Medical Assistance in Death

My wife’s brother’s daughter, our niece who was in her early 50’s recently died of Pancreatic Cancer and she used the Medical Assistance in Death law that we have in Canada. Her loss is felt by her children, her parents, by us and all of her close relatives and friends. The grieving will take a long time, I came across an interesting article in the BC Medical Journal that looks at the issue of providing bereavement support to families when someone in the family has chosen this option from the medical providers' point of view.

The study concluded that bereavement following a medically assisted death is unique and bereavement support is needed. While most respondents consider providing bereavement support to be a moral and/or professional obligation, they also believe this responsibility should be shared between the family physician and the MAID provider.

What was encouraging is that in response to findings from this study, a guide for patients and families experiencing MAID is now available to support healthy grieving. The guide is available here (pdf file)

Here is an excerpt from the guide:

You have likely put a great deal of thought into your decision to request Medical Assistance in Death (MAiD). Faced with advanced, incurable disease and disability, you have determined that at some point your symptoms and decline will become intolerable and you wish to have an assisted death.

By this time, you have had a formal assessment with one or more physicians or nurse practitioners (NPs) are aware of the options available to you, and have also completed the Patient Request Record form.

Period of Reflection

Typically, there is a 10-day minimum waiting period between your request date and the day you may receive MAiD. This time is formally referred to as the Period of Reflection and is meant to ensure that you have time to carefully consider your decision. An exception could be made to the reflection period if both your first and second medical or nurse practitioner agree that:

•        your death is fast approaching, or

•        you might soon lose your capacity to provide informed consent.

It may be reassuring to know that even though you have been approved, you may still have questions, fears, and worries to work through. Living with dying may be new to you and you may also experience anticipatory grief. You may decide to hold off on setting the date for MAiD to wait and see how things progress. Or, you may have been thinking about this a long time and want to proceed.

·        During this period of reflection, you may want to focus on the people and activities that you enjoy most and consider:

·        What do I most want to do (practical tasks, outings, projects, bucket list activities)?

·        How would I like to spend this time (alone or with others or a combination)?

·        Who should I see and what is important for me to say to these people?

·        What memories or stories do I want to share (highlights, achievements, regrets)?

·        Share information and memories with your family and friends in a way that works for you, whether written or recorded.

·        Do not postpone difficult decisions or conversations; talking about hard things will resolve anxiety and contribute to your peace of mind.

·        What do I need and want help with, and who can help me?

·        Those close to you may experience anticipatory grief; which is a feeling of grief occurring before an impending loss. If they do they should talk with each other and/or a professional if needed.

·        If you have questions or concerns, talk with your family, friends, physician or Nurse Practioner.

·        This is naturally a time of reflection but also take the time to enjoy yourself.