[Canada] Canadian Politics Redux

[Barrister]

Earlier BB & Jacob agreed that 1 in 15 was a bit high. In the report I linked yesterday, it talks about how only 68% of MAID demands were administered. Of that unaccepted 32%, 1/3 were from people that simply died before the demand was treated/administered.

Somehow, it doesn't seem so bad to me then.

So excluding those who died anyways, roughly 75% of all MAID requests are acted on.  And the numbers are increasing every year.

[viper37]

OK so first of all the Quebec requirements are the same as the Canadian requirements.  That's because ordinarily killing someone would run afoul of the laws against murder, which is the criminal law, which is under federal jurisdiction.

So lets take your example - chronic asthma.

Requirement number one is you have to suffer from an incurable illness.  Asthma can not be cured, only treated.  And note that the "incurable illness" does not need to be fatal.

Requirement two is an "advanced state of irreversible decline in capability".  Well, asthma does come in various degrees.  But if you're someone who can not engage in any strenuous physical activity because of your asthma I think you would qualify.

Requirement three is "constant and unbearable physical or psychological suffering that cannot be relieved in a manner the person deems tolerable".  Problem here is it's entirely subjective.  Someone who says "My inability to do any strenuous physical activity is unbearable to me.  There are medications available, but I don't like the side-effects".

The law was written with in conjunction with the Federal parliament, so it does not surprise me.

Now back to asthma.

There are cures available, both on private insurances and on public insurances, even for severe cases, that go beyond the usual medications.

Are there some cases that are unrecoverable?  Possibly, but they are fewer now than 20 years ago.

On this, I know what I'm talking about.

Asthma can not be cured, but it will be treated to the point where your symptoms will disappear.  Where as last year at the same date I was coughing, taking a pause climbing my stairs, unable to walk to the end of my yard... I can now do all of that and walk over 500m without being tired, and I barely cough anymore.

Now, obviously, 500m isn't much, but compared to constantly coughing and spitting by walking 2m and just talking 1 year ago, that's huge progress to me.  So, I'm slowly getting there.

As for not being able to engage in strenuous physical activity, no, the threshold is higher than that.  It's really for someone unable to do daily activities.  Like I was a year ago, but with no end in sight.

I don't see how someone with serious chronic asthma, if they wanted it and said the right things, wouldn't qualify for MAID.

Like I said, I have chronic asthma and I wasn't treated properly.  And Covid did a solid number on me.  Once I got the proper doctor, the proper reference for the good specialist, things started to improve.

It's not a question of "wanting it".  It's a question of having a medical professional following you who will recognize your disease as serious enough to warrant MAID.

Now, I see two problems with that with a disease like chronic asthma, and I'm gonna use my case.  And I'm not alone because I recently chatted with a few other persons suffering from the same issue.

1) The doctor does not recognize the seriousness of the problem you suffer.  He/she tells you to take your pumps and the problem with go away by itself.

2) The doctor can not see a treatment for you, but recognize how serious it is and does it best to find a reference for the proper specialist(s).


If it's #1, the doc is never going to sign any paper for MAID.  If it's #2, the doctor is not willing to abandon your case yet, but you're lost in the administrative machine waiting for the right specialist to treat you.  No doctor is going to sign any paper for MAID on this.  They're going to give you antidepressants.


While I do not know about other diseases that may be similar in gravity to asthma (diabetes, maybe?), I would figure the process is the same.

[Barrister]

Like I said, I have chronic asthma and I wasn't treated properly.  And Covid did a solid number on me.  Once I got the proper doctor, the proper reference for the good specialist, things started to improve.

It's not a question of "wanting it".  It's a question of having a medical professional following you who will recognize your disease as serious enough to warrant MAID.

Now, I see two problems with that with a disease like chronic asthma, and I'm gonna use my case.  And I'm not alone because I recently chatted with a few other persons suffering from the same issue.

1) The doctor does not recognize the seriousness of the problem you suffer.  He/she tells you to take your pumps and the problem with go away by itself.

2) The doctor can not see a treatment for you, but recognize how serious it is and does it best to find a reference for the proper specialist(s).


If it's #1, the doc is never going to sign any paper for MAID.  If it's #2, the doctor is not willing to abandon your case yet, but you're lost in the administrative machine waiting for the right specialist to treat you.  No doctor is going to sign any paper for MAID on this.  They're going to give you antidepressants.


