Medical help to die: “isolation or loneliness”, important factors for many patients

Almost half of the people who have received medical aid to die (AMM), and whose natural death was not predictable, cited “isolation or loneliness” as determining factors in their choice.

These figures. However, which have been relatively unnoticed, are taken from the fifth annual Health Canada report on the AMM published last February and covering the year 2023.

The “way 2” in debate

AMM’s requests rank in two groups: track 1. Consequently, for people whose natural death is predictable, which represents almost all of the 15,343 people euthanized in the country in 2023.

Way 2 brings together 4.1% of people whose end of life remains difficult to predict in a close future.

Although the types of suffering declared are comparable between the two groups. Furthermore, the report reports a significant difference in one place: patients 2 are much medical help die: “isolation loneliness”, more numerous (47.1%) to cite isolation and loneliness as a factor than those already at the end of life (21.1%).

Road 2 is represented at almost 60% by women, more prone to long -term chronic diseases, according to Health Canada. Nevertheless, Neurological disorders and other problems such as diabetes or chronic pain are the most frequent underlying causes.

Being alone is not enough

Alain Naud. clinical professor at the Faculty of Medicine at Laval University and summight in this area, explains that the solitude of a patient “does not change anything or not a request” to the doctor.

“We must at the base have a serious. incurable disease or disability and the only great age, the fact of being 97 years old, to be isolated and to have no family, it is not an eligibility criterion,” says this expert involved in the debate for almost twenty years.

Archives photo, Jean-François Desgagnes

Admittedly, he nuances, “it is often part of their reflection and it is one of the many arguments that lead them to make their decision”.

Is it possible that some people make a different choice if they are better surrounded? “It is possible,” he admits.

“There are certainly people with whom it plays. And that if it was not a reality, would they have applied for medical help to die? It may not be. There may be people with whom it is possible. ”

Way 2, established in 2021 in Canada, is still debated. In March. for medical help die: “isolation loneliness”, example, a report by the UN Disabled Rights Committee recommended in Canada to put an end to it, for fear that the AMM replaces usual care.

Psychological suffering

In March 2027. eligibility for AMM must be extended to people with the sole medical condition of severe mental illnesses, after several postponements related to the hesitation of the federal government to move forward.

The cabinet of the Minister of Health Marjorie Michel confirms that the schedule still holds.

Andrew Lawton. a conservative deputy who suffered from psychological distress in the past, intends to table a bill in the fall to prevent the enlargement of the MA.

90 days of waiting

Road 2 was established in 2021 in Canada after a Decision of the Superior Court of Quebec in the Gladu-Truchon affair, two heavily disabled people for whom natural death was not “reasonably predictable”. Unlike lane 1. patients in medical help die: “isolation loneliness”, track 2 must wait 90 days between the first evaluation and the service of the MA in case they change their mind.