A Maritime research firm says three quarters of people polled are in favour of allowing medical assistance as an end-of-life option.
According to the Government of Canada, a total of 6,749 Canadians have made requests since federal legislation was passed in June 2016 allowing eligible Canadians to request assistance in dying (MAID).
According to the Canadian government website, in Atlantic Canada last year, from Jan. 1 to Oct. 31, 2018, 195 people requested assistance in dying, with the most reported underlying medical condition being cancer-related.
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Narrative Search, a Halifax-based market research company, included a number of questions on the issue in their telephone survey, from July 31 to Aug. 25, to find out how many Atlantic Canadians support MAID and the legislation.
“Every single quarter we reach out and talk to Atlantic Canadians about issues, and this was just a topic that we asked about,” said Margaret Brigley, CEO of Narrative Research.
Finding support across Atlantic Canada for MAID
Based on a telephone sample of 1,500 adults, they found that three quarters (77 per cent) of Atlantic Canadians support medically assisted dying.
While support for MAID is high across Atlantic Canada, residents in P.E.I. (70 per cent) are somewhat less likely to support the law allowing medically-assisted dying.
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In New Brunswick the support is at 77 per cent, in Nova Scotia at 77 per cent and in Newfoundland the support is at 80 per cent.
Across the population, higher income earners, those under the age of 55 years, and those with higher education levels are most likely to support medically-assisted dying.
Easing restrictions
According to Narrative Search, three quarters of Atlantic Canadians also support easing restrictions for those with advanced Alzheimer’s and dementia.
In 2018, as reported by Global News, a terminally ill Halifax woman ended her life with medical assistance – but not before issuing a deathbed plea to federal lawmakers.
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Audrey Parker said she wanted Ottawa to drop a provision that says anyone approved for a medically assisted death must be conscious and mentally sound at the moment they give their final consent for a lethal injection.
Parker, who was suffering from a Stage 4 breast cancer diagnoses, said it forced her to choose to die sooner than she would have liked.
The same provision that Parker issued a plea against is also applicable to people living with dementia, but the way it’s experienced can be very different because unlike certain types of cancer, dementia is a brain disease that can cause cognitive impairment.
Under the current law, according to Alzheimer Nova Scotia, a person with advanced stages of dementia will likely not be able to legally consent to MAID given the requirement for applicants to be capable of retaining and understanding new information, analyzing the information and making an informed decision.
‘MAID is very complex’
The advanced effects of dementia in its advanced state may impair a person’s capacity to make an informed decision about their end-of-life care, so if a person loses capacity they can no longer access MAID.
In light of this, the people that were interviewed for the survey were asked if they ‘completely support’, ‘mostly support’, ‘mostly oppose’, or ‘completely oppose’ changing the law to allow those with Alzheimer’s and dementia to have the option to make an early request for an assisted death.
More than 70 per cent of people voted completely and mostly support in New Brunswick, Nova Scotia and Newfoundland. But in P.E.I., support was again lower at 62 per cent.
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The CEO of the Alzheimer Society of Canada, Pauline Tardiff, says “MAID is very complex.”
She said the society is there to support Canadians living with dementia and caregivers through the process of making their end of life decisions, including MAID if that’s what they want.
‘It’s difficult to predict future suffering’
The society is also an advocate for improved quality palliative care that is adequately resourced and available to all people with dementia as they near the end of their life.
“Until someone loses capacity, they can request MAID, including if they presently live with dementia. That is possible,” Tardiff said.
But Tardiff explains that with dementia a person may not be suffering immediately until mid or advanced stages and at that point the individual loses their ability to consent.
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At the moment MAID is administered, the individual also needs to reconfirm their intent to go through the process, and needs to do so with full understanding.
Tardiff said sometimes the person with dementia is quite happy in their state, and don’t know that they have dementia. As a result, the person is not necessarily able to logically think through their current or future pain and suffering.
‘How do we want to die?’
“In our experiences supporting people living with dementia, it’s not that everybody wants access to MAID. But they do want to have the choice around their end of life care and death,” she said.
“MAID is bringing to the fore the discussion around how do we want to die? So that’s a good thing, in a sense, because in our culture, we’re not talking about end of life,” Tradiff said. “I would also say that our statement honors the challenges of decisions or understands the challenges of decisions for end of life care. They are very complex and we’re not having enough of them.”
According to a statement released by the Alzheimer Society in Oct. 2019, it’s important for people living with dementia to make their wishes known to their family members while they are still capable of doing so.
“The prevalence of dementia and Alzheimer’s is increasing in Canada, with incidence increasing with age. Here in Atlantic Canada, we have the highest proportion of seniors in the country,” said Brigley.
According to the Alzheimer Society, there are currently 17,000 Nova Scotians living with dementia, and over half a million across Canada.
“Given the diseases’ particular relevance for our population, it’s not surprising that public support for a change in legislation to ease restrictions for those with advanced Alzheimer’s and dementia is strong,” Brigley added.
Four in ten ‘completely support’ such a change, according to Narrative Search.