Skip to main content
The excellent research by Downar (1) and colleagues provides vital Canadian data to inform future practice and policy. These findings fit well with my experience in assessing approximately 150 Toronto MAID applicants (2); with one notable exception. Downar et al. report that only 6.6% of families of MAID patients or MAID providers raised concerns post-mortem about difficulties assessing MAID, such as delays in referrals to a willing MAID assessor or provider or lack of clarity on how to make a request. When I routinely asked all MAID patients that I assessed if they had experienced difficulties with their MAID referrals, approximately one-third reported concerns, with some reporting delays of several months. While some of these related to lack of knowledge or information, others were caused by family, partners, friends, spiritual advisors or clinicians actively attempting to delay or prevent their MAID requests. As the authors mention in their study limitations, the third party reports they could analyze post-mortem “may not have represented patients’ experiences accurately”. Provincial and local MAID referral sources need to be better advertised and accessible to reduce delays and suffering.
References:
1. Downar J, Fowler RA, Halko R, Davenport Huyer L, Hill AD, Gibson JL. Early experience with medical assistance in dying in Ontario, Canada: a cohort study. CMAJ. 2020 Feb 11.
2. Stewart DE, Rodin G, Li M. Consultation-liaison psychiatry and physician-assisted death. Gen Hosp Psychiatry. 2018;55:15-19.
Donna E. Stewart CM, MD, FRCPC
University Professor, University of Toronto
Centre for Mental Health, University Health Network