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Mary Wilson was rapidly deteriorating with Alzheimer’s when she received a medically assisted death in 2017.

The Alberta woman was still cognitively aware and could carry complex conversations, but those chats might take an hour and a half instead of the usual 15 minutes, says her son, Ken Campbell.

She had also begun retreating from the world as the disease progressed: she put coffee cups in bathroom cabinets and spoons under pillows; she needed help getting dressed and had a loss of bladder control.

Wilson, an intellectual with three post-secondary degrees, stopped reading and started watching Disney musicals on repeat.

“Talking to my mom was like watching a beginner driver parallel park,” Campbell says of her final days.

Wilson hosted an intimate house party with family and friends before receiving MAID.

At the party she would smile and lean forward as if preparing to speak, but then lose her train of thought as everyone quieted to listen, saying only, “Nevermind,” Campbell says.

Her window for eligibility to receive MAID appeared to be closing – once a person with an untreatable condition loses the mental capacity to consent, it’s illegal to provide them an assisted death.

“Advanced requests were not available, and that was a big frustration for my mother,” says Campbell.

That is no longer the case in Quebec, where a person with a serious and incurable illness like Alzheimer’s can request MAID, months or years before their condition leaves them unable to consent. The move has received praise from patients and advocates who believe people with Alzheimer’s should get to decide if they want to endure the full extent of their decline. But it’s also generated confusion and criticism among some in the medical community who raise moral and legal questions.

In Wilson’s case, she was able to turn to her doctor and say “I’m ready,” recalls Campbell.

But he says that his mother would have wanted to ask for MAID in advance.

Wilson was diagnosed with dementia in 2012 and began a rapid decline in 2017. Her doctors had time to observe the speed and signs of her descent.

The acceleration of an Alzheimer’s patient’s illness – and their window of eligibility – largely varies case-by-case, says Dr. Konia Trouton, president of the Canadian Association of MAID Assessors and Providers.

Neurological conditions accounted for 12.6 per cent of people who received MAID in 2022. Out of those cases, which include Parkinson’s disease and ALS, dementia made up nine per cent, representing 150 people, Statistics Canada data shows.

They have to be in advanced decline, but still able to explain their diagnosis and give consent, says Trouton, who has been providing MAID in British Columbia, Alberta and Ontario since 2016.

Sandra Demontigny, who lives in Lévis, Que., applauds her province for fighting to advance MAID in Canada. She has started drafting personal criteria that would mean she’s ready for the procedure.

Patients making an advanced request must detail the circumstances in which they’d want MAID, such as if they lose control of their bowel, or forget their children’s names.

Demontigny, 45, knew she wanted to apply for MAID when she was diagnosed with Alzheimer’s at 39.

Demontigny saw the distress in her father’s eyes as he suffered from Alzheimer’s – the same illness his mother had – and it was like he was saying “save me,” she says. He could no longer eat or drink at the end of his life. He lay on the floor like a baby learning to walk, she recalls.

She decided that if she was diagnosed, she would seek a medically assisted death.

“I cannot imagine myself, and my children seeing me like that,” Demontigny says, pausing as tears muffle her words.

More than a decade after her father died, signs of her own illness appeared.

Demontigny says she’s already losing her memory, and sometimes asks the same question repeatedly. “I’m not the same person as before,” she says.

The federal government will launch consultations later this month about expanding advanced requests for medical assistance in dying.

Dr. Catherine Ferrier, who has spent four decades diagnosing and treating patients with neurocognitive disorders in Montreal, is firmly opposed to advance requests saying, “I find it barbaric.”

She posits the dilemma of a dementia patient with advanced consent who pulls their arm away when the doctor tries to insert the needle.

“You’re going to have to either hold them down or sedate them in order to do that,” Ferrier says.

If a patient’s refusal is a manifestation of their illness, the MAID practitioner can proceed, she says, but “that leaves a huge leeway for the subjectivity of the doctor.”

“We talk about ageism and we talk about ableism, discrimination against people with disabilities. To me, this displays all of that. Somebody who’s not actively contributing to society anymore, somehow it’s OK to just lower your standards for consent and remove that person from the population,” says Ferrier.

But Trouton says this is why the details of a person’s request are so important: “They’re going to have to outline what suffering will look like and how that can be objectively identified, like five or 10 years later.”

“That does mean that when a patient refuses, like a person with dementia who’s happy, it’s going to be hard for us to indicate, what does a refusal look like,” says Trouton.

The Quebec government website states that health and social services professionals, such as nurses and social workers, are expected to answer a patient’s MAID-related questions and help them find a provider. A doctor or specialized nurse practitioner would prepare the advanced request with the patient and record it with the provincial registry.

