I would like to thank the committee for having me here this evening to provide some insights and opinions.
First off, I have an apology. I thought I was going to be speaking about advance directives, but I'm happy to provide comments and thoughts about any aspect of MAID and MAID care.
I work as a neurologist in my day-to-day work. I work with people who have had strokes, many of whom experience intolerable suffering after and cannot access MAID because of a lack of capacity. I have been a MAID assessor and provider in Nova Scotia since the law began in 2016. I am the clinical lead for medical assistance in dying in Nova Scotia with respect to administration and trying to promote good policy, etc. Finally, I am co-chairing and chairing a national committee that's looking at developing educational standards for MAID across the country. It is funded by Health Canada and I'm very grateful for their involvement in this process.
When medical assistance in dying for mature minors was mentioned, I was taken immediately to a case that I actually saw and worked with. It was a young woman who began her medical journey when she was 19, which was just above being a mature minor. She suffered from an intolerable pain problem. She lived with that pain problem for five years. She saw endless numbers of medical specialists, surgical specialists and underwent numerous different treatments for her problem.
When I was asked to see her, it was because track two legislation had just been introduced. I was asked to do an assessment to determine whether she was eligible for a medically assisted death even though her natural death was not reasonably foreseeable.
On the basis of a review of her entire medical history, my understanding of the nature of the problem, which was neurological in nature, and in discussion with consulting experts across the country, I came to the understanding that her natural death was not reasonably foreseeable, but there was no option for further treatment for her. Just shy of her 23rd birthday, she had a medically assisted death in her home surrounded by her family and I was there to provide the medication that brought that about.
In many ways, the experience of that death was an experience for the entire family. They had gone through this journey with her, from when she was underage and beginning to experience the difficulty with this problem, all the way through helping her understand and move forward with the treatment decisions, etc.
In getting to know her, it became quite obvious that she had become an expert in her own problem. She had done the research, she had listened to the doctors and she had listened to the therapists, etc. She weighed her options and she finally made the decision that she would not want to go through some experimental therapies, which were not likely to help her going forward. She engaged in very frank and open conversations with her parents. They were not necessarily onside initially and there was some family strife as a result of that, but eventually they came around and were able to support her.
At the end of the day, she is the closest experience I have with a mature minor in terms of an ability to go through this process and see it through to the other end. Her death was peaceful. She was surrounded by her family and her friends, who lingered. We stayed around after and I can't remember how many pots of tea we drank while talking about her journey and telling stories. I'm still in contact with her family to this day, periodically.
Unfortunately, I don't have the academic background that Dr. Morrison brings to this process, but I think the clinical aspects of this are very similar to what goes on with adults. It's all about communication. It's all about ensuring capacity. It's all about understanding your options and being able to act upon them. Age doesn't necessarily define what that understanding ought to look like or could look like. I know plenty of people who are in their forties who are not capable of making decisions and they are not unwell.
I think I will yield at this point because I am finished.