(New York Times) — When Canada’s first MAID law, Bill C-14, passed in 2016, it was reserved for those who were over 18, eligible for health care and mentally competent to consent to death. They needed to have a “serious and incurable illness, disease or disability”; be in an “advanced state of irreversible decline in capability”; and have “enduring physical or psychological suffering” that was “intolerable.” Their natural deaths also had to be “reasonably foreseeable.” In other words, they had to be dying.

The early paradigmatic cases were people in their 70s and 80s with terminal cancer: educated, affluent men and women who didn’t want to die slowly, perhaps in pain, perhaps slipping in and out of consciousness for hours or days. In one poll, an overwhelming 86 percent of Canadians were found to support MAID’s legalization.

But clinicians who agreed to assess dying patients were visited by other kinds of patients too: people with chronic pain or spinal-cord injuries or slow-moving, early-stage neurological disorders, like Parkinson’s and multiple sclerosis — people who were suffering terribly but who weren’t dying of their conditions in any immediate way. MAID assessors would have to tell these patients that they didn’t qualify.

At the same time, Canadian newspapers were publishing stories about people who were denied MAID and then went on to take their own lives, alone or fearful. One was Cecilia Bernadette Chmura, a 59-year-old with chronic pain who killed herself with a handful of hoarded pills, crushed in a coffee grinder, and whose husband was taken into custody after her death. Her husband had insisted that his wife die in her own bed, in his arms, instead of alone in a motel room, as she initially suggested to protect him from prosecution. (He was not charged.)

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