While I do not know about other diseases that may be similar in gravity to asthma (diabetes, maybe?), I would figure the process is the same.

I mentioned "wanting it" because, to be clear, I'm not accusing doctors of straight-up murdering people against their will.

So lets take your example, because I think it actually does highlight the risks of MAID.

As you say, asthma is treatable but not curable.  And that's the distinction the law uses.

You can read lots of stories a little bit similar to yours - someone is really struggling with some kind of disability.  This might be going on for years.  But then maybe one day a service provider suggests MAID as an option.

That very thing happened to a disabled veteran who had been fighting to get a wheelchair ramp installed.

If offered, you would have said no to MAID.  The disabled veteran certainly did.  But what if someone was feeling really depressed at the time was given it as an option?

[Grey Fox]

Like I said, I have chronic asthma and I wasn't treated properly.  And Covid did a solid number on me.  Once I got the proper doctor, the proper reference for the good specialist, things started to improve.

It's not a question of "wanting it".  It's a question of having a medical professional following you who will recognize your disease as serious enough to warrant MAID.

Now, I see two problems with that with a disease like chronic asthma, and I'm gonna use my case.  And I'm not alone because I recently chatted with a few other persons suffering from the same issue.

1) The doctor does not recognize the seriousness of the problem you suffer.  He/she tells you to take your pumps and the problem with go away by itself.

2) The doctor can not see a treatment for you, but recognize how serious it is and does it best to find a reference for the proper specialist(s).


If it's #1, the doc is never going to sign any paper for MAID.  If it's #2, the doctor is not willing to abandon your case yet, but you're lost in the administrative machine waiting for the right specialist to treat you.  No doctor is going to sign any paper for MAID on this.  They're going to give you antidepressants.


While I do not know about other diseases that may be similar in gravity to asthma (diabetes, maybe?), I would figure the process is the same.

I mentioned "wanting it" because, to be clear, I'm not accusing doctors of straight-up murdering people against their will.

So lets take your example, because I think it actually does highlight the risks of MAID.

As you say, asthma is treatable but not curable.  And that's the distinction the law uses.

You can read lots of stories a little bit similar to yours - someone is really struggling with some kind of disability.  This might be going on for years.  But then maybe one day a service provider suggests MAID as an option.

That very thing happened to a disabled veteran who had been fighting to get a wheelchair ramp installed.

If offered, you would have said no to MAID.  The disabled veteran certainly did.  But what if someone was feeling really depressed at the time was given it as an option?

Then they have to start the process and get multiple professionals over multiple rounds to agree that MAID is available to them.

[Barrister]

Then they have to start the process and get multiple professionals over multiple rounds to agree that MAID is available to them.

If you're a Track 1 patient (that is you have a reasonably forseeable natural death) you can potentially receive same-day MAID.

If you're Track 2 (no death reasonably forseeable) you have to wait 90 days, but that's still much faster then many other medical appointments.  So if you're suffering you can receive MAID in 3 months, or wait 12-18 months for that specialist referral.

This is all covered in the Cambridge University Press article.

[Grey Fox]

Maybe we should fix those delays then?

[viper37]

If offered, you would have said no to MAID.  The disabled veteran certainly did.  But what if someone was feeling really depressed at the time was given it as an option?

One year ago, I would have said no, because I had other responsibilities.  Without these, I think I would have said yes rather than living like this.

Doctors and other personal aren't supposed to offer it unless the patient asks, it's against their ethical code in Quebec.  They may face sanctions by their respective order.  Other people could suggest it to a vulnerable person though, yes. But we enter another realm.

There's a grey zone when it comes to mental illness.  but the impression I got from the conference is that it had to be severe and incurable, and by incurable, it meant non treatable.   Like a cancer patient whose pain you can no longer alleviate with morphine. 

It's hard to describe.  Not my field of expertise and I wasn't paying much attention.  Like I said, it wasn't what I expected.  I thought it would be something about Azlheimer diseased and other neuro-degenerative diseases.  Dad's gf booked the conference.  Not what I expected and I wasn't ready to have this conversation with everything that was happening in the family.

[crazy canuck]

"But absolutely hearing loss would be enough to qualify!"

BB, if you really believe that then that explains your other posts.  I suggest to you that your understanding of the legislation is simplistic.

Hearing loss, on its own, could not possibly be considered to fulfill the requirement that the patient "experience unbearable physical or mental suffering"

To meet that criteria something more than mere hearing loss would be required.  For example, the thing that caused the hearing loss also causes excruciating and constant pain which the patient will experience the rest of their lives.  Or worse still, the prognosis is that that pain which continue to get worse until finally the patient must be constantly sedated, in which case they will lose the capacity to give consent.

