No medical assistance in dying for happy demented people

No medical assistance in dying for happy demented people
No medical assistance in dying for happy demented people

Your mother, who suffers from Alzheimer’s, has always expressed the desire to die the day she no longer recognizes her children. And when that day arrives… she’s crazy, sure, but she’s in perfect happiness. What are you doing ?

Posted at 1:12 a.m.

Updated at 6:00 a.m.

This is the rhetorical question I asked Friday in the column.

Rhetorical, because even if Quebec gave the green light, in June 2023, to medical assistance in dying (MAID) for people suffering from a neurodegenerative cognitive disorder, the law will not be in force until at least another year. Additionally, the Canadian Criminal Code prohibits advance requests, and the federal government appears in no hurry to change it.

Read our column “We need to talk about dementia and death”

Rhetorical, too, because the Quebec legislator anticipated the move. When the time comes, there will therefore be no moral dilemma to decide for the doctor responsible for the case. A demented, but happy person will simply not be eligible for MAID.

The law provides that MAID must be administered when the medical situation of the incapacitated person “gives rise to a competent professional believing, on the basis of the information available to him and according to the clinical judgment he exercises, that she experiences persistent, unbearable physical or psychological suffering which cannot be alleviated in conditions deemed tolerable.”

In the office of the Minister responsible for Seniors, Sonia Bélanger, they confirmed to me that MAID cannot be administered as long as the demented person does not show any suffering. “It hasn’t been explained or understood well, so people are going to be very frustrated [si ça se fait malgré le Code criminel]because very few people will be able to benefit from it,” fears the Dr David Lussier.

The geriatrician, who is one of the many experts consulted during the development of the bill, welcomes the cautious approach of the legislator: “Why would we take away the right to change from a person who has cognitive disorders? »

Others see it as a real problem. “Let us respect the choice of the person who was there before, when they were in their right mind,” pleads the Dr Georges L’Espérance, president of the Quebec Association for the Right to Die with Dignity.

We need to talk about dementia and death, I wrote on Friday. So the conversation is started. I spent part of the day reading testimonies – sometimes comforting, sometimes heartbreaking. With the permission of the authors, here are some selected pieces:

“I was 36 years old when the first symptoms of Parkinson’s appeared in me. In my head, it was always clear, one day in the future I was going to exercise my right to die with dignity. Because I want to live and die as Stephanie, the one and only person that I am. I don’t want to live in the shadow of myself stationed in a CHSLD. It’s a shame if the shadow of myself seems happy, because it won’t be THE Stephanie I always was. I want us to remember Stéphanie who loved life even when she was sick, who drank too much wine and who used too many church words! You know, I didn’t choose to be sick, I have no control over it. But know that it is very reassuring to know that you can have control over your death. »

Stéphanie Longpré, 49 years old

“I am responsible for my 98-year-old aunt who lives in a CHSLD. When she was “in her right mind”, my aunt was haughty, critical, a little racist. She lived in an upscale neighborhood in Ville Mont-Royal and only traveled first class. For seven years, she has shared a room with another unknown lady and eaten hospital food. When I visit her, she is smiling, she is happy to see me, tells me that she likes the food and that she is very comfortable in her room. Of course, I make sure she never runs out of port, chocolate, or ginger ale. But that’s not what transformed her…”

Louis Faille

“I have been a geriatrician for 35 years. People with dementia have been my daily life. I have always wondered how one would manage to exercise anticipated will [des patients qui demanderont l’AMM]. I have been around some unhappy demented people, but above all I have been around happy demented people, anosognosic demented people (who do not know that they are demented and are no worse off for it), demented people who go about their lives of demented people. My own mother is housed in a CHSLD in a state of heavy dependence and sometimes I look at her and I have the impression that I have never seen her so serene. »

The DD Manon Chevalier

“My 82-year-old sister (who suffers from Lewy body dementia) experienced a lot of aggression with the attendants [du CHSLD] and U.S. She is miserable. She weighs barely 80 pounds. She doesn’t work anymore. She recognizes us, but she lives in her world. I consider that she has a terrible end of life. She was a proud woman. Today, she is a shadow of her former self. She is not happy. In short, what does all this mean? Please be assured that my will will be changed as soon as possible. »

France Masson

“My mother has Alzheimer’s. She is housed in a CHSLD where she receives excellent care in a wing housing 12 people with dementia. These people can walk around as they please and live a life approaching normal for their condition. My mother would not have wanted to see herself like this, she who was so proud! If she could, she would have signed consent to MAID when she was in her right mind. I know, we talked about it. Today, my mother is not unhappy. She lives in her world. She has daily pleasures. She finds that she has a nice room at the CHSLD. I look at her and wonder how we could administer MAID today. I am a strong supporter of MAID and always have been. But looking at my mother who does not suffer and who has a life, I wonder… Those who suffer are those who stay and who remember “the before”. »

Christine Grant

“My mother probably had borderline personality disorder. Beautiful and passionate, it was unthinkable to spend three hours in her company without a conflict breaking out or a wave of emotions overwhelming her. Intelligent and rebellious, impulsive and often hurtful; I grew up an only child with her. Alzheimer’s made his last five years of life a grace and a form of healing for me. She had become even-tempered, sweet and adorable. I wanted to take care of her (instead of running away from her like before). For my part, these years of dementia were precious. In my opinion. »

Catherine Menard