I don't think they are mutually exclusive. If we want the debate on extending medical assistance in dying to include advanced directives, it's altogether possible that we would see people choosing that option while fully aware that they've made that decision because they don't want to be caught in a situation that's not equitable.
As for the relational autonomy I was speaking about earlier, you're right to mention that our decisions are rooted in a context that is both cultural and familial. We are influenced by a lot of factors. It is in fact quite possible that one's decision about opting for medical assistance in dying is, as Mr. Lemmens said, based on the perception we have of available care.
Someone might not want to feel diminished, and it's a choice they make. I'm not questioning that. What I'm saying is that if we go in that direction, then it shouldn't be become the only option. I spoke earlier about therapeutic abandonment. I believe that it's really important to continue to expend a lot of energy and resources on quality care for people.
I don't know whether that answers your question. Don't hesitate to get back to me as needed.