planning is no longer the status quo. However, deathbed wills have persisted as a…
I have found it uncommon for a family member or beneficiary to exert undue influence to pressure a patient to pursue MAiD. What worries me is the vulnerability of patients to undue influence from physicians who may embrace therapeutic nihilism and bias patients unduly towards MAiD. I suggest that, for capacity to consent to MAiD, the test of “ability to appreciate” should be expanded to require an appreciation of the views and wishes of supportive family members and friends.