In 2017 the province of Ontario passed legislation entitled: “Medical Assistance in Dying” (MAID). The ostensible purpose of MAID is to assist terminally ill and suffering patients with euthanasia services. MAID can be administered by a doctor or a nurse practitioner. While it is sensible to enshrine protections into such a law to prevent abuse/misuse, the provisions of MAID are draconian to say the least.
Once a patient receives the paperwork for MAID, they are evaluated to determine if they are eligible under the law. The day the paperwork is signed and the request is approved is termed “Day Zero”. The patient must then wait 10 days before MAID can be executed. Thus, on “Day Eleven” the patient can be administered 3 drugs to induce death – one that heavily sedates, followed by another that suppresses breathing, followed by a third which stops the heart. It’s essentially the voluntary version of “Lethal Injection” used on condemned capital murderers in the United States.
Because Canadian healthcare refused my father-in-law proper treatment; and because they refused him access to hospice or respite care; and because they refused him adequate home nursing care; he said “then I just want you to end it”. He asked for MAID for a full week before the paperwork was finally delivered and his evaluation could be performed. Strangely, one of the dolts who did the evaluation – a nurse practitioner named Brad Gunn (to be discussed in a future article) – had only days earlier denied him hospice care. According to Brad, Dad wasn’t “eligible” for end-of-life hospice, but he was a green light for MAID – figure that one out.
Of course the whole hospice fiasco is a story in-and-of-itself. Brad did Dad’s MAID evaluation after asking us to leave the room (which we did), but never bothered to track us down afterward to tell us he was done, or what he concluded. He also claimed in our presence, that Dad wasn’t eligible for hospice since he could hobble to the bathroom (only with assistance) and was “still eating”. My comment was “so if I go to hospice right now, no one will be moving or eating?” I never did get an answer to that. We were also told there as “no room in hospice” even though we spoke to the hospice coordinator who told us she had a room, and that the idea that movement and eating precluded hospice care was “ridiculous” and “absolutely not true”. I would also note that Brad performed NO qualitative or quantitative evaluations for hospice in our presence – it was just an arm wave. He then later put the decision for hospice back on the hospital – which came as a surprise to the doctors and nurses there who stated unequivocally that it was Brad’s call.
Anyway, Brad is definitely a douche and a liar, and he gets his own post.
So Dad has been “approved” for MAID, but now must wait 11 days to get his wish. But there’s another problem – the doctor who does the MAID procedure will be out of town on Day Eleven and Dad is sinking fast. With no treatment and minimal care, his bilirubin is rising and his albumin levels are falling, which means the toxins are building up in his system and that translates eventually into a loss of lucidity.
That is the other “rub” in MAID – you can say “kill me, kill me, kill me” for 10 days straight (and Dad did exactly that for every day he was with us), but IF, on Day Eleven you can’t say it because you’re not lucid – they won’t do it.
The doctor who has done some 20 of these MAID procedures told us that in her experience, only a small percentage of the patients approved for MAID ever live long enough (and retain sufficient lucidity) to have the procedure performed. Indeed, a review of the statistics for assisted death in Canada paints a troubling if obscure picture for the province of Ontario.
While the provinces of Alberta, Manitoba, Saskatchewan, Quebec and the Maritimes report the number of MAID requests as well as the number of those requests that actually make it through to fruition – Ontario and British Columbia (BC) do not. If one examines the populations of BC and Ontario (5,020,303 and 14,446,515, respectively), and then examines the number of MAID procedures performed (773 and 1211, respectively), we can calculate a “MAID rate” per 100,000. The MAID “success” rate for BC is 15.4/100K people, and for Ontario it is 8.4/100K people. That is, the MAID rate is nearly double in BC than it is in Ontario.
While there can be many explanations for the differences in that rate, one could intelligently speculate (when taking into consideration what the doctors told us), that at least one possibility are the long and protracted delays associated with Ontario’s implementation of MAID.
So let’s sum up shall we? We are Canadian healthcare and we are so very, very awesome! We won’t treat you. We won’t provide you with proper palliative care. We won’t approve a dying man for hospice. But you can ask us to kill you, but we will drag our feet until you die suffering like a dog!
Ontario’s MAID is a joke, but no doubt, they will spin this into some kind of wonderful feature of their Potemkin Village of a healthcare system.