Medical Assistance in Dying committee  Absolutely. I think the longer that you have conversations about what a person wants, the better situated you're going to be for understanding the request and, more importantly, the better the request is going to be. What we don't want is the kind of situation that Dr. Ferrier

Medical Assistance in Dying committee  Absolutely. Yes. Over time, that is true. Partly why I'm all in on it after a serious diagnosis and I might seem to be more lukewarm on pre-diagnosis is that I'm juggling. From a public policy perspective. I think it's absolutely defensible, but in fact we need to do it after di

Medical Assistance in Dying committee  I think you could certainly conceptually make that argument. I think people may express concern that the sands are shifting. That's why I've tended to stick with the language of saying that it's for the person to decide what constitutes “intolerable suffering”, so then I might sa

Medical Assistance in Dying committee  Yes.

Medical Assistance in Dying committee  Yes. I think with the end stage you can still say they're suffering according to their conception of suffering, because it would be an existential suffering. I think the situation that makes your case would probably be unconsciousness. When you're truly unconscious, it's probab

Medical Assistance in Dying committee  That's simply not true. That is not what the Supreme Court of Canada said. The Supreme Court of Canada said that a prohibition is void if it prohibits somebody from accessing MAID who clearly consents. That is not the same thing as saying that MAID is permitted only when someon

Medical Assistance in Dying committee  On irremediability, two things are going on. One is for the patient and one is for the clinician. The patient decides what treatments, if any, they're willing to try. Then the clinician says, “Here's what I understand about whether that will or will not work.” That's a clinical

Medical Assistance in Dying committee  Advance directives happen at a provincial or territorial level. They are largely about withholding and withdrawing treatments: People get to make a decision now about what treatment decisions they want made and how they want them made in the future, should they lose decision-maki

Medical Assistance in Dying committee  Yes, it's very real. There are several ways, and the first is to point out that the stigmatization in some sense goes in both directions. If you don't let people have advance requests, you're in a sense saying that people with dementia can't be trusted to make decisions for them

Medical Assistance in Dying committee  I think they need to hear the evidence about the impact on vulnerable populations. It is not what is being presented. I would plead for you to talk to the primary authors on the empirical research that's been done in the Netherlands, Belgium and in Canada, none of which demonstra

Medical Assistance in Dying committee  I believe absolutely that it is for the individual to determine what constitutes a life of enduring and intolerable and irremediable suffering for them. It's very clear that it can be physical suffering or psychological suffering or existential suffering. It's for the person to d

Medical Assistance in Dying committee  The first thing I would say is do not—please, do not—blend the two regimes and think that if it's dementia, you go through advance request, and if it's something else prior to diagnosis, you go through the mandate or the advance directives in any other province. Do not blur them.

Medical Assistance in Dying committee  I think the case is made most strongly when you have a diagnosis for a serious and incurable condition. You can respond to a lot of the concerns people have about advance requests: You don't know what condition you're even going to have, so how can you possibly project yourself o

Medical Assistance in Dying committee  For people who are before diagnosis—and we have been talking about strokes and so on—we also need to inform people about alternatives to MAID in those circumstances. Those include palliative sedation and voluntary stopping of eating and drinking. Quebec has done a much better job

Medical Assistance in Dying committee  Do you mean when it's being triggered and used? What's really important is we need to think of these differently in terms of the procedural safeguards and what the documents would look like and what the processes would be. There are indeed failings in the advance directive regim