Wednesday, November 18, 2020

Dr Mai: I already see the MAiD law being broken and a clear lack of safeguards.

Dr Lauren Mai is a stroke neurologist who speaks about treatment options for stroke patients. She expresses concerns that MAiD assessors are not experts in stroke recovery and propose MAiD as the solution.

Something that's always remarkably surprising from the stroke literature, for example, is that people with the most devastating strokes, once they have got over that acute phase and they have lived with that disability actually rate their quality of life on par with those who would not have disabilities.

There is this one surgery that we offer to people who have had the most devastating strokes where its life saving. People often say, should I even bother offering that because they will be left with so much disability. If you actually interviewed those very people who have experienced that surgery and say would you still have asked for that life saving procedure or would you have been better off dying? It's an overwhelming 70% to 80% who will say absolutely I would want that life saving surgery.

And their family, who maybe burdened with their care-giving, for example, echo that thought that, Yes, this is a life still worth living. And it's amazing, but it's almost hard to believe it until you see those people and you ask them that question and its so uplifting to see.

Even though, what I perceive has perhaps a very difficult life, a challenging life, because of functional dependence, is a life that is worth living, that has meaning, and really brings meaning to those around them as well.

The reality is, referral to an assessor for medical assistance in dying gets you to someone who may not be an expert in what it is that you are presenting with in your medical condition.

Medical assistance in dying assessors are often very pro medical assistance in dying and see autonomy as the most important value and so if a patient is requesting it that assessment happens to be, are they able to consent or not. And unfortunately we are just seeing such high rates of acceptance for medical assistance in dying when there would be real concerns about whether this patient is even truly terminally ill. So I already see exceptions to the law being broken and really a clear lack of safeguards.

When we are asking MAiD assessors to see these patients, its easy for them to come up with any sort of reason to say that there is some sort of illness that makes death reasonably foreseeable.


AL Meggers said...

I’m a retired educator MD/ PHD
Please know that WE CANNOT HAVE LAWS THAT EMPOWER FAMILIES AND THE PERSONNEL IN HOSPITALS TO TAKE ANY LIFE BECAUSE THERE ARE TOO MANY POSSIBLE ERRORS IN TESTS INTERPRETING TESTS WRONG DIAGNOSIS ETC ETC and even depression ! The legislators are being misguided bribed and given emotionally bogus scenarios for the sole objective of monetary gain! Until this changes physicians need to treat their patients in their homes!

gordon friesen said...

Dear Dr. Mai,

When we see trees on a wind-swept slope, clinging to an absolute minimum of soil, we are witnessing the power of life. And why would human life be any different ?

You have noted that even you are amazed at the resilience shown by your patients. And unfortunate, the dominant myth holds that only a special few will adapt. In actual fact, we can confidently expect people to positively adapt, especially where that psychology is fostered.

Realistically, all doctors should approach all of their patients, knowing that success in this domain is the normal human default. And that knowledge should communicate itself, in turn, to the individual patient.

To allow assisted death inside a protected window of at least five years, would be grossly irresponsible. To suggest such a thing should remain criminal.

Gordon Friesen, Montreal

Rory Leishman said...

Dear Dr. Mai:
I was struck by your observation:
“Something that's always remarkably surprising from the stroke literature is that people with the most devastating strokes, once they have got over that acute phase and they have lived with that disability actually rate their quality of life on par with those who would not have disabilities.”
I can speak to this issue from personal experience with my father. He was a remarkably talented engineer who rose from humble beginnings to the most senior ranks of management in two large Canadian companies. Dad loved his work; cared for the wellbeing of the thousands of men and women with whom he worked; and was deeply respected and appreciated in return by many of his colleagues from the humblest workers to the most senior managers. I can well imagine that at the height of his managerial career, Dad might have said to himself that if he was crippled by a stroke, could no longer work and lost his autonomy, he would no longer want to live.
In fact, in 1967, father, aged 55, did have a devastating stroke and became deeply depressed. Had medical assistance in suicide been legal, he might have killed himself. Instead, despite enduring many dark nights of the soul, he managed with crucial assistance from my mother and his medical caregivers to regain the will to live and survive for another 15 years.
So called “medical assistance in dying” in Canada is a euphemism for legalized physician-assisted suicide. It is a great evil. As you point out Dr. Mai, no one can know for sure under what circumstances she would no longer want to live. And no one can know for sure that a suicidal patient cannot be helped to regain the will to live.
Instead of facilitating suicide, all of us should thank God for exceptionally kind and talented nurses and physicians like you Dr. Mai who are dedicated to caring for their patients and will provide them with palliative care through the natural dying process, but will never take any action with the intention of killing, or assisting in the killing, of a vulnerable fellow human being.
Rory Leishman