1. Don't Delay Discussing Your End-of-Life Care
Bringing up the issue of end-of-life care may seem difficult but waiting until the last-minute carries risks. When an illness progresses or a person’s health deteriorates, it sometimes becomes impossible to express your wishes in time. By thinking through and discussing these choices in advance, you maintain control over what is truly important to you. You also allow your loved ones to be better prepared and avoid situations of doubt or stress during an already trying time.
Planning isn’t rushing: it’s simply ensuring that your voice will be heard, no matter what.
So, if you’re considering medical assistance in dying, don’t hesitate to make your request even if you’re not ready to set a date.
95% of requests for medical assistance in dying in Quebec are made by people who are at the end of their life. But too many people still submit their requests too late: in 3% of requests, the person dies from their illness before they can even be assessed, and 12% of assessed requests do not result in medical aid in dying because the person dies before the assessment is completed or care is administered.
There’s no need to set a specific deadline when making a contemporary request for medical aid in dying, as long as you plan to receive the care within a reasonable timeframe. It’s also always possible to change your mind, as long as you’re able to do so.
Also, don’t forget to complete your Advance Medical Directives. Advance medical directives allow you to clearly express your wishes regarding care in situations where you may no longer be able to make decisions. Taking the time to write them today ensures that your choices will be respected tomorrow. It’s important to remember, however, that advance medical directives cannot give rise to medical assistance in dying.
2. Don't prevent yourself from requesting medical assistance in dying because you don't believe you're eligible.
There is no set list of accepted or rejected conditions for receiving medical assistance in dying: it all depends on your individual situation.
If you have a serious and incurable health problem (illness, disability, or condition) and you are experiencing physical, psychological, or existential suffering that you consider intolerable, you can make a request.
3. If you suffer from a serious and incurable illness leading to incapacity, you can make a contemporaneous request and/or an advance request for medical assistance in dying.
Learn about both to make the choice that best suits your situation. They are not mutually exclusive.
4. If you encounter obstacles, be aware that several recourses exist.
When making the request
No practitioner can be forced to administer medical aid in dying (this is known as conscientious objection), but it is prohibited to refuse to assist a person in formulating their request.
The healthcare professionals involved have an ethical obligation to respect the patient’s wish to complete a request for medical assistance in dying and to support them in drafting and submitting it.
Statements such as “You’re not there yet” or “Talk to your children first” are not acceptable if you consider that the time has come to submit a request.
During the assessment
You have the right to request a second medical opinion if an assessor determines that you are not eligible for medical aid in dying. Another practitioner may assess your request differently.
In the event of excessive delays in processing your request due to administrative obstacles or a lack of cooperation, a written complaint can be filed with the Collège des médecins du Québec (CMQ) and the Complaints Commissioner of the institution concerned. Each institution has a commissioner whose contact information is easily accessible online. If the situation is urgent and complex, it is recommended that you contact the Complaints Commissioner directly.
It’s also helpful to be aware of the 12 rights of healthcare users, which include the right to receive adequate and timely services. However, some delays cannot be challenged if they are due to a lack of resources.
For support, you can contact the AQDMD, the Council for the Protection of Patients, or seek help from a social worker through your family medicine group (GMF), by calling 811 (option 2), or by contacting your CLSC.