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LATEST ON MAID – SOME HOPE: SOME DESPAIR

Let’s start with some great news. After passage of Bill C-7 on March 17, 2021, the Alzheimer’s Society of Canada (ASC) announced revision of their policy on MAiD.

https://alzheimer.ca/en/help-support/im-caring-person-living-dementia/end-life-care/medical-assistance-dying

This is a major and significant change. After the announcement of the original form of MAiD in 2016, the Society’s Policy was completely opposed. Stalled for review in 2019, it came out in 2020 with a completely neutral stance – not opposed; not in favour – and don’t initiate discussion. Staff could provide information upon request, but no active assistance.

Continue reading LATEST ON MAID – SOME HOPE: SOME DESPAIR

IT’S REAL: MAID FOR DEMENTIA

April 28, 2021

It’s taken almost five years, and after all the palaver of Bill C-7, people with dementia have limited access to Medical Assistance in Dying (MAID).  Here is what Dr. Stefanie Green – Head of CAMAP (Canadian Association of MAID Assessors and Providers) and Dr. Jocelyn Downie – Chair of Law (Dalhousie Univerity) have to say …

https://policyoptions.irpp.org/magazines/april-2021/for-people-with-dementia-changes-in-maid-law-offer-new-hope/

And DWDC (Dying With Dignity Canada) has summed it all up in this overview of ‘what-to-do’ for all people interested in requesting MAID.   Scroll down to find the specific reference for people with dementia.

https://policyoptions.irpp.org/magazines/april-2021/for-people-with-dementia-changes-in-maid-law-offer-new-hope/

It’s not perfect.   We have to wait until the Senate of Canada to finish its review of a number of factors, but mostly, a section dealing with Advance Requests (ARs).   If completed as we hope, then access to MAID for people with dementia will be much improved.

Update on Maid – January 2021

In the past few months, much has been written (and not written) about MAID.   Early November, I offered the following brief to the Justice Committee just before its anticipated review of MAID following the direction of the Quebec Superior Court regarding its Truchon and Gladu decision of September 2019.

After much back and forth in both the House of Commons and the Senate, the entire matter has been postponed again until February 26, 2021.   The Senate has been apprised of my recommendations vis-a-vis a brief similar to that which I advised the Justice Committee of the House (above).   

Needless perhaps, but I am frustrated and endeavouring to go directly to the public through whatever media access is available.   Consequently, the Toronto Star recently published the following article.   

I am following up with a brief entitled “Let’s Get Real“.   Hopefully, we may see something more on TV, radio, and the press by February when the Senate Review should be returned to the House of Commons for final consideration.   It’ll be all about Bill C-7, which basically responds to the issues raised by the Quebec Superior Court (Gladu and Truchon).   

A more complete review of MAID is anticipated by June, but that may be forestalled by an anticipated Federal Election.   We’ll see …

Comments are welcome to rposno@gmail.com

Letter to David Lametti – Remove the Failures of MAID

On the week of July 12, 2020,  CBC National TV broadcast of their previously taped (March 5) Town Hall on MAID of which I was part.  Minister Lametti reiterated over-and-over that he understood each plaintiff and that the espoused needs would be studied in a forthcoming consultation and review of MAID.   So, I sent the following letter to Minister Lametti and relevant others.   If you didn’t see the broadcast, you may access it through the reference at the bottom of the letter.

DATE: 23.07.2020

TO: THE HONOURABLE DAVID LAMETTI, MINISTER OF JUSTICE AND ATTORNEY GENERAL
    THE HONOURABLE PATTI HADJU, MINISTER OF HEALTH
    THE HONOURABLE CARLA QUALTROUGH, MINISTER OF DISABILITY INCLUSION

CC: KATE YOUNG, MEMBER - LONDON WEST
    PETER FRAGISKATOS, MEMBER - LONDON NORTH

RE: FORTHCOMING REVIEW/CONSULTATIONS RE MAiD
________________________________________________________________


Dear Hon. David Lametti

It was a pleasure to meet you on the recent CBC broadcast of a Town Hall on Medical Assistance in Dying (MAiD).   I have written you on four previous occasions about the necessity of revising MAiD - particularly with respect to the needs and wishes of people living with dementia.

Your proposal of C-7 is good, but in terms of the overall needs of a suffering population, it is only a part solution.   Some of these needs were explained and exemplified on the Town Hall ... and in every case, you said their needs were understood and would be considered in your anticipated forthcoming consultations and review of MAiD.