Helping patients write advanced requests will be an intensive process given the level of detail required. Trouton says she worries that there won’t be enough physicians and nurses trained to meet the expected demand.

“It’ll be impossible,” Trouton says. “That’s what I’m quite worried about.”

This report by The Canadian Press was first published Nov. 8, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

OTTAWA – Canada is still not on track to meet its commitments under the Paris climate agreement, federal Environment Commissioner Jerry DeMarco said in a new report on Thursday.

Ottawa has promised to reduce greenhouse gas emissions to be 40 to 45 per cent below 2005 levels by 2030, but so far they have only fallen seven per cent below 2005 levels.

In a news conference after the reports were tabled in Parliament, DeMarco said it is still possible to meet those targets but the “task is much harder because there’s only six years left to do essentially 20 or 30 years’ worth of reductions.”

“It’s not time to give up,” he said.

While progress is “painfully slow” on some of the government’s policies, DeMarco said, “that’s not a reason to just throw up our hands and say we won’t make it.”

“We owe it to our children and our grandchildren to make as great an effort as possible to meet these global challenges.”

The report looked at 20 of the 149 measures from the government’s 2030 Emission Reductions Plan progress report, and found they were being implemented too slowly to fulfil their intended goal.

Only nine of those were on track and another nine were facing challenges.

The other two had significant barriers like delays in meeting milestones, including the initiative to get Indigenous communities off diesel fuel, and the oil and gas emissions cap. The government only published the cap’s draft regulations on Monday, after promising the measure in the 2021 election.

“Overall, the federal government had advanced a variety of mitigation measures to support progress towards a net-zero transition but had still not made sufficient progress to reduce greenhouse gas emissions to meet its 2030 target,” the report reads.

The report also zeroed in on whether Environment and Climate Change Canada has reported on its progress with enough transparency. In 2021, Parliament passed a law requiring the department to set emission targets and to publish emissions reduction plans and progress reports.

That law requires the department to include in its progress report what additional measures could be taken if Canada is not on track to meet its 2030 targets. As such, DeMarco said he expected more measures to be included in last year’s progress report since Canada clearly knew it wasn’t doing enough to meet the target.

Of the 32 additional measures the department published — in addition to the 149 existing ones — DeMarco found only seven were new measures. Three of them enhanced existing measures, and the other 22 were ones the department had already reported.

That included continuing to develop the Canada Green Buildings Strategy, which was already in the original plan.

DeMarco found the government has made strides in consulting with the provinces, territories and Indigenous Peoples, and that the department met its legislative reporting requirements. However he was critical of the government’s transparency with regards to its modelling data — concerns which he also raised in his report last year.

“Although the department made marginal transparency improvements on modelling assumptions for federal measures in the emissions projection report, it still provided insufficient details,” DeMarco’s latest report read, noting the department only provided details for one-third of the measures it included in its modelling.

“This issue of the lack of transparency in the modelling continues to be an ongoing concern, which can undermine the trust and credibility in the reported progress,” the report read.

Speaking to reporters outside the House of Commons on Thursday, Environment Minister Steven Guilbeault said the government could do better on transparency, and reiterated the work already done to bring emissions down.

“I agree with (DeMarco). We need to continue moving forward to implement measures to reach our 2030 target,” Guilbeault said.

“I should point out it’s the first time in Canada’s history emissions are going down because of measures that the government is taking.”

Guilbeault said final regulations for clean electricity standards will be released in the coming weeks.

This report by The Canadian Press was first published Nov. 7, 2024.

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Conspiracy theorist Alex Jones’ Infowars broadcasts could end next week as he faces a court-ordered auction of his company’s assets to help pay the more than $1 billion defamation judgment he owes families of victims of the Sandy Hook Elementary School shooting.

Or maybe not.

Both opponents and supporters of the bombastic internet show and radio host have expressed interest in bidding on the Infowars properties he has built over the past 25 years. They include Roger Stone, an ally of Jones and Donald Trump, and anti-Jones progressive media groups. If Jones supporters buy the assets, he could end up staying on Infowars.

Up for sale are everything from Jones’ studio desk to Infowars’ name, video archive, social media accounts and product trademarks. Buyers can even purchase an armored truck and video cameras. For now, Jones’ personal social media, including his account on X, formerly known as Twitter, with 3 million followers, are not up for sale, but court proceedings on whether they should be auctioned are pending.

