B.C. judge halts the medically assisted death of Alberta woman

OTTAWA – Global Affairs Canada says it is aware of the death of a Canadian citizen in Russia.

But the department won’t confirm reports the Canadian was among four foreign fighters who had crossed into Russia to fight for Ukraine.

The Globe and Mail reported today that four foreigners, including at least one Canadian, were killed on Sunday in a firefight in Russia’s Bryansk region, which borders Ukraine.

Asked about the report, a spokesperson with Global Affairs would only say the federal government is aware of the death of a Canadian and that it offers its condolences to family and friends of the deceased.

Russia’s embassy in Canada forwarded The Canadian Press a statement from Russia’s security service saying “four saboteurs” were killed by border agents and soldiers in the Bryansk region on Sunday.

The statement says the four killed were in possession of “foreign-made weaponry” and personal items, including a Canadian flag and a prayer book written in Polish.

It added that one of the soldiers killed had a tattoo suggesting he had been a member of a U.S. army parachute regiment.

This report by The Canadian Press was first published Oct. 30, 2024.

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TORONTO – Andrée McGrath is living “a really wonderful life.”

She and her husband of 49 years, Rick McGrath, live in Kanata, Ont., where they golf, take walks and laugh loudly and often. They travel south for the winter and adore their two grown-up sons.

After the 68-year-old was diagnosed with Alzheimer’s disease about a year ago, she cried.

“A lot, a lot, a lot — I cried,” McGrath said in a phone interview, choking up.

“I have a wonderful marriage and I frankly wish I had, you know, 20 years of good health, 20 more years to enjoy it,” she said.

McGrath is determined to keep doing the things she loves. When the time comes that she can’t, she said, she wants a medically assisted death.

”I am so in favour of MAID. We’ve already talked to our family doctor about it and he said, ‘well, we’re not there yet.’ So he knows that his hands are tied,” she said.

As of Wednesday, people with dementia in Quebec are allowed to make advance requests for MAID, before they lose the capacity to provide informed consent. But such requests are still illegal under the Criminal Code.

“If we could do that in Ontario, I’ll probably be one of the first ones to line up and sign it,” McGrath said.

After caring for her mother and grandparents in the late stages of Alzheimer’s disease years ago and watching them forget who she was, McGrath is determined not to let her own dementia progress that far.

“That’s really heartbreaking,” she said.

The federal government has said it still needs to do more consultations, which will start in November, before making a decision about advance MAID requests in the rest of the country.

The Alzheimer Society says people with dementia should have the right to request medical assistance in dying in advance — but it must not be a replacement for high-quality palliative care.

“People with a diagnosis of dementia deserve the same rights as everyone else. So if MAID is a legal end of life option for people, then we believe that it should be accessible to people with dementia,” said Cathy Barrick, CEO of the Alzheimer Society of Ontario, in an interview.

But it’s important to make sure patients also have the option to receive dementia-specific, comprehensive palliative care that would provide the best quality of life possible, she said.

”Having a choice between sort of feeling like you’re going to languish and be neglected (in a long-term care home) — it’s really no choice at all,” Barrick said.

“We wouldn’t want people to make a decision to end their life prematurely out of fear of what might happen. So obviously a lot of our advocacy is around making sure that people have options available to them at end of life.”

The challenge with Alzheimer’s disease and other forms of dementia is that it’s hard for someone to predict how they will feel at a later point in time as their disease progresses, Barrick said.

In signing an advance request for MAID, patients would need to communicate multiple specific circumstances that would have to happen in order for them to have MAID in the future, such as not being able to recognize family members and being unable to communicate.

”The first and the most important thing is for them to make their wishes known and they need to be abundantly clear about what those wishes are,” said Barrick.

“It needs to be extremely specific, you know, not something vague of like, ‘well, if it seems like I’m suffering, you know, do it then,'” she said.

Dr. Samir Sinha, geriatrician and clinician scientist with Sinai Health System and University Health Network in Toronto, said it’s critical to have a family member or friend to serve as an advocate to ensure their loved one’s wishes are carried out in the spirit they were intended.

”You might say, ‘if I end up in a state where I cannot recognize my own family members, I would consider that intolerable suffering. So I would want someone to end my life at that point,” said Sinha, who served on a federal subcommittee looking at the issue of advance requests for MAID.

But three or four years later, the patient might be at the point where they don’t recognize their family members, yet “you go in to see the person and, you know, there they are smiling and happy to see you. They don’t know who you are, but they seem to be content. They seem to be happy,” he said.

“And then the question is, what do you do then?”