[Barrister]

"But absolutely hearing loss would be enough to qualify!"

BB, if you really believe that then that explains your other posts.  I suggest to you that your understanding of the legislation is simplistic.

Hearing loss, on its own, could not possibly be considered to fulfill the requirement that the patient "experience unbearable physical or mental suffering"

CC, I keep quoting the guidelines, and giving you examples.  You in turn just keep repeating "that'
s not how it works".

You're calling me simplistic.  I'm calling you idealistic and/or naïve - you're describing how the legislation probably ought to work, or how you or I think it should work - but not how it's actually working.  The guidelines are incredibly expansive.

If offered, you would have said no to MAID.  The disabled veteran certainly did.  But what if someone was feeling really depressed at the time was given it as an option?

One year ago, I would have said no, because I had other responsibilities.  Without these, I think I would have said yes rather than living like this.

So I mean this is the thing that keeps coming up in these stories (and yes, they're all anecdotal because they're not keeping very good statistics).  Person who is really suffering.  The suffering could be treated, either because of financial resources, or not finding the right combination of meds, or just waiting for a long-delayed doctor's appointment.  So someone offers MAID as a solution.

[Grey Fox]

Let me find another controversial topic where CC & BB have opposite view. BRB.

[Jacob]

So I mean this is the thing that keeps coming up in these stories (and yes, they're all anecdotal because they're not keeping very good statistics).  Person who is really suffering.  The suffering could be treated, either because of financial resources, or not finding the right combination of meds, or just waiting for a long-delayed doctor's appointment.  So someone offers MAID as a solution.

Sounds like increasing health care spending would alleviate this issue, then.

[Barrister]

So I mean this is the thing that keeps coming up in these stories (and yes, they're all anecdotal because they're not keeping very good statistics).  Person who is really suffering.  The suffering could be treated, either because of financial resources, or not finding the right combination of meds, or just waiting for a long-delayed doctor's appointment.  So someone offers MAID as a solution.

Sounds like increasing health care spending would alleviate this issue, then.

Sure.

But governments of all stripes have been trying to reduce medical wait times for at least a couple of decades now, with very limited success.

Tightening up the guidelines and rules around MAID seems much more achievable.


It's like the gun violence debate in the US.  Republicans will say that governments need to increase security spending, have armed teachers at schools, perhaps "red flag" laws - all of which has merit.  But also the US could just restrict the number of guns.

[Jacob]

"Healthcare is so terrible I want to die!"

"Joke's on you, you're not allowed to die."

...

More seriously, I guess it depends on whether you prioritize minimizing suffering (in which case increasing health care funding and allowing MAID are the choices), or on preventing deaths (in which case increasing health care funding and forbidding MAID are options).

[crazy canuck]

"But absolutely hearing loss would be enough to qualify!"

BB, if you really believe that then that explains your other posts.  I suggest to you that your understanding of the legislation is simplistic.

Hearing loss, on its own, could not possibly be considered to fulfill the requirement that the patient "experience unbearable physical or mental suffering"

CC, I keep quoting the guidelines, and giving you examples.  You in turn just keep repeating "that'
s not how it works".

You're calling me simplistic.  I'm calling you idealistic and/or naïve - you're describing how the legislation probably ought to work, or how you or I think it should work - but not how it's actually working.  The guidelines are incredibly expansive.

If offered, you would have said no to MAID.  The disabled veteran certainly did.  But what if someone was feeling really depressed at the time was given it as an option?

One year ago, I would have said no, because I had other responsibilities.  Without these, I think I would have said yes rather than living like this.

So I mean this is the thing that keeps coming up in these stories (and yes, they're all anecdotal because they're not keeping very good statistics).  Person who is really suffering.  The suffering could be treated, either because of financial resources, or not finding the right combination of meds, or just waiting for a long-delayed doctor's appointment.  So someone offers MAID as a solution.

You are giving very biased characterizations that support your view.

[Barrister]

You are giving very biased characterizations that support your view.

CC, in this debate I never expected to even get into, I've provided news reports, academic papers, Parliamentary committee evidence, and quoted Government of Canada websites.

You just keep baldly asserting I'm wrong.

You really don't seem very open to another point of view, so I think we're done here.  Bless your heart!