What’s Up Doc?: Facing the end of life cannot be easy
By DR. NOORALI BHARWANI on May 24, 2022.
Right now, I know three individuals who are terminally ill. Two are my close friends and one is a close relative. I have known them for many years. It is hard to write how I feel about this. Sometimes, I wonder why some people die suddenly (like my dad, brother and sister died) or die from a terminal illness that can go on for weeks and months (like my mom, and other sister died). I am pretty sure everybody has thought about how they would like to die. There are pros and cons to sudden death versus prolonged death. Now Canadians with incurable illness have a third option called medical assistance in dying (MAID). Dying is part of life. Dying with dignity is everybody’s desire. Some are afraid to die because we don’t know what it feels like or what will happen once our heart stops beating and we stop breathing. Is it possible to die with dignity? There are many end-of-life care options. For example: palliative care in an institution, do not resuscitate orders, refusal or withdrawal of treatment, palliative sedation to ensure comfort and finally MAID. Before we discuss medical assistance in dying, I would like to mention one name – Dr. Jack Kevorkian (1928 – 2011). He was an American pathologist and euthanasia proponent, who gained international attention through his assistance in the death of more than 100 patients, who were terminally ill. He publicly championed a terminal patient’s right to die with physician’s assistance, embodied in his quote, “Dying is not a crime.” He was convicted of murder in 1999 and was often portrayed in the media with the name of “Dr. Death”. There was support for his cause, and he helped set the platform for reform. He spent eight years in jail for assisting a patient with Lou Gehrig’s disease to die. It has taken almost 30 years for Dr. Kevorkian’s dream come true. According to the Health Canada website, on March 17, 2021, the Government of Canada announced changes to Canada’s MAID law. The new law includes changes to eligibility, procedural safeguards, and the framework for the federal government’s data collection and reporting regime. The law clearly defines who may be eligible to obtain MAID and the process of assessment. The law ensures eligible Canadians will be able to request MAID according to the new law, and that the appropriate protections are in place. Physicians and nurse practitioners can legally provide MAID. Pharmacists, health-care providers and family members can legally help. These people can assist in the process without being charged under criminal law. The federal legislation does not force any person to provide or help to provide MAID if it is against their religious or other beliefs. There are two types of MAID available to Canadians. They each include a physician or nurse practitioner who directly administers a substance that causes death. Second option is known as self-administered MAID. A doctor can provide or prescribe a drug that the eligible person takes, in order to bring about their own death. Several conditions have to be met to be eligible for MAID. A person should be at least 18-years-old and mentally competent. Should have a grievous and irremediable medical condition, make a voluntary request for MAID that is not the result of outside pressure or influence, and give informed consent to receive MAID. We know one day we are going to die. To die with dignity is the best way to go. How do we prepare for that? There are no simple answers. As Woody Allen said, “I am not afraid of death. I just don’t want to be there when it happens.” I wish you all good health, happy times with long life. Dr. Bharwani is a general surgeon, freelance writer, photographer and author of A Doctor’s Journey and Doctor B’s Eight Steps to Wellness. His books are available at http://www.nbharwani.com. You can discuss this article and other articles on his website: nbharwani.com and sign up for RSS feed, Twitter or get on the email list. 18-17
