Evidence of meeting #3 for Medical Assistance in Dying in the 44th Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was maid.
A video is available from Parliament.
9:40 p.m.
Liberal
René Arseneault Liberal Madawaska—Restigouche, NB
Thank you.
I imagine my speaking time is nearly up, Madam Co-Chair.
9:40 p.m.
Bloc
Luc Thériault Bloc Montcalm, QC
Thank you, Madam Chair.
I would like to address Ms. Baylis.
Your testimony touched me deeply, Ms. Baylis. I don't think there is anything more beautiful than wanting a human being to be able to be surrounded by the people close to them and suddenly feel calm on the threshold of death and surrounded by the love of the people close to them. That really touched me deeply. Thank you for sharing that moment.
You have had quite amazing experience in health care, not just as a nurse, but also as a person. Didn't that help you think about things, for example, to understand these issues of advance directives or advance requests, or preparation? I wonder about something on this subject. You talked about trying to put directives or a process in place at the time a person makes a will. Is it necessary for all that to be notarized, in your opinion?
9:40 p.m.
Retired Registered Nurse, As an Individual
Yes, I would recommend that a document be made, medically and legally and through Parliament as something that all parties agree on, and that it be complied with across Canada.
9:40 p.m.
Bloc
Luc Thériault Bloc Montcalm, QC
Thank you.
Ms. Gwartz, you talked about problems accessing palliative care and, in that context, medical assistance in dying. In your opinion, it is therefore still very difficult to make palliative care accessible, but also to ensure that it does not preclude medical assistance in dying. In short, you are saying that if a person has access to palliative care, they do not necessarily have the option of requesting medical assistance in dying within that environment.
Did I understand you correctly?
9:40 p.m.
Nurse Practitioner, Primary Health Care, As an Individual
Yes. That's true in some institutions for certain, and actually in some communities as well. I can speak mostly to my own community, in which palliative care is quite available. The people here get very high-quality palliative care, but they are not always offered the opportunity to be aware of or make choices related to MAID.
9:45 p.m.
Bloc
Luc Thériault Bloc Montcalm, QC
So in a way, the slippery slope argument associated with expanding or permitting medical assistance in dying in the terminal phase still generates fear. It seems that palliative care practitioners and their institutions don't always offer the option of having medical assistance in dying as part of their services. That is a situation one would not have believed possible, given that palliative care has been the only solution advocated for 50 years. We understand that this is an exemption.
In your opinion, how could that be resolved where you work?
9:45 p.m.
Nurse Practitioner, Primary Health Care, As an Individual
For a start, you could look at how institutions are able to establish these policies.
As I understand it, Prince Edward Island has actually passed legislation that prohibits institutions from preventing MAID in their organizations. I did hear a bit of the previous presenter, Dr. Herx, and I think there's a lot of disconnect. I think that MAID is not part of palliative care. MAID is a different part of health care, medical care, but it is part of end-of-life care. It's an end-of-life option and it needs to be seen that way.
It's unfortunate that there is, as I said, a disconnect or disharmony between some palliative practitioners and the practice of MAID.
9:45 p.m.
The Joint Chair Hon. Yonah Martin
Thank you. That is time.
Mr. MacGregor, you have five minutes.
9:45 p.m.
NDP
Alistair MacGregor NDP Cowichan—Malahat—Langford, BC
Thank you so much, Madam Co-Chair.
Ms. Baylis, I'd like to echo the words of my colleague Monsieur Thériault and thank you for sharing that very personal story with this committee on your husband's passing, the journey he took in exercising his wishes, and how he wanted to leave this world surrounded by the love of his life and his family.
In the document that you provided to our committee, you say, and I quote, “I strongly believe that my rights as a Canadian citizen are being violated, as I do not have the opportunity to currently preplan my end of life.” You want to see that medical and legal protocol completed so that any and all outside interference, whether they be political, religious or special interest groups, are removed, so that really it is the agency of the individual that shines through.
Ms. Baylis, in a panel we had in the first hour, we had a physician who was talking about what would happen if someone were to sign an advance directive and many years from the signing of that advance directive, their future self lost capacity but also had a change of heart. Have you ever wondered about that?
Let's say you were to sign an advance directive that was perfectly legal in Canada. Have you ever been personally concerned that you might change your mind in the future but lose the capacity to express that change of mind?
9:45 p.m.
Retired Registered Nurse, As an Individual
I believe that would be part of what the medical and legal people would come up with. That would be all built in. You can change your will at any time, so you should be able to change your mind at any time. I think it would be all part of that protocol lined up and passed through Parliament.
9:45 p.m.
Retired Registered Nurse, As an Individual
I listened to the whole night, so I heard all the contestants.
9:45 p.m.
NDP
Alistair MacGregor NDP Cowichan—Malahat—Langford, BC
You did. Okay. What did you think when you heard the testimony that some physicians have expressed that there is a stigma attached to ageism, a stigma attached to the way we care for our elderly—a fear of growing old, a fear of decay and losing your capacity? Did you have any thoughts or personal views on what you heard earlier?
9:50 p.m.
Retired Registered Nurse, As an Individual
Well, on some of it I agreed, but like everybody, we have to respect everybody's views. This is where the problem comes in. There are millions of people out there, and we all have different views. We have to somehow come up with something that comes up the middle and we can all agree on.
9:50 p.m.
NDP
Alistair MacGregor NDP Cowichan—Malahat—Langford, BC
We also heard from palliative care physicians, one of whom stressed that they are there to provide medically assisted life, and that they would make sure that patients have the full understanding of all options available to them to carry that life through to its natural end.
I'm wondering what your opinion is of someone who, through their own free will, enters palliative care, but then maybe decides, “This course of care is no longer for me. I wish to now access medical assistance in dying.” Do you think that the physicians who work in the palliative care world should have some kind of transition plan or be asked to respect the patient's wishes? Do you have any views on that?
9:50 p.m.
Retired Registered Nurse, As an Individual
I believe strongly that they should respect the patient's wishes. Unfortunately, that's very difficult with a lot of doctors. Some of them will not talk about MAID, period. I think that's wrong.
9:50 p.m.
NDP
Alistair MacGregor NDP Cowichan—Malahat—Langford, BC
Thank you once again for providing your testimony to our committee today.
Madam Co-Chair, I will cease my questions there. Thank you.
9:50 p.m.
The Joint Chair Hon. Yonah Martin
Thank you.
I will turn this over to my co-chair, Monsieur Garneau.
9:50 p.m.
Liberal
The Joint Chair Liberal Marc Garneau
Thank you, Senator.
We'll now proceed to questions from the senators.
We will begin with Senator Mégie.
9:50 p.m.
Marie-Françoise Mégie
Thank you, Mr. Chair.
My question is for Ms. Gwartz.
Ms. Gwartz, you were with your mother, who received MAID. If I understood correctly, that is what persuaded you to embrace this practice.
Can you tell us about the rigorous process you follow with your patients who request MAID?