LAST WORDS: SEEKING LIGHT
Medical assistance in dying is choice, man writes
Ottawa’s Clarence Byrd is scheduled to have an assisted death this morning, seven months after his wife, Ida, 65, opted for medical assistance in dying due to glioblastoma.
Byrd, 82, now suffering from inoperable esophageal cancer, has written a personal reflection on the value of medical assistance in dying (MAID). In it, he explains why he’s devoting the bulk of his $6-million estate to MAID: He wants the money used to demystify a medical procedure that he believes can alleviate much human suffering.
Half of his estate will go toward establishing clinic space to counsel people interested in applying for MAID; the other half will establish an endowment fund to support the Champlain Regional MAID Network. Byrd’s assisted death is to take place at 9 a.m. at his home in downtown Ottawa.
“My life has become one long agony with no light at the end of the tunnel,” he told the Citizen.
CLARENCE BYRD
Ida Chen was my wife for more than 43 years. From day one, we were best friends, and our complementary skills allowed us to produce more than 150 books on financial accounting and taxation, including Canadian Tax Principles, the leading tax text for Canada’s colleges and universities.
We were always close. After I stopped classroom teaching 15 years ago, we were together all the time. We hiked, skied, and biked all over North America. We shared great food, continued to write books, and had several beautiful homes. Our life together was beyond our wildest dreams; it was a wonderful romance.
But in December 2016, Ida was diagnosed with glioblastoma, a particularly aggressive type of brain tumour. We were told that, while the cancer’s progress could be slowed, it was almost certain to result in Ida’s death. The normal life expectancy after diagnosis is 12 to 15 months.
Since we were in Florida at the time, Ida elected to have immediate surgery at the University of
Miami Hospital prior to returning to Canada. This was followed in Ottawa by chemotherapy and radiation.
Additional surgeries were required in 2017 and 2018 when the cancer returned after periods of remission. During these years, Ida struggled with instability in her leg and a speech impediment. She sometimes made progress, but usually the disease pushed back.
In 2019, Ida began to have tumour-related seizures. In addition, the leg problem reached a point where she could no longer ride her bike, a devastating blow to her quality of life.
By September, it was clear that further surgery would be required. This was undertaken in October 2019 and turned out to be a disaster: Her leg was left largely paralyzed, her speech impediment was worse, her right arm was paralyzed, and a serious infection developed in the incision that required constant draining.
Ida was transferred to The Ottawa Hospital Rehabilitation Centre, where she struggled to regain
I believe that MAID is not well understood by the public and, more importantly, by many medical practitioners.
her mobility. After several weeks, it became clear that she was not progressing. At this point, she applied for Medical Assistance in Dying.
She had two interviews with doctors, who handled the situation beautifully. Given her condition, approval for an assisted death was easily granted: Ida described her life as one of total agony.
The procedure was scheduled for Nov. 6. Thanks to the tremendous staff at the rehab centre, I was able to stay with her in the hospital the night before. We did some early morning snuggling, and, after breakfast, I was able to take her for a drive to some of our favourite places around Ottawa. At 2 p.m., Ida died with medical assistance. She did not have the slightest hesitation and passed with a beautiful smile on her face.
Less than four months after Ida’s death, I was diagnosed with esophageal cancer. While the first prognosis was favourable, further testing indicated that, because of the tumour’s location, surgery was not an option.
While chemotherapy and radiation can provide some control of the cancer’s progress, surgery is really the only “cure.” I was told this tumour would kill me probably within 12 to 18 months.
Given this, I applied for and received permission for MAID. I cannot tell you how much peace of mind this gave me. There was tremendous comfort knowing that I would not have to undergo unnecessary suffering at the end of my life.
I have come to believe that MAID is one of the most valuable medical procedures that we have. It eliminates weeks, and in some cases, months or years, of unnecessary suffering. It also spares the healthcare system the cost of sustaining the life of someone who does not want a life extended. The system, for instance, could have spent a quarter of a million dollars to prolong Ida’s life, something she clearly did not want.
I believe that MAID is not well understood by the public and, more importantly, by many medical practitioners. To help correct this situation, I am leaving almost all of my estate — a substantial amount — to MAID, with a direction that it be used to enhance the community’s understanding of this procedure.
Anyone 18 years old or older with a serious illness or disability that makes death foreseeable can make a written request for MAID. The individual must be eligible for OHIP and be capable of making their own health-care decisions.
Ida’s case was a classic example. She was suffering intolerable agony from cancer, and death was easily foreseeable. In addition, she had rejected further surgery. There really wasn’t any question as to whether she qualified for MAID.
I was surprised to find that I qualified. While my death from esophageal cancer was reasonably foreseeable, I was still undergoing treatment to control the disease at the time. I was pleased to find my application approved.
The written request is a simple form that is completed by the applicant. It requires the signatures of two witnesses. The witnesses cannot be family members and they cannot have a financial interest in the death of the applicant.
In our cases, we used neighbours as witnesses. Signing the written request starts the mandatory 10day waiting period before MAID can occur.
Individuals must have two assessments by two different physicians or nurse practitioners to determine if they meet the legal criteria to receive MAID. It’s important to understand that, once approved, an individual retains the right to an assisted death. Implementation can take place after 10 days, after 10 weeks, or after 10 months, at the discretion of the applicant.
Once the MAID staff is advised that the individual wishes to proceed, an assisted death can usually be arranged in a couple of days. Implementation can take place in a hospital or a home. For Ida, it had to be the hospital. For me, it will be at my Ottawa home.
Once a venue is chosen, a day and time will be selected. The individual can generally select who will be present and there’s also discretion as to the degree of ceremony involved. At the appointed time, the doctor and any guests will come into the individual’s room, and after any chosen ceremonies, the doctor will inject a series of drugs that will eventually stop the individual’s heart and lungs. There is absolutely no discomfort involved. Ida died with a smile on her face.
The individual controls every part of the procedure.
For some people, social and religious beliefs make it impossible for them to consider MAID. Similarly, some medical professionals find MAID conflicts with their training, which focuses on maintaining life.
I fully understand and respect these positions and do not intend this article to be a challenge to such views.
But, as I hope I have made clear, I believe that MAID is a wonderful procedure that relieves dying people of unnecessary suffering. It is my hope that this article will enhance your understanding of this procedure, as well as alleviate some of the fears that you may have regarding its implementation.