Among the several conditions that have to be met in order for a person to obtain medical assistance in dying following an advance request in Quebec is that the person is “exhibiting, on a recurring basis, the clinical manifestations related to their illness and described in their request,” and that a physician or specialized nurse practitioner has cause to believe “the person is experiencing enduring and unbearable physical or psychological suffering,” the province’s website says.

It’s also important that advance requests for MAID “are not considered kind of a ‘one and done’ thing,” Sinha said.

When people are first diagnosed, it’s “absolutely devastating,” he said, and they may have very specific ideas of what circumstances they don’t want to live with down the road.

But “dementia is a journey that can carry on for years,” Sinha said.

“Care needs and preferences will evolve with time,” and patients should regularly revisit their advance requests with their caregivers to ensure the condition under which they would want MAID are still the same, he added.

Barrick emphasized that a diagnosis of Alzheimer’s disease or other forms of dementia “is not the end,” noting that although everyone is different, people generally live five to seven years after learning they have it.

“For most people, most of that time can be quite positive,” she said.

“People go on to continue on with their life. Some people can continue to work, travel, socialize — all the things (that)have meaningful engagement in their life.”

Having MAID as an option for when they deteriorate can actually provide reassurance and removes a worry that allows some people with dementia to live their lives as well as possible, Barrick said.

This report by The Canadian Press was first published Oct. 30, 2024.

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HALIFAX – Nova Scotia Liberal leader Zach Churchill has pledged to build 20 new collaborative care centres and expand services at 20 existing clinics as a way to help tackle the province’s stubbornly long family doctor wait-list.

Outside Soldiers Memorial Hospital in Middleton, N.S., in the Annapolis Valley, Churchill discussed part of his party’s vision for health care, which includes more clinics where doctors, nurses, pharmacists and other health professionals collaborate under one roof.

As of October, the province’s primary care registry listed 145,000 Nova Scotians without a family doctor. Churchill said access to care is particularly difficult in rural areas where patients without family doctors often end up in emergency rooms — if they are open.

“At this hospital, the emergency department has been closed more than it’s been open over the last three years,” he said. “Collaborative care centres are proven to be an effective model for providing people with quality care, and they will certainly attach patients to doctors and primary care providers.”

The government says that across the province there are already 107 collaborative teams working in about 50 clinics that are in various stages of development. The 20 new clinics the Liberals are promising would cost about $40 million — a bill the party plans to amortize over 25 years, bringing the estimated yearly capital cost to $1.6 million.

To encourage health workers to staff the new centres, the Liberals would offer a one-time $15,000 bonus to professionals such as pharmacists and therapists who commit to five years of service. As well, the party would double the existing incentive for doctors to $10,000 a year from $5,000.

Churchill pointed to the success of the collaborative care centre in Clare, N.S., as an example of the potential way forward. He said it’s fully staffed and patient attachment is so high the clinic is able to take on extra patients from nearby Yarmouth, N.S., and Digby, N.S.

“Imagine if we can replicate that success in every region of our province,” he said, while offering no timeline on when the new clinics would be in service.

Elsewhere on the campaign trail, NDP Leader Claudia Chender said in an interview with News 95.7 host Todd Veinotte that an NDP government would work toward establishing collaborative care clinics in every community.

“We need to prioritize primary care and make sure everyone has a doctor or a clinic they can go to,” Chender said, adding that the collaborative model, which relies on nurses and other medical professionals in addition to doctors, is ideal for a province that is short on physicians.

The Progressive Conservatives — elected in 2021 on a promise to fix the health system — have made “a million announcements, they’ve spent billions of dollars,” she said. “We haven’t made a dent in that (primary care wait-list). That has to be the priority.”

Progressive Conservative Leader Tim Houston made a health announcement of his own on Wednesday, promising to open a Halifax-based medical clinic to treat symptoms of menopause.

“The fact of the matter is women have traditionally been underserved by our health system. That’s just a reality,” Houston told reporters. Such a clinic, he said, is needed for the 350,000 women over 40 who don’t get adequate treatment for symptoms related to menopause.

“For too long, too many of these women have been left feeling like they’re fending for themselves in isolation as their bodies go through challenges,” Houston said.

The party estimates it would cost $4 million to set up the clinic and $2.4 million annually to operate it, and that it would provide care for approximately 13,000 patients per year. No timeline was offered on how long it would take to get the clinic up and running.

Houston added that a Tory government would “explore” creating a provincial health billing code that would fund family doctors to do menopause counselling.

At dissolution, the Progressive Conservatives held 34 seats in the 55-seat legislature, the Liberals held 14 seats, the NDP had six and there was one Independent. Election day is Nov. 26.

This report by The Canadian Press was first published Oct. 30, 2024.