I presume such consultation and review will take place shortly after anticipated passage of C-7 in November.

We have had MAiD in practice for almost five years, so we don’t need to be entirely dependent upon the hypothetical and conjectured problems of the Canadian Academy of Academies (CAA).   We have real Canadian data and the experiences of Canadian practitioners and volunteers in providing MAiD.   We also have the experiences of many deserving Canadians who are experiencing difficulties in obtaining MAiD (many like the people in the Town Hall).   These practitioners and participants should form the basic and essential elements of your consultation and review.

The Canadian Association of MAiD Assessors and Providers (CAMAP) is able to suggest participants and Dying With Dignity Canada (DWDC) can similarly suggest participants and volunteers - much like those in the Town Hall.   Hopefully, as requested before, I would like to be part of this review. (Complete resume material can be provided upon request.)

This could be the time to remove the failures of MAID and bring it forward to meet the promise and requirements of the Supreme Court of Canada.


Respectfully submitted

Dr. Ron Posno  B.A., M.Ed., Ed.D.
519-473-3479
1101-940 Springbank Drive
LONDON, ON   N6K 0E3


ATTACHMENT:    https://www.cbc.ca/news/health/town-hall-assisted-dying-maid-legislation-1.5491824

MAID anytime – with or without medical considerations.

In June I set out “Where We Were With MAID” largely as a consequence of a virtual presentation I had made to a men’s Probus Club in Mississauga (see post).   Toby Stewart, one of our supporters, caught it and submitted the following for consideration.  He’s positing an extension of my proposal:   he wants to request MAID anytime – with or without medical considerations.   Just when he’s ready and he’s willing to leave the final responsibility with his ‘Substitute Decision Maker’ as specified in his request and Will (Power-of-Attorney – Health).   He is not alone.   An increasing number of people have spoken to me about this kind of consideration.   This would mean a lot – particularly with those with mental health problems or those who are completely exhausted from fighting serious, painful medical conditions.

Think about it.   A number of us would like to know what you think.  (Please use my email address .. rnsposno@gmail.com)

Toby’s position:

I advocate farther than you do to completely ‘liberalizing’ Self-Euthanasia via MAID. My sole caveat (the same as is legally required with anyone’s Will & Testament) is that I be of ‘sound mind’ at the time I communicate my choice to die via MAID. (This can be communicated via an Advance Care Directive should one later become incompetent mentally… and that again parallels one’s only legal requisite when one creates one’s Will… and I have no problems with needing two witnesses for either of these two legal EOL-end-of-life documents.)

I believe that my right to die shouldn’t require some terminal diagnosis to qualify for MAID (nevermind all the other current legal hurdles) … after all, we each begin to die from the moment we’re born. Therefore, it follows that I (and anyone else who so chooses) should be able to die peacefully at the time of my own choosing — ideally before any severe pre-requisite medical condition otherwise requires me to consume limited healthcare resources over a potentially long duration (while displacing others more needing those same resources to survive). I will know when it is my own time to die – based upon much sound assessment and forethought, coupled with a communicated list of threshold criteria.

IF our laws prevent me from accessing this EOL — by my own choice when I’m still of sound mind — via a simple inexpensive injection, then I’ll choose a more violent means — which will be more traumatic to all concerned — my surviving family first (even though I’ve had ‘the talk’ with them), and secondarily any witnesses or first responders… plus potentially the person(s) driving the truck, train, bus or whatever.

Unrestricted access to MAID is eventually what I’d like to see in place… ideally removing assisted suicide from our Criminal Code altogether… and allowing anyone who chooses MAID as their right to die method, to proceed as one would with other any other ‘elective’ medical procedures… at the time of their choosing.

Thank you for facilitating this discussion for us, and for allowing me to contribute my hoped-for future MAID vision to you and to your other followers.

I am one of the many who submitted such points to the federal ‘CONsultation’… and I also comment similarly in other forums eg. Healthy Debate… and the old (pre-Ford) Health Quality Ontario… but without much effect – at least not so far. I will continue to advocate for ‘liberalizing’ EOL MAID!

I am also a DWDC member and contributor.

BE PREPARED – NOT SCARED

Good words!   This was set up as a webinar for our local chapter of the Alzheimers Society (ASLM).   It is designed to help people with dementia and their respective caregivers to better prepare for their coming years.

It details major considerations and takes people through three major stages:  Get Real – Get Ready – Get a Plan.   Sometimes amusing but always definitive, it’s proving to be a good resource for the best use of the remaining years.

