‘A personal choice’ nd
More Canadians seeking medical assistance in dying
On the night of Sept. 1, 2016, Sylvia Henshaw received a long-awaited call when she returned home from spending the day with her husband, Douglas, in the long-term care facility where he lived.
For three months, 84-yearold retired surgeon Dr. Douglas Henshaw of Berwick, N.S., anxiously waited for a response to his request to end his life with medical assistance under the recently enacted MAID (Medical Assistance in Dying) Program.
That night, Douglas Henshaw was informed that he was among the first Nova Scotians to qualify for assistance under the new MAID guidelines.
TRAPPED BY HIS BODY
Leading up to that call, Dr. Henshaw, who had been active and adventurous most of his life, had found himself confronted by debilitating illnesses in the form of heart disease and stroke. In 2011, he was diagnosed with the chronic, progressive neurodegenerative disorder Parkinson’s Disease.
Sylvia Henshaw would say later that family and friends observed he aged almost overnight.
The Parkinson’s symptoms had encroached more and more on Henshaw’s day-today living as time passed. He lost his independence along with his mobility and his ability to speak.
“His speech was soft, slow and often slurred. His mind was still sharp, but he was trapped by his body,” Sylvia Henshaw would write later in an article which is part of a series of articles published by
Dying With Dignity Canada. He had always made it clear that this was unacceptable to him.
“Doug was a man who lived on the edge, always looking for new adventure. I had known for many years he did not want to live with a chronic, debilitating illness. He was accustomed to being in control, and he always had an exit plan, should he feel his life become unbearable,” she said about those difficult days.
THE EXIT PLAN
The exit plan Henshaw would choose became possible on May 30, 2016, when the Parliament of Canada passed Bill C-14 into law. According to the government, the bill amended the Criminal Code and related Acts, allowing physicians and nurse practitioners to legally provide medical assistance in dying, known as MAID, to “eligible, competent adults in accordance with specified safeguards.” MAID would provide Canadians with a new option for end-of-life care.
“He was so relieved,” Sylvia Henshaw said about her husband’s response to the goahead given on the call. “And he actually smiled his old smile, which must have been so difficult because he had the mask, the Parkinson’s face, unable to smile and show emotion.”
Arrangements were made for the MAID provider to come to the nursing home in five days to provide MAID on Tuesday, Sept. 6, the day after Labour Day. “Now let’s have a good weekend,” Henshaw told his wife.
The Government of Canada’s Fourth Annual Report on Medical Assistance in Dying indicates the number of medically assisted deaths in Canada in 2022 grew by 31.2 per cent over 2021, totalling 13,241 provisions, accounting for 4.1 per cent of all deaths in Canada. In 2022, the total number of medically assisted deaths reported in Canada since the introduction of federal MAID legislation in 2016 was 44,958.
During that time frame, 267 deaths under the MAID program were recorded in Newfoundland, 156 in Prince Edward Island and 1,068 in Nova Scotia.
Retired Nova Scotia senator Jim Cowan served on the Special Joint Parliamentary Committee, which made recommendations to the government in 2016, leading to Bill-c14, the original framework for MAID.
“It is a personal choice. It’s empowerment of the informed, competent individual to make a choice,” Cowan said.
“And you might make a different choice. That’s your right,” he said. “You don’t have to participate.”
Cowan was the former chair and is currently a board member of Dying With Dignity Canada. He said polls show broad public support for medical assistance in dying.
Dying With Dignity spokesperson Sarah Dobec said research shows that 84 percent of people across Canada continue to support the original Carter v. Canada decision that introduced Canada’s assisted dying legislation.
“The support is equally high amongst all demographics. It’s not just young people or old people who look at this. It’s across the population,” Cowan said.
“Support is high. It doesn’t seem to make any difference what religion people identify with or no religion,” he said.
I think it’s a question of autonomy of individual rights,” said Cowan.
“And I think that the experience in Canada has been very, very positive and we have a very good system.”
THE PROVIDER’S PERSPECTIVE
Dr. Tim Holland is the head of the Bioethics Department at Dalhousie University and a family physician in Nova Scotia. He has been a MAID Provider since it became legal.
Holland said the numbers are growing because services are expanding, and the public is learning about them.
“I had always been interested in medical assistance and dying,” Holland said. “I’m a strong proponent of patient autonomy and their ability to make their own decisions regarding their health and their lives.”
Holland said MAID gives the patient control over the disease.
“This process in a person’s life is a very positive experience for them in a very negative situation.”
“I will ask the family ,‘How do you feel about this?’ because you want to involve the family as well. They will say, ‘I’m not happy about it but I understand it. And I support my mom, or I support my dad or my brother,’ ” said Holland.
Dr. Megan Miller is a Palliative Care Physician and MAID Assessor and Provider on Prince Edward Island.
“I have been doing it since it became a legal option in 2016,” Miller said.
“My career has been to help people at the end of life for quite some time and when MAID became a legal option in Canada I saw it as a new end-of-life care option that people had available to them. And I decided that for me personally I would be comfortable helping people with their end-of-life care in whatever way they wanted to proceed,” Miller said. “Whether that was having a natural death with palliative care, I could support that and if they were choosing and met the legal criteria for MAID and wanted to proceed with MAID, I could also help them with end-of-life care in that way.”
A REALIZATION
Sylvia Henshaw said she came to the realization she could not alleviate the emotional and physical pain her husband was experiencing.
“It wasn’t until I supported him in his quest to end his life that I could actually help him,” she wrote after his death. She also realized that knowing his life was coming to an end made his remaining days better.
When she arrived early at the care facility on Sept. 6, 2016, she found her husband up and already dressed, anxiously awaiting her arrival.
She brought the meal he requested: shrimp, tomatoes, cheese and strawberries, coffee and oatcakes. They also enjoyed a walk on the grounds as she pushed her husband of 40 years in a wheelchair. After a nap, the physician team arrived.
She was by his side, holding his hand while he watched what was happening as the doctors prepared him for the procedure.
“His death was quick, painless, dignified and peaceful, in a room filled with love, compassion and respect,” Sylvia Henshaw wrote later. “That is what most of us would choose.”
“My husband of 40 years, Dr. Doug Henshaw, died on September 6, 2016, at the age of 84. He died the same way he lived — on his own terms,” she wrote.
It is still her firm conviction.