Canada debates offering physician-assisted death to patients who aren’t terminally ill

Ron Posno has early-stage dementia. He wants to make sure that if his capacity becomes so diminished, he can take advantage of Canada's assisted death law. But it does not provide for people with dementia.

Posno figured Canada, which in 2016 passed a federal law on what people here call medical assistance in dying, would be a place where he could set out his wishes to die on his own terms while he was still competent. As it turns out, “advance requests” like the one he tried to make are not allowed.

Now the government of Prime Minister Justin Trudeau has introduced a bill that would overhaul the process.
Polls show widespread support in Canada for broadening access. But much like the law it is intended to replace, the bill has faced criticism — for being too restrictive or too expansive or too confusing.

For Posno, “it failed dementia patients again completely.

...

Canada’s law is more liberal than those of the U.S. jurisdictions where the practice is legal. In those jurisdictions, which include California, New Jersey and the District of Columbia, only mentally capable, terminally ill patients with a prognosis of six months or less who can self-ingest the drugs are eligible.

But implementing the law in Canada has not been without challenges.

Doctors puzzled over the definition of a “reasonably foreseeable” natural death. Ellen Wiebe, a physician based in Vancouver and one of the first in Canada to provide medical assistance in dying, remembers hashing out policies in email discussion groups.
Criticism exploded in 2018 over the case of Audrey Parker, a 57-year-old woman with terminal breast cancer that had spread to her brain. Fearful that the disease might rob her of the mental cognition to consent a second time, she scheduled her death earlier than she otherwise would have wished.

Doctors reported that patients were forgoing pain medication, even though it increased their suffering, so they could provide that second consent.

”

Canada debates offering physician-assisted death to patients who aren’t terminally ill