The vast majority of my patients will die a natural death. At most 20 per cent will die from cancer after years of chemotherapy, surgery or radiation. If they live in Toronto, they’ll have superb palliative care at the end, courtesy of the renowned Princess Margaret Hospital and the five other teaching hospitals in the city. Their palliative care teams can step in and offer home services of placements to a hospice.
But not everyone lives in Toronto.
The real tragedy is that only 16 per cent of Canadians can actually access these services.
Last month’s Supreme Court ruling on patient-assisted dying (PAD) will now let us involve our families (or other designated care-givers) in deciding to ‘pull the plug.’
We’ll be able to manage where and when we die with a degree of peace, comfort and certainly we didn’t enjoy before. But again, the ruling applies only if we have a terminal condition and are enduring immense and unremitting suffering.
You may have Huntington’s disease, or ALS, Lou Gehrig’s disease. Yours may be a severe painful condition like spinal stenosis, or yes, even early Alzheimer's. It may be progressive and untreatable tumors like those that caused Dr. Donald Lowe, the renowned SARS doctor from Mt. Sinai Hospital in Toronto, to rail against the system that prevented him from taking control of his own exit.
Even with the new liberalization of assistance in helping us to die well, the experience in other countries tells us that only about 2 per cent of Canadians will opt for this route.
So, even if the Supreme Court’s decision affects only a very few of us directly, its indirect effect has the power to change millions more.
That change comes in giving ourselves permission to have the kitchen-table chat with our families about our own values and wishes about how we want to die.
But before you have that chat, I’d urge you to do two things.
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