Earlier this year, I was talking with some folks about my now completed book, an assisted-suicide family thriller called When I Killed My Father. One woman, A—, told me that her father had died recently after choosing a medically assisted death that is now legal under Canadian law. I asked her if I could call her and ask her more about the experience. She said yes.
In the United States, there are eight states and the District of Columbia that have medical-aid-in-dying laws. Oregon has had the law for 25 years. The British Columbia law is similar to those laws in U.S. jurisdictions, except in two significant ways. In the U.S., the person who wishes to die must be diagnosed with a terminal disease, and have six months left to live. In British Columbia, however, anyone who has a “grievous and irremediable medical condition causing suffering that is intolerable to the patient” may qualify.
The other major difference is that in the U.S., the patient must self-administer the prescribed drugs, whereas in B.C., a doctor may also administer the drug.
How did your father’s death and decision to die come about?
My dad was two weeks shy of his 88th birthday. He enjoyed robust good health for 86 of those 88 years. In the last year, his health declined rapidly. He spoke frequently about how tired he was of the medical intervention — all the stuff he had to do every day to manage multiple chronic conditions.
I didn’t know if he was aware that medically assisted death is legal in Canada. I talked with my sister about bringing it up. She was in agreement.
So I said to him, did you know this law in Canada allows you to end your life legally? He was not aware the option was available.
How did you bring it up?
My dad was organized. He had made his will a good ten years ago. He started talking to me about his bank accounts, his will. His financial affairs were in order. His funeral wishes were known. His death was not a taboo subject in our family.
It was probably in the course of talking about his health. He said he was tired of doing all “this.” He didn’t specifically say he wanted to die, but it was implied, and had been implied a number of times before.
In that last year, he had moved into a senior residence. It was a nice retirement home. He didn’t have to cook. He didn’t have to snowblow. We were moving forward. We all expected he might live into his nineties like his parents did.
Q: What happened then?
He was interested, but we didn’t talk about it pertaining to him, only generally.
I asked him if he remembered Sue Rodriguez, who had ALS and sued the government for the right to die. She lost, but she started the right to die movement in Canada.
His health continued to decline. He was told he had to have a major surgery.
He decided he didn’t want to do that. He wrote us an email, told us he’d been to his doctor to say he didn’t want the surgery and they had discussed whether he was eligible for the end of life option. The answer was yes, and he chose it that day.
He had had surgeries and every time he went under general anesthesia his memory would be terrible for a while afterwards. I didn’t know if he would remember our conversation about Sue Rodriguez, but he remembered very well.
He didn’t tell us beforehand. He made his own decision. He talked with his doctor and then told us. He had been in a relationship with a woman for many years and although very sad, she understood and supported his decision, as did my sister and I.
How did it play out?
The law states you have to be assessed by two doctors. You don’t have to have a terminal illness, but the end of your life must be foreseeable, and your condition has become unbearable to you. It is for the individual to decide what unbearable is.
There’s screening so someone who is depressed would be ruled out.
His family doctor was one of the two to assess him. She was the one who administered the drugs. Doctors don’t have to perform the procedure, but if they don’t want to, they have to refer you to someone who will.
She found another doctor in her clinic who would do the second assessment. All that happened in a day. That evening he emailed us. There was a mandatory ten-day waiting period. He chose the day after the waiting period ended. It sounds strange to say, but he was so relieved he could do this, he was very happy.
My sister and I traveled to stay with him. We went to the doctor with him to hear about what would happen. What drugs they would give him, how long it would take.
My dad wanted to be sitting on his living room couch and that’s where it happened. Not bedridden.
Dad said anyone who wanted to be there could be. My sister and her husband and daughter — his only granddaughter — were there. As was his partner and her daughter. I was there too.
On the morning of, a nurse put in two IVs, one on each arm, and left. She then came back a short while later with the doctor. There is a procedure the doctor must follow to reconfirm the person’s intention.
“You know why I’m here, J—. You requested this.” He had to sign another form. The family thought that was overkill, the additional paperwork, but it is there for safety in case someone has changed their mind.
Knowing he’d have to give a final consent, my Dad refused any pain medication so he would be fully conscious and there would be no doubt about his consent. He thanked Sue Rodriguez.
The administration of drugs began. First he was put to sleep. His final words were, “I think it’s working.”
He fell asleep. I put a pillow behind his head. It took ten to fifteen minutes to give all the drugs through the IV. There is an option to take it orally, but some people have nausea problems, vomiting.
First came a sedative, then lidocaine, then an anti-seizure medication, and finally propofol, which stops the lungs.
His death was very peaceful. A couple of deep breaths and then he stopped breathing. I have been present at two other unassisted deaths, where the person was struggling for breath. He didn’t struggle, just relaxed.
How did you react?
It was hard. I was crying. I really wanted to sob, but I was concerned he would be distressed if he could hear me, so I held myself back as much as I could.
Afterwards, I didn’t feel the need to cry anymore.
You felt comfortable even though you were sad?
Yes. There was never any question that this was what he wanted.
When he chose to end his own suffering, he ended mine as well. I hated seeing him suffer. I was at peace too.
How long has it been?
Four months.
I miss him a lot. When other people I’ve been close to have died, I missed them, but this experience is so different. This was a positive experience. My mom died of colon cancer. She had a long, terrible death. My dad nursed her through it. He didn’t want that experience for himself. It was terrible for all of us when she died. It was ruthless. This was so different. I was at peace with it and I still am.
What about the other people in the room?
I was focused on my Dad. We were sitting on the couch side by side. I could feel his shoulder next to mine. He had an eye problem, had an eye patch, and I was on that side. That was why I sat close to him — so he could feel me because he wouldn’t have been able to see me.
I don’t think my sister cried. Dad’s partner and her daughter were on the other side of him. I couldn’t see them. We were all pretty quiet.
Were there any obstacles, bumps in the road during the process?
None. I thought there would be more bureaucracy. But the B.C. government website was clearest I’ve ever read. Very good about explaining what the steps were. And that’s what did happen. Everyone we dealt with was helpful and compassionate.
Thank you for sharing your story.
UPDATE: Sections of Canada medically assisted dying law were overturned by a court in September, with a Quebec Superior Court justice declaring the federal and provincial laws are too restrictive. Like the U.S. laws, the Canadian law requires the patient have “foreseeable or imminent death.”
Justice Christine Baudouin ruled that “The reasonably foreseeable natural death requirement deprives both individuals and claimants of their autonomy and their choice to end their lives at the time and in the manner desired.”
The provision will not be suspended for six months to give the government time to develop a new law.
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