Before Don Findlay got sick, he was full of life.
In fact, his wife Bonita called him “an Energizer Bunny.”
“He could run circles around me,” she said.
But after undergoing treatment for more than a decade, his cancer progressed in the spring of 2018.
Don was becoming more fatigued and his medical options were dwindling. The Findlays, who married later in life, had previously discussed their end-of-life decisions and both of them were open to the idea of using medical assistance in dying (MAID). Don decided he wanted to use MAID services. At that point, Don’s cancer was untreatable and he also had a cardiovascular and respiratory illness.
They approached their family doctor to start the process of applying for MAID. Their doctor was supportive of Don’s decision but was not able to help. Unsure of where to turn, they contacted Dying with Dignity Canada, based out of Ontario. They pointed the Findlays to Fraser Health.
From there, they started the application process. During his first of two assessments, the doctor asked Bonita what she thought of Don applying.
“I’m not happy with this,” Bonita remembers saying.
“I’m saddened by it. I’m not ready for this, but I totally understand. This is his decision.”
Bonita said she knew it was her job to be supportive. And all of their children – both had children from previous marriages – were supportive of Don’s decision.
At the time of his death, the law required that the individual must be able to consent right before using medical assistance in dying. Don was worried that his mental state would decline, so he wanted to go on his own terms sooner rather than later.
“I wonder sometimes if he had felt confident that he could have had it delayed that he might have waited longer,” Bonita said.
In 2021, an amendment was made to the law where a waiver of final consent could be signed under specific circumstances.
The time was less than two weeks from the day Don was approved to the day he passed. He decided he wanted to die at home in South Surrey with only Bonita by his side.
That day was Aug. 28, 2018.
A nurse was the first to arrive. She asked Don if this was something he still wanted.
“Yes,” he said.
Then, two doctors arrived. One was there to learn from the doctor performing MAID (the Findlays had agreed to this). The doctors explained what the medication would do and how he would go peacefully. The doctors asked Don one final time if he consented.
“Yes, absolutely,” Bonita recalls him saying.
The doctors administered the medication.
Brûlée, the Findlays poodle, was in the room when Don passed. Bonita recalled that Brûlée knew exactly when Don died. She pushed underneath her arm and put her nose on Don’s arm. Brûlée stayed with Don until the funeral home came to transport his body.
Don was 81.
Bonita describes MAID as “a compassionate medical option for people who want to choose how they end their life.” She stressed the importance of it being a compassionate option and a choice.
“So providing the option to people to say when they’ve had enough, and they want to go this way, their choice, is awesome.”
Alex Muir, chair of Metro Vancouver’s Dying with Dignity Canada, said people must remember it is a person’s choice. The individual must make the request, meet the medical criteria, and undergo two independent medical assessments to ensure eligibility.
MAID first became legal in Canada in 2016.
In recent years, Muir said most of the controversies surrounding it are related to people with disabilities. Poll findings from a survey conducted by the Angus Reid Institute and released in November 2020 found 65 per cent of Canadians polled were concerned about the elderly and disabled being able to access MAID.
They are worried that some people would use it to avoid burdening others.
“Some people argue that you shouldn’t allow people who are disabled to access MAID and that’s not fair,” Muir said, adding it’s important to remember that those people must also meet the medical eligibility requirements and go through the same steps to be approved.
According to Health Canada, the number of British Columbians who used MAID in 2021 was 2,030, which is 1,836 more than in 2016.
Eighty per cent of Canadians polled in the 2020 Angus Reid survey said it should be easier to make their end-of-life conditions. Of those polled, 33 per cent were supporters of MAID, while 48 per cent were cautiously supportive, and the remaining 19 per cent were against it.
The survey also found that those who opposed it entirely were often religious, visible minorities or born outside Canada.
Some health-care providers will not perform MAID due to how it conflicts with their personal beliefs. The government of B.C. said in these cases, “health-care providers must not discriminate against people who make this request (for MAID) and must provide an effective transfer of care if they choose not to offer that care themselves.”
Faith-based hospitals and hospice societies remain exempt from the requirement to deliver medical assistance in dying, including St. Paul’s Hospital in Vancouver.
THE NEXT CHANGES
Originally, Bill C-7, the law surrounding who can access MAID in Canada, was set to change again on March 17, 2023. On Thursday (Feb. 2) Justice Minister David Lametti introduced the bill seeking to delay extending the eligibility until March 17, 2024.
“We need to be prudent. We need to move step by step, making sure that people within the profession, Canadian society at large, has internalized this step,” Lametti told reporters. “To be honest, we could have gone forward with the original date, but we want to be sure. We want to be safe. We want everybody to be on the same page.”
After this new date, those with a mental disorder as their sole medical condition will be able to access MAID if they meet all the eligibility requirements. The government formed an expert panel on MAID and mental disorders that released 19 recommendations in May 2022.
These recommendations will assist the government in deciding how to best support the goal of delivering MAID safely and compassionately.
Carolyn Bennett is Canada’s Minister of Mental Health.
“I feel the weight of ensuring that the government moves forward with MAID for persons with a mental disorder in a way that is consistent with the goals of autonomy, equity, and respect,” she said.
Despite an expert panel determining that the proper safeguards are in place, the federal government announced in mid-December it intends to legislate further delay. It has not indicated for how long.
“Not everybody is ready,” Justice Minister David Lametti said.
Madeline Li, a cancer psychiatrist who sits on several MAID-related panels, says the Liberal government is still working on developing the practice guidelines around cases with patients whose only underlying condition is a mental disorder. As of December, she said, a draft of the guidelines was still under peer review.
Once they are finalized, Li said they will be sent to provincial and territorial bodies to be incorporated into regulations, and then built into professional practice through medical colleges.
– With files from James Smith and The Canadian Press
** This story has been updated on Feb. 2, 2023