Picking a day to die: Part 2 of one man’s journey through medically assisted death

Mike Sloan spent his last days sharing his story of terminal cancer and his decision to choose medical assistance in dying. In Part 2 of this CityNews series, the health incident that could have meant he wouldn't die on his own terms.

By Adrian Ghobrial

Even as his illness made it difficult to swallow soup, Mike Sloan was still spouting witty remarks.

“I’m getting a lot of people hitting on me so there’s a real bonus to this. I’m so svelte. I like that word, ‘svelte’,” he said, showing off his new reversible belt.

In August 2019, doctors gave Sloan six to 10 weeks to live. In September, he was talking with a rasp, as his anaplastic thyroid cancer affected his throat. He didn’t think he would make it much longer.

When CityNews met with him again in November, he recently suffered what he believed to be a small stroke, which sent him to the hospital. His right arm was impaired, and it was increasingly difficult to eat. He was also losing weight.


RELATED: One man’s invitation to document his medically assisted death; Part 1 of a CityNews series


The stroke, which he said included collapsing in his kitchen, was a difficult reminder to Sloan that, if he waited much longer to die, he might not be able to do it on his own terms.

“That fall last week in the kitchen was another one of those wakeup calls where I thought, I can’t keep running around the issue,” Sloan said.

His greatest fear was the possibility his cancer would eventually asphyxiate him.

“I wouldn’t say I’m waiting to die but there’s a bizarre emotional toll that goes along with this,” he said. “I realize one of these days I’m going to have to pick a date.”

Canada’s original assisted death legislation, passed in 2016, states death must be reasonably foreseeable for someone to qualify. The person must also be able to actively consent up to the day of their death.

This has meant some people with a terminal illness have moved forward with medical assistance in dying (MAID) before they’re ready to die because they’re afraid a medical episode may render them unable to consent down the road.

Sloan shared this difficult decision with his thousands of followers on twitter, where he openly talked about the complexities of choosing a doctor assisted death.

On Nov. 13, 2019 he posted, “I woke up at 4AM thinking, ‘I have to pick a date.’ … While I’m not afraid of dying, the notion of picking a day is so surreal.”

If Sloan’s medical episode had rendered him unconscious or wiped out his memory, he wouldn’t have been able to give consent to move forward with a medically assisted death. Sloan was weighing his wish to make the most of his remaining time against his health’s impact on his ability to consent.

“When you’re not in pain, it’s very hard to say it’s time to go,” Sloan explained. “I feel very much like I’m on a tight rope. When do I make the right decision?”

There’s now a bill before the Senate with changes to the law that would have made Sloan’s final months less of a balancing act. For people whose deaths are reasonably foreseeable, it would waive the requirement for additional final consent immediately before a doctor administers death.

“It’s about reducing the suffering that people go through, and helping people,” says Minister of Justice David Lametti. “It’s about autonomous decision making, respectful of life, respectful of death.”

CityNews spoke one-on-one with Lametti, who is heading up the government’s legislative drive on MAID, as he awaits a response from the Senate.

“We have a deadline: it’s the end of February. We want to have Bill C-7 in place,” he says.

That deadline is driven by a 2019 Quebec court ruling, which found the original laws infringed on Canadians’ freedoms.

The federal government didn’t appeal, setting off the court-imposed deadline to update the laws. After three court-granted time extensions, the changes have cleared the House of Commons and now are at a Senate committee for review.

“This is about people making decisions for themselves, not about making them for other people,” Lametti tells CityNews. “I want all Canadians to be able to have a similar set of rights across the country.”

The legislation before the Senate would remove the rule that someone must be able to consent right up to the moment they’re about to die.

Controversially, it would allow people to choose MAID, even if they’re not presently dying, or their death isn’t reasonably foreseeable. If that rule passes into law, someone with a condition such as fibromyalgia or chronic pain could receive a doctor-assisted death after completing a 90-day assessment period. The proposed changes have faced criticism for going too far, even from those who generally support assisted death.

“We also have to realize that if you end the life of people prematurely it’s not a benefit, it’s a harm,” says Trudo Lemmens, a professor in Health Law and Policy at the University of Toronto. Though Lemmens has defended the previous legislation at Quebec Superior Court, he believes the proposed changes go too far.

“If you take away the protection against premature death, and singling out people with disabilities and chronic illness, you’re basically discriminating against them in access to one of the most essential rights they have – which is the right to life,” he says.

CityNews has also spoken to members of Canada’s differently abled and indigenous communities, who say the proposed legislation is dangerous, considering the insufficient supports in place for those members of society. Their stories will be featured as the series continues.

“There is a core group that is just against it,” acknowledges Lametti. “But the vast majority of Canadians support this, and the vast majority of the medical community support this, and we’ve determined it as a right under the Charter.”

 

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