I’m not quibbling

Yesterday I received a comment on the rant I wrote earlier this week about the unbearable mental suffering of many people who are in an advanced stage of dementia and how awful I thought it was that there was no Medical Assistance in Dying (MAID) option to help to free these individuals from the torture chamber their minds had become.

This is what the woman said:

“Some definite misinformation in this post. Dementia is a neurological condition not a psychiatric one. There is now a protocol for allowing people to include dementia in their maid protocol… it’s called a waiver of informed consent and in progressive hospice care is becoming more mainstream.

“Many people now in their 90s and facing death grew up in strict religious environments and would never consider ending their life sooner than God calls them. So, I would object to the idea that this woman’s sons should be able to make a decision ie put her out of her perceived misery early, as that would not be her wish.

“The issue of assisted dying is complex and should be studied with care. Thankfully those in our 70’s will have greater choice when we come to the end of life. accurate information is important.

“I’ve sat bedside at several deaths over the last few years. Generally the final moments are peaceful and almost always reflect the way that individual led their life. Profoundly privileged to have sat vigil with some incredible people.”

Well, okay. Interesting. Dementia is considered a neurological condition, not a psychiatric condition. And this means…?

I wrote back: “Thank you for your comment. I think there may be some quibbling here when you speak of ‘neurological’ versus ‘psychiatric’. What I’m talking about is extreme mental anguish and having to live with it, whatever its cause. If you are reading this and are able to do so, I would very much appreciate being directed to information about waivers of informed consent as they would apply in these circumstances.”

And I received this reply:

“No quibbling…Dementia is clearly defined as a neurological disorder and mental illness is a psychiatric disorder, two separate and different conditions. You can do a quick google search to learn the difference. Also just search for Waiver of Informed Consent relative to MAID. This process is being used widely by compassionate hospice doctors. It only applies to neurological conditions like dementia and NOT to psychiatric/mental health conditions. That is why it is important to understand the difference between these two conditions. Not quibbling at all.

“Thankfully the government is moving more slowly to change the MAID rules around psychiatric issues.

“Not trying to be critical but this is an area I am passionate about and reasonably well informed about.  Hope this info helps to clarify.”

I am sorry, but I am going to dig in my ill-informed heels. Mental anguish is mental anguish, however you define its cause.

What prompted me to write my rant the other day was the suffering of a mother’s friend, but I’ve seen it before: my partner’s mother, the elderly parents of other friends.

Yes, the woman who left these comments is correct. It is possible for people with dementia to access MAID. An early diagnosis and an awareness of the horror that is to come have prompted many to take steps to escape later while they are still deemed to have the capacity to make this decision and sign a waiver of final consent. Therein lies the rub.

As detailed in this Dying with Dignity factsheet…

All good if you have the time. However…

So, there is no legal form of escape for my friend’s mother or the countless others who did not, in their seventies, make appropriate plans for later life.

I stand by what I wrote the other day. I do understand the need to protect the elderly from avaricious heirs. But I also most fervently believe that forcing someone to live in a state of fear and confusion is, as I said, nothing short of elder abuse. And I’m not quibbling about that.