This past week, Canada took another step forward to address fundamental changes in access to services for mental health. The 988 Suicide Crisis Hotline went live to provide immediate contact and support services for those in a mental health crisis. Calling or texting 988 gives anyone free twenty-four access to…
Many older people are choosing the option of ‘aging in place’ at home, and as they age, some will have complex health care and personal care needs. To effectively plan for care and manage the care journey, the person responsible for managing their care will need easy access to secure…
As our population ages, more people are faced with caring for an elderly family member who wishes to remain at home despite their complex health and personal care needs. A few years ago, I wrote an article about the proliferation of healthcare coordinators, navigators, and community care coordinators trying to…
It is just as important to know the limitations of a power of attorney for personal care as it is to know your responsibilities.
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.
Capacity is a key component of estate litigation, especially in guardianship and attorneyship disputes. Questions of when someone has begun acting as an attorney for property and whether a person had the requisite capacity to designate a party as their attorney are some of the ways this issue plays out….
Why is it important to determine a primary diagnosis and prognosis before assessing needs? Let’s get back to basics. If the dispute relates to the care of an elderly person, it is important to determine the person’s clinical baseline based on standardized assessments.
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.
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.