Sisters Alicia and Christie Duncan were given just 48 hours' notice that their mother, Donna, was scheduled to undergo Medical Assistance in Dying (MAiD), a process they believed was initiated due to a mental health crisis rather than a terminal illness. Donna, a 61-year-old retired psychiatric nurse, had been approved for Canada's streamlined 'Track 1' MAiD pathway, intended for individuals whose natural death is reasonably foreseeable.
According to her daughters, Donna's condition stemmed from a spiraling mental health crisis exacerbated by a car accident in February 2020 and the isolation of the COVID-19 lockdown. She exhibited paranoia, believing she was being targeted by snipers, and was reportedly spending significant amounts of money on a psychic who claimed to detect heavy metals in her food. She also complained of pain when eating, describing it as "swallowing shards of glass," and developed extreme sensitivities to light and materials, leading her to wear clothes inside out and use safety pins to keep her bedsheets smooth.
Despite her daughters' pleas, Donna's MAiD appointment was scheduled for Tuesday, October 26, 2021, just days after she informed her family of her approval. In a last-ditch effort, Alicia and Christie contacted the police and obtained an arrest warrant under the Mental Health Act to have their mother transferred to a psychiatric ward. However, Donna was discharged from the ward without their knowledge and died via lethal injection on Friday, October 29, 2021. The sisters stated they did not have an opportunity to say goodbye and next saw their mother at the crematorium.
Questions of Capacity and Systemic Failures
Canadian government guidelines require MAiD candidates to be of sound mind and have a "grievous and irremediable medical condition." Alicia and Christie maintain their mother lacked the mental capacity for MAiD, arguing that the system, once initiated, moved with an efficiency that prioritized completion over thorough assessment of her mental state. Alicia described the process as medical practitioners acting with "technical efficiency of factory workers on a production line."
Alicia believes her mother's death highlights flaws in Canada's end-of-life legislation, citing approvals for non-terminal conditions like hearing loss and frailty. She now advocates for stricter safeguards to protect vulnerable individuals who she believes could benefit from adequate healthcare and support to live. Her activism is partly a result of what she terms "sanctuary trauma" experienced after her mother's death.
Before her car accident and subsequent mental health decline, Donna was described as a vibrant and caring individual who had dedicated her career to helping mental health patients. Her daughters believe her symptoms were the result of a psychosomatic disorder, a theory supported by a psychiatric assessment conducted less than a month before her death. However, this diagnosis did not prevent her MAiD approval.
A Race Against Time
The sisters' awareness of MAiD was limited until Donna's common-law partner began discussing it. Alicia recalled her shock upon receiving a document titled "Dignity with Dying Canada" in October 2021, believing her mother was not terminally ill. By the time of Donna's first MAiD assessment, the process moved rapidly. The sisters faced legal and logistical hurdles in their attempt to intervene, with lawyers citing time constraints or conflicts of interest.
Donna was admitted to a psychiatric ward on Wednesday, October 27, following an attempted suicide, but was discharged the following Friday, hours before her death. The police launched an investigation into Donna's death a year later, making her the first known MAiD death in Canada to be investigated. However, the investigation reportedly stalled when the Fraser Health Authority declined to provide MAiD assessment records to the police, citing privacy protections.
Alicia Duncan has since published a memoir titled 'The Other Side of the Straitjacket' detailing her experience. She has also presented her case to the UK parliament, urging for stricter oversight in end-of-life legislation, particularly concerning mental capacity assessments. Canada has one of the highest rates of euthanasia globally, with MAiD accounting for 4.7% of deaths in 2023. Concerns have been raised about potential cost savings for the government through MAiD, with a 2021 report estimating significant financial benefits as an alternative to palliative care.