By Lethbridge Herald Opinon on April 26, 2019.
David R. Amies
DYING WITH DIGNITY, CANADA
Dying with Dignity, Canada (DwD) has designated April 2019 as Advance Care Planning Month. DwD is Canada’s largest organization devoted to helping Canadians understand and plan for “end of life issues.” Much as we do not like to contemplate the ends of our own lives, a little thoughtful housekeeping carried out well in advance of our own demise will prove to be a worthwhile exercise. The Lethbridge Chapter of DwD would like to offer some advice.
It is important that people have valid wills. These can be drawn up easily on kits that can be bought cheaply from stationery stores. However, those that have complicated personal affairs will probably benefit from professional advice. It is also important to give someone Power of Attorney. That person can then step in to manage one’s financial matters if doing so becomes too difficult because of illness or debility.
It is also wise to draw up an Advance Care plan. Thus, should you fall gravely ill or suffer a serious accident, a properly constituted document is in place that lays out how you want your treatment and care managed. Would you want cardio-pulmonary resuscitation? Tube feeding and hydration? Admission to an intensive care unit? One more round of chemotherapy? Kits (Alberta version) for helping with preparing such plans are available from the DwD website (www.dyingwithdignity.ca). Family doctors can also provide useful advice on this topic.
In the Advance Care Plan, you are able to appoint a substitute decision maker. This person will be able to see that your previously drawn up wishes are adhered to. It is perhaps natural to appoint your spouse but it is worth remembering that he or she is likely to be roughly your same age and so it might be better to consider asking a son or daughter or a trusted friend to assume this responsibility.
Lastly, it is important to complete the documents contained in the Goals of Care Document or the “Green Sleeve.” They can be obtained at your personal physician’s office or from Alberta Health Services offices. It is necessary to complete this paperwork with the help of your doctor. The material in the Green Sleeve asks you to consider various scenarios that you may find yourself in and to consider how you would want to be managed. The Green Sleeve should be stored in a prominent place where EMT personnel could find it and should accompany the patient to hospital.
Since 2016, medical assistance in dying (MAiD) has been legal in Canada and to date about 5000 people have availed themselves of the new laws. The law is clear as to who qualifies and information can be found on the Alberta Health Services website, from your own doctor or through DwD. Each of us has our own views about this sensitive topic and it is well to convey your own personal thoughts about its applicability to you to your family and especially your substitute decision maker. Anyone wishing to end their lives via MAiD must retain full mental capacity to the very end of their lives. At present, advance directives are not acceptable to access MAiD.
These matters are all complex and take work to organize them satisfactorily. Nevertheless, the tasks involved are well worth doing. This letter is only a brief outline but should help to point readers in the right direction. Lastly, when everything is drawn up, it is vital that all of the documentation is regularly reviewed to ensure that it remains relevant to your evolving wishes.
David R. Amies is a member of the Clinicians’ Advisory Council, Dying with Dignity, Canada, and member of the Lethbridge Chapter of DwD.