Hurrying to meet a looming court deadline, the federal government has given Canadians two weeks to weigh in on how far to extend access to medical aid in dying. The Government of Canada has launched an online public consultation aimed at obtaining Canadian's views on amending the federal medical assistance in dying legislation. Canadians and interested stakeholders are invited to share their views online until January 27, 2020.

Who can provide medical assistance in dying and who can help
Those who can provide medical assistance in dying services are:

• physicians
• nurse practitioners (in provinces where this is allowed)

Those who can help provide medical assistance in dying include:

• pharmacists
• family members or other people that you ask to help
• health care providers who help physicians or nurse practitioners

These people can assist in the process without being charged under criminal law. However, physicians, nurse practitioners and other people who are directly involved must follow:

• the rules set out in the Criminal Code
• applicable provincial and territorial health-related laws, rules and policies

Protecting the right of providers to act according to their beliefs and values

Not all health care providers will be comfortable with medical assistance in dying. The federal practice may not be consistent with a provider's beliefs and values. The federal legislation does not force any person to provide or help to provide medical assistance in dying.
Provincial and territorial governments have the responsibility for determining how and where health care services are provided. They may also make policies around where medical assistance in dying can take place as long as they do not conflict with the Criminal Code.

There are 2 types of medical assistance in dying available to Canadians. They each must include a physician or nurse practitioner who:

• directly administers a substance that causes death, such as an injection of a drug
  • this is becoming known as clinician-administered medical assistance in dying
  • it was previously known as voluntary euthanasia

or

• provides or prescribes a drug that the eligible person takes themselves, in order to bring about their own death
  • this is becoming known as self-administered medical assistance in dying
  • it was previously known as medically assisted suicide or assisted suicide

The consultations will also ask Canadians whether assisted death should be expanded to give people in specific situations access to a doctor or nurse practitioner's help to die:

• So-called "mature minors" — people under age 18 considered by doctors to be capable of directing their own care.
• Cases involving "advance requests" — where a patient stipulates they would like their life to end at a later time when they are no longer competent to give consent.
• And people who wish to end their lives solely because of mental illness.

Process for requesting the service
The legislation contains safeguards to make sure those who ask for medical assistance in dying:

• request the service of their own free will
• are able to make health care decisions for themselves
• are eligible (this means they meet all of the listed criteria)
• can and do give informed consent, which includes being informed of all care options available to them to help relieve suffering

These safeguards will guide health care providers to carry out this service appropriately and in a way that protects people from abuse or misuse.

Talk to your physician or nurse practitioner about end-of-life care options in relation to your medical condition or circumstances.

To participate in the online public consultation: www.justice.gc.ca/eng/cons/ad-am/index.html
 

As of 2016: An estimated 564,000 Canadians are living with dementia. By 2031, this figure is expected to rise to 937,000, an increase of 66 per cent.1 The combined health-care system and out-of-pocket costs of dementia is estimated at $10.4 billion. By 2031, this figure is expected to increase by 60 per cent, to $16.6 billion.1
Footnotes: 1. Prevalence and Monetary Costs of Dementia in Canada, a report by the Alzheimer Society of Canada (2016)

Dementia is a term that generally refers to a variety of brain disorders. Different physical changes to the brain cause different dementias. Some are reversible, meaning that they can be treated and cured, while others are irreversible, meaning there is no cure. Symptoms worsen over time and include: loss of memory, changes in judgment and reasoning, difficulty performing familiar tasks, problems with language and changes in mood and behaviour. Alzheimer’s disease is irreversible and eventually fatal. Other dementias include vascular dementia, frontotemporal dementia (including Pick’s disease), Creutzfeldt-Jakob disease and Lewy body dementia. Dementia is not a normal part of aging, but age is the biggest risk factor.

Stigma is one of the biggest barriers for people with dementia to live fully with dignity and respect. That's why The Alzheimer Society is excited to kick off the second year of their awareness campaign--Yes. I live with dementia. Let me help you understand—to spark conversations and encourage Canadians to see dementia differently.

Once again this year, the experts are doing the talking: people with lived experience. Their vibrant ambassadors are openly and honestly sharing their stories to show Canadians a pathway to understanding. After all, who better to educate the public than those who face stigma every day?
By highlighting the humanity that is part of every single person living with dementia, the awareness campaign seeks to convert judgement into compassion and assumptions into understanding.
It's time to see dementia differently.

Check out ilivewithdementia.ca for useful information and resources to help you learn more and take action to end dementia stigma.

If you are concerned about a family member, loved one or friend experiencing signs of Alzheimer's-give us a call to see how we can help.  

​Photo by Huy Phan on Unsplash