Getting infected with COVID-19 changed Tracy Thompson’s life forever. More than two years have passed since the original infection, but her symptoms still dictate her days, leaving her with severe fatigue, robbing her of energy and her ability to work.
Thompson, a 50-year-old Toronto resident, says her lingering illness and lack of significant financial support prompted her to begin the process of applying for medical assistance in dying (MAiD), a procedure that first became legal in Canada in 2016 .
“[MAiD] is an extreme financial consideration,” she told CTV News Toronto.
After 26 months of lost income since the onset of symptoms, no foreseeable ability to work and no support, Thompson said she expects to run out of money in about five months.
“My choice is basically to die slowly and painfully or quickly. Those are the options that remain,” she said.
In addition to severe fatigue, Thompson lists a number of symptoms she has developed from long COVID: She can no longer read books or write text longer than a tweet. Her vision usually begins to blur around sunset. She has a hard time digesting food. Her taste and smell have changed. On some days, the oxygen exchange in her lungs is impaired, which makes it difficult to breathe. Scars mark her heart from the swelling she got from myocarditis.
A year after Thompson became ill, MAiD legislation was revised in Canada. Previously, only those whose natural deaths were reasonably foreseeable – otherwise known as Track One patients – were eligible to apply for MAiD. For example, terminally ill patients.
The legislation, amended in March 2021, led to the creation of a second-time patient. Now, a Canadian suffering from an “intolerable” and “irreversible” illness, disease or disability who may not be near the natural end of life may also be eligible for assisted dying.
The latest data from Health Canada shows that 7,595 Canadians chose medically assisted death in 2020 – representing 2.5 per cent of deaths in the country. This marks a more than 34 percent increase over the previous year.
In 2020, however, only patients who had a reasonably foreseeable death were eligible for MAiD. Since then, the potential pool of candidates has grown significantly.
‘THERE IS NO CURE’
Before Thompson contracted COVID-19, she worked as a chef in Toronto.
Her work consisted of long hours packed with quick decisions and physical exertion. Now, she says, deciding whether to get up and fill a glass of water can stop her day.
“From able-bodied and employed to almost bedridden. I can’t get up for an average of 20 hours. I have very little capacity to expend energy physically, mentally and emotionally, so I try to stay at home all the time,” she said.
Not that Thompson wants to die. In fact, she still appreciates the little bursts of joy in life.
“I am very happy to be alive. I’m still enjoying life. The chirping of birds, the little things that make up the day, are still pleasant to me, still pleasant. I still enjoy my friends,” she said.
“There is much in life to enjoy, even if it is little.”
Still, a world where Thompson has no access to income is not one she thinks she can survive in.
“I don’t relish the idea of suffering for months to come to the same conclusion. When support doesn’t come, things won’t change,” she said.
“It seems irrational to put myself through this only to die in the end.”
Because Thompson’s illness is not clearly outlined in eligibility for the Ontario Disability Assistance Program (ODSP), which currently provides a single applicant with a maximum amount of $1,169 per month, she believes it could take years to qualify – something that many Ontarians who have applied under the program is not unusual for. Even if Thompson qualifies, she says the entire monthly alimony amount would at best cover her rent.
“That would be my entire living budget,” she said.
So far, Thompson has sought one doctor’s approval for MAiD and is waiting to hear back from a second specialist. To be considered, an applicant needs two independent doctors or nurse practitioners to confirm that they meet the criteria. This goes along with a written MAiD application signed by the person applying for it.
The applicant has until now before the procedure to withdraw his consent. Ultimately, once the criteria are met, the decision is in their hands.
Although Thompson is still working through the necessary steps, she is confident she will receive approval.
“As far as I know, I would meet the criteria. I am very sick.”
“There is no cure. There is no treatment. You don’t have to be terminally ill,” she said.
“A DIFFERENT LIFE”
While Thompson is currently eligible for MAiD, there is a new group of Canadians who will be able to apply in a few months.
As of March 17, 2023, applicants with a mental illness as their only underlying medical condition will be eligible for MAiD in Canada.
Mitchell Tremblay has already written his letter for consideration.
Mitchell Tremblay has written his letter requesting medically assisted dying (supplied). “I’ve been in the system since I was 18,” Tremblay, now 39, told CTV News Toronto. “I never had roots. I never had a chance to heal.”
At age 17, he received a number of mental health diagnoses, including post-traumatic stress disorder (PTSD), generalized anxiety disorder, and major depressive disorder.
The following year, a few days before his eighteenth birthday, his parents kicked him out of the house.
“My parents didn’t believe any of it,” he said. “If the help had been there, I would have had a completely different life.”
Tremblay has been with ODSP for nearly 15 years. At first, he said roughly $1,000 was enough to live on. With a gradual change since then, he said he is barely surviving.
“I’ve basically been living on the same amount since 2008,” he said. “I’ve been homeless so many times I can’t keep track of them.”
Looking back, Tremblay said if he had had financial and emotional support, even just 10 years ago, he could have had a “totally different life.”
“WORRILY INADEQUATE”
Dr. Nahid Dosani, a palliative care physician in Toronto and head of health equity at Kensington Health, said many people choosing to switch to MAiD after the recent revision are doing so to ease their suffering.
But it can be difficult to uncover the root of suffering, he says.
“One of the things that becomes very difficult to digest is when the suffering is related to the fact that people don’t have housing or food, and how that is so difficult to separate from the suffering related to a medical condition,” he said.
“My concern is that we are creating a situation where it is easier for people to choose death by MaiD than to choose to live well because society does not offer them adequate access to money, housing, food security and social support,” he added Delivered.
A lack of affordable housing and financial support alone does not qualify a patient for assisted death, but Dr. Stephanie Green, a physician practicing in Victoria, British Columbia, said such complications can add to a person’s suffering.
“Suffering is one of the elements required for eligibility for MAiD, so it’s impossible to dismiss these issues when assessing someone,” she said.
As an MAiD practitioner, Green said part of her job is to assess the issues contributing to a person’s suffering and strive to seek out, inform and provide the limited resources that exist.
“Our health care system is woefully inadequate to serve our population with these resources,” Green said. “But I don’t think we can hold these patients hostage.”
There are circumstances in which assisted dying is appropriate, said Dr. Harriet Van Spol, a physician in Hamilton, Ont. participated in MAiD research. “But when it comes to socio-economic status, living conditions, loneliness or manageable symptom control, it’s quite tragic that people have to choose MAiD,” she said.
Van Spall said part of the problem is that society has become so transactional that we view some lives as more valuable than others.
“We need to be careful not to enforce laws that inadvertently help people end their lives because they don’t feel valued or respected or that they belong,” she said.
As Thompson takes steps toward assisted dying, she says she is aware of how MAiD and access to assisted dying intersect with marginalized groups in society.
“The government as a body is telling people that they are ready to help them to death because they don’t have enough money to live decently. That’s a pretty clear signal to me that you don’t belong here unless you’re capable enough or capable enough to work to generate a profit,” Thompson said.
“That seems really clear to me.”
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