The auctions resulted from Jones’ personal bankruptcy case, which he filed in late 2022 after the Sandy Hook families were awarded nearly $1.5 billion in damages in lawsuits in Connecticut and Texas over his claims that the school shooting was a hoax. Many of Jones’ personal assets also are being liquidated to help pay the judgment.

The deadline to submit bids and nondisclosure agreements on the Infowars assets is Friday afternoon. After the bids are reviewed, prospective buyers deemed qualified will be invited to a live auction that could see multiple bidding rounds next Wednesday. Any items not sold will be put up at another auction on Dec. 10.

Jones has expressed confidence that supporters — whom he did not name — will buy the assets of Infowars and its parent company, Free Speech Systems, allowing him to continue using its platforms. He also appears to be preparing for losing the brand because he has set up new websites and social media accounts and has been directing his audience to them.

“There’s a lot of buyers, people that are patriots that want it and will come in,” Jones said on his show in August. “If not … we’ll work with somebody else, fire something up. And it’ll be a little bit of a hiccup for the crew, and things. But that will just make us bigger.”

Email messages to Infowars and Jones’ bankruptcy lawyer were not returned.

It’s not clear how much money the auctions might bring in. In court documents, Free Speech Systems listed the total value of its properties and holdings at $18 million. Proceeds from the sales will go to creditors including the Sandy Hook families, who have not yet received any money from Jones and his company.

Confidentiality agreements and sealed bids generally are used in auctions to maximize bid amounts while preventing bidders from talking to each other and driving down the offers. The trustee in Jones’ bankruptcy case said in court documents that the procedures for the Infowars auction were designed to attract the highest possible bids.

Christopher Mattei, a Connecticut lawyer representing the Sandy Hook families, called the auctions an important milestone in their yearslong fight to hold Jones accountable. He also said the families will be seeking a portion of all Jones’ future income.

“From the beginning, the Connecticut families have sought to hold Jones fully accountable for his lies and to protect other families from him,” Mattei said. “Stripping Jones of the corrupt business he used to attack the families while poisoning the minds of his listeners is an important measure of justice.”

The families sued Jones and his company for defamation and emotional distress for repeatedly saying on his show that the 2012 shooting that killed 20 first graders and six educators in Newtown, Connecticut, was a hoax staged by crisis actors to spur more gun control.

Parents and children of many of the victims testified that they were traumatized by Jones’ hoax conspiracies and threats by his followers.

Jones, who has since acknowledged that the shooting did happen, is appealing the judgments.

Jones has made millions of dollars from his internet and radio shows, primarily through sales of nutritional supplements, survival gear, clothing and other merchandise.

Stone, the Jones and Trump ally and a conservative commentator, said on his X account and on Jones’ show that he would like to put together a group of investors to buy Infowars. He did not return email and social media messages on Thursday.

“I understand the importance of Infowars as a beacon of the truth, as a beacon of truthful information. And therefore, I would like to do whatever I possibly can to ensure, if possible, that Infowars survives,” Stone said on Jones’ show in September.

People on social media also have urged billionaire Elon Musk, owner of Tesla and X, to buy Infowars, an idea Jones has backed but Musk has not publicly responded to.

On the other side, Jones’ detractors have shown interest in buying Infowars, kicking Jones out and turning it into something else, such as a news site that debunks conspiracy theories or even a parody site. They include officials at two progressive media sites, The Barbed Wire and Media Matters for America.

An opinion piece by The Barbed Wire in September by publisher Jeff Rotkoff had a headline that read, “Let’s Buy Infowars. Alex Jones used these exact materials to exploit his viewers, peddle conspiracy theories, and damage the lives of grieving parents. We want revenge.”

Rotkoff urged readers to donate money to help put in bids, but he said Thursday that The Barbed Wire, based in Jones’ home state of Texas, was now unlikely to make any offers.

“But we have talked to a number of similarly ideologically aligned bidders and we are certain we will be outbid,” Rotkoff said in an email. “We’re thrilled that there appear to be multiple well-resourced bidders who share our interest in undoing much of the damage to our country done by Alex Jones. We’ll be rooting for those folks to be successful.”

He declined to say who the other potential bidders were.

Who exactly has submitted bids so far has not been disclosed. Jeff Tanenbaum, president of ThreeSixty Asset Advisors, which is helping to run the auction along with Tranzon Asset Advisors, would only say there have been a large number of inquiries.

If detractors buy up Infowars’ properties and Jones gets the boot, he should be able to build new platforms fairly quickly, said Melissa Zimdars, an associate professor of communication and media at Merrimack College in Massachusetts.

“As long as there is an audience hungry for his content — and there is — he’ll be able to utilize X and various fringe social media platforms,” she said in an email.