The nature of kids is that they bounce back. Generally speaking, when kids are ill, even when they're really ill, they get better. The number of kids in my practice who have been so ill in a life-limiting or life-ending way has actually been fairly small. Even in the hospital, I can probably count on two hands the number of kids I've treated who, if MAID were available, would have been candidates in some way. That isn't to say that it shouldn't be available. A small sample size does not in fact make a piece of information or a policy decision not worth considering.
You speak about maturity, and I think that's exactly what we are talking about. It's the capacity to understand and the capacity to think about what the consequences of a decision might be. To that point, I would say that having a really robust understanding of what is being offered, of what MAID is, is in fact a criteria for eligibility. Without that clear, voluntary understanding, MAID simply wouldn't be on the table.
There are a lot of 90-year-olds I've seen who have requested MAID where I've thought, “Actually, I don't think they really do understand.” I would say that even “maturity” is potentially a difficult word. It's really about that procedure-specific capacity: “Do you understand what I am offering you right now, this thing, in this moment?”
In folks with dementia, there are often moments of lucidity when I think, yes, they have great capacity, and then there are moments when they don't. It's time-specific. It's incredibly specific.
I hope that answers your question.