Ron Posno

WALK WITH ME

Ever wonder .. do I have dementia?   Does your family wonder or are you concerned about a friend?

Common questions and they all need an answer.   This presentation was established for a Senior Women’s Probus Club in London.   Almost 100 attended and almost all reported that they had some answers and knew where to go for help.   Try it out.   I designed it to educate but also to show that people with dementia can live better in a dementia-friendly community.

Ron Posno

WHERE ARE WE WITH MAID? JUNE 2020

Good question … in February the Minister of Justice drafted Bill – C7, took it through the House of Commons, sent it to the Senate and announced he was hoping to clear it through the Legislative Assembly by June in order to meet the demands of the Quebec Superior Court.

And then nothing (presumably due to the COVID pandemic) … until two weeks ago when the Minister advised the press (Parliament isn’t working), that he had requested a five-month extension of terms from the Quebec Court.

Well, in mid-May, I made a Zoom presentation to a Senior Men’s Probus Club in Mississauga. Given the current hiatus, the club wanted to know where we’re at with MAID. You may be interested, too.

Ron Posno

WHERE WE’RE AT AND WHAT WE WANT WITH MAID

We haven’t communicated directly for some time, so I thought I’d try to bring you up to date. You know I’m most interested in meeting with Minister Lametti and his panel for the scheduled review of MAID legislation. On March 5, I was honoured to be part of a CBC TV National review panel on MAID in company with David Lametti et al. About eight persons representing various needs for MAID were also present. Susan Desjardin of the DWDC Board very ably assisted Lametti in questioning and responding to the panel. It took a whole hour, and I was pleased. Each panellist was able to present at least one concern to Lametti.

Unfortunately, the pandemic has intervened. The show was planned for broadcast on March 11 when Lametti and the government were expected to respond to the Superior Court of Quebec. Well, Lametti got a four-month extension, and the pandemic happened. Our panel review has been postponed indefinitely. I’ll advise when I know more.

Since we have to wait for governmental attention to return to MAID, I wrote the following plea to itemize the issues which I’d like to discuss with the planned and scheduled Review of MAID in June.

I’m not sending this to the media or Lametti yet. We need to get the door open again, but the world will move on. When I have the right moment, I’ll send it. However, if anything in my plea can serve you in any way, please go ahead and use it. And I’ll be glad to talk/email with anyone.

Attachments: In PDF and Word (docx) formats. Choose which works better for you.

https://www.posno.ca/wp-content/uploads/2020/03/PLEASE-COME-WALK-WITH-ME.pdf

https://www.posno.ca/wp-content/uploads/2020/03/PLEASE-COME-WALK-WITH-ME.docx

DEMENTIA SAFE

This week I spoke with the local ladies’ Probus Club about dementia   My emphasis was on ‘opening the door’ by eliminating fear and prejudice.   By all reports, I succeeded: the ladies want a better, dementia-friendly community.   They now know how.   They said ‘so.’   Try it on… 

WE ARE NOT ALONE

From deep in the heart of Mexico comes an American voice (Loretta Downs) speaking of “How To Die When You’re Ready.”  Loretta is sincere, personable and extremely well-informed.    She knows more about MAID than most Canadians – right up to the recent survey on the subject by the Federal Government.    Enjoy her video below

https://www.youtube.com/watch?v=z4SnQaPg2Ro

Not only will you gain perspective, but you may also find it useful in engaging others “in the conversation.”   I’ve already had people tell me they’re sharing it with ‘dad’ or ‘mom’ or their siblings.

Thanks .. Ron

REVISIONS TO MAID

On January 13, the Minister of Justice, David Lametti announced the beginning of a review to revise MAID.   It’s really in two parts – the first is a questionnaire to be included with the study of the  Should be  Should be Quebec Superior Court’s Ruling (Gladu and Truchon – September 2019).   The Prime Minister has already announced the Federal Government will not appeal the Quebec Court’s decision and will look at ways to remove ‘other restrictions.’   The second part will begin in June and anything can happen.   The study will encompass the Canadian College of Academies(CCA) report of last December.   CCA had been commissioned to present problems(no suggestions nor solutions) respecting MAID’s exclusion of minors(under 18), those with mental health problems, and people with dementia. 

I don’t expect a quick review (I may not live long enough).
As you might expect, I have prepared my recommendations based upon the need for MAID to be simpler, more caring, and administered with the dignity and privacy it deserves.   My submission follows.

