Advanced Directives Help Dying Canadians Control Their Future

Patients who are considering the option of medically-assisted dying, are advocating for the right to sign “advanced directives” in case they lose the physical or mental ability to do so later on. (flickr/michael_swan)

Bill C-14 is an Act passed by the federal government last May which legalized medical assistance in dying. Though it was an important accomplishment for Canadian legislatures, the bill fails to address the availability of advanced directives for patients seeking a medically assisted death.

Advanced directives are documents which specify what steps should be taken to save or end a person’s life once that person is no longer able to consent to those actions for themselves. They serve as a living will, and allow people who would like to receive medical assistance in dying to “plan ahead” for a time when they will not be able to communicate their wishes to a doctor.

However, as written on the Government of Canada’s website, federal law currently requires informed consent “at the time of your request” and “immediately before medical assistance in dying is provided.” As advanced directives can only provide prior consent, they cannot be accepted under the law.

That means that patients with, say, dementia have no way to consent to medically assisted death ahead of time, when their mental faculties have left them, even though they know that they would not like to continue hanging on. This is despite the fact that, if a patient meets all of the requirements and gives their consent for medical assistance with dying, they have every right to rescind that consent until they have passed on.

The process to request and receive medical assistance with dying is extensive, requiring a written submission and constant communication with the physician or nurse practitioner who will be administering the treatment. Eligibility requirements state that the patient must have a “grievous and irremediable medical condition” and “be in an advanced state of decline that cannot be reversed.”

If a patient’s ailment is irreversible, an advanced directive would serve to give them a chance to live out the rest of their cognizant lives without worrying about how their deteriorating condition will affect their loved ones in the future.

Patients deserve the right to control their future. Let them enjoy what cognizant time they have left with their loved ones and administer treatment when they’ve requested it, rather than prolonging a life of suffering because they have lost the ability to consent to medical assistance with dying.

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