World of Wonder? (WOW)

Does that mean “world of wonder?”

So many things coming together at the same time and we seemingly have the right politicians coming to the field at the right time to provide leadership (now that’s a world of wonder).   We have the Truchon & Gladu case from Quebec and the wonderful promise of the Prime Minister “to not appeal .. and study the legislation to remove other restrictive practices.”

The door is opening.   Take a look:

https://www.dyingwithdignity.ca/quebec_plans_advance_requests

https://www.cbc.ca/news/canada/montreal/medical-assistance-in-death-report-1.5377890

https://www.theglobeandmail.com/canada/article-from-dementia-to-medically-assisted-death-a-canadian-womans-journey

In spite of my optimism, I realize it’s not a straight course.   There are gaps.   Look at this news piece from CTV on December 8, 2019…

https://www.ctvnews.ca/video?clipId=1849846&jwsource=cl

Obviously, we have a way to go .. but you and I can play a role in this evolution of Canadian medical history.   Here’s what I wrote .. and I’m going to write more to every MP and MPP for whom I can find an email address.   Please join in and help “kick the ball” down the field.   The goal posts are wide open.

A Brief to Professor Lemmens

DATE: 29/10/2019 

TO: Trudo Lemmens 

CC: Jule Briese 

FROM: Ron Posno 

RE: RESPONSE TO MS BRIESE RE MAID FOR ALZHEIMER PATIENTS


Dear Professor Lemmens: 

Please feel free to share any or all aspects of this response with whomever you deem appropriate. 

I appreciate your willingness to share your remarks to Jule Briese regarding MAID for Alzheimer’s patients with me for purposes of sharing discussion. Having been similarly employed as a professor, I can respect the limitations of your time and will understand if you cannot become engaged in some lengthy analysis. Jule and I simply want you to be aware of our thoughts and feelings respecting the limitations of MAID as it is currently legislated and practised. 

Continue reading A Brief to Professor Lemmens

As promised, Pauline Tardif has provided me with reference to the new ASC Position regarding MAID

While MAID is not to be regarded as obligatory .. it is a personal, informed choice and considered as a part of Advanced Care Planning.   Persons with dementia can say either “no” or “yes,” but they should be informed and counselled about all their choices with respect to the provisions of care – both living and palliative.

https://alzheimer.ca/en/Home/News-and-Events/Media-centre/Statements

I am elated!   It provides for everything we need: support for information about MAID;  counselling support for those considering a choice for MAID;  and acknowledgement of the shortfalls of the current legislation and the need for support for Advanced Requests (ARs).

We have a way to go, but this new ASC position clears the way for advocates for better legislation and professional practices.

Thank you to the ASC Board, Pauline and all the others who contributed to this new enlightened position.

Ron Posno

Good News – August 1, 2019

Really good news, the Alzheimer’s Society for Canada(ASC) is revising its policy regarding MAID.   Pending ratification by the Board of Directors in September, the ASC will post its new policy on their website.   Now we can move forward with programmes that truly provide a “Beacon of Hope” for many people living with dementia.   And now, more importantly, we can actively support Dying With Dignity Canada(DWDC) in its attempts to rectify the shortfalls of MAID.   See the ASC’s stated intention as of August 1, 2019.

London Morning with Rebecca Zandbergen – March 25, 2019: Dementia Awareness

Public Education Coordinator Susan Oster and Ron Posno, who was diagnosed with mild cognitive impairment, tell London Morning about a series of workshops aimed at dissolving the stigma around dementia.

https://www.cbc.ca/listen/live-radio/1-158-london-morning/clip/15681505-dementia-awareness

University can be hard. It’s even harder when you’re 81 and have Alzheimer’s

And just to illustrate that there is life after a diagnosis of dementia, here’s a friend of mine – Ron Robert – who at the age of 80 years took on the challenges of a university degree.   From grade ten years ago, he’s now an A+ student.   He’s also studied his own life and he doesn’t want to be “warehoused”:   he wants MAID.   Check his story …https://www.thestar.com/news/insight/2019/04/17/university-can-be-hard-its-even-harder-when-youre-81-and-have-alzheimers.html

For people with dementia, a fight for the right to die

Just this month (May 3), Maclean’s magazine posted a story on MAID by Shannon Proudfoot – a frequent contributor of articles featuring common problems of MAID and people with dementia.   You can check some of the current issues right here.

https://www.macleans.ca/society/for-people-with-dementia-a-fight-for-the-right-to-die/