A Calgary woman's assisted death was delayed earlier this year after her father was granted an injunction by the court.Jeff McIntosh/The Canadian Press
UPDATE: On March 25, 2024, a Calgary judge ruled that the woman can access medical assistance in dying despite her father’s efforts to persuade the courts to block her request. The decision also prevents the daughter from receiving the procedure for at least a month so her family can appeal.
An Alberta father has asked a judge to block his daughter from accessing medical assistance in dying because he believes she is ineligible and unable to consent, despite physicians approving the woman’s application.
The 27-year-old woman, identified as M.V. in court documents, argued her father, known as W.V., does not have legal grounds to challenge her right to MAID. The identities of the people involved in the case, including the doctors, are shielded by a publication ban.
M.V.’s assisted death was delayed earlier this year after her father was granted an injunction by the court. The case could help define the rights of patients and family members under Canada’s new assisted death legislation and could help determine what role, if any, the courts have in reviewing expert opinion from medical professionals when it comes to MAID.
W.V., in a legal document filed earlier this month in Court of King’s Bench in Calgary, said the courts have the ability to review MAID approvals stemming from Alberta Health Services because there is a legislative vacuum.
“There is no other means by which the proper functioning of the MAID system in Alberta can be checked prior to the patient’s death,” his lawyers argued. The lawyers added that Alberta’s “refusal” to enact regulatory oversight for MAID “seems to be an invitation for the court to step in and fill the role of an absent legislature.”
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Under the current law, capable adults may receive an assisted death if they have an irremediable physical condition causing intolerable suffering that can’t be relieved with care acceptable to the patient. Their death does not need to be “reasonably foreseeable.” They may have a history of mental illness, but they are only eligible for their physical condition.
Meanwhile, a person’s right to privacy limits medical information that can be shared with a third party. This means that, if patients don’t want relatives and families involved, caregivers may be excluded from MAID assessments, or find out, after the fact, that their loved one has been approved.
M.V. lives with her parents and has autism, according to court documents, and her father believes she has undiagnosed mental illnesses that impair her capacity to give consent, making her ineligible for the program. She also has a history of “doctor shopping” for physicians who will provide her with a “formal diagnosis for purported adverse medical conditions” and help her access MAID, according to the father’s court documents.
M.V.’s parents believe she first applied for MAID in 2021, with one physician approving and one rejecting her application. This meant she did not qualify for the program. A year later, W.V.’s court filings argue, M.V. received an alternative assessment that deemed her so ill that death would come within hours or days.
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In 2023, M.V. applied for MAID again, although her court documents indicate this happened in August and her father’s point to June. She was assessed by medical professionals and approved in November, according to M.V.’s court submissions. In her father’s court filings, his lawyers argued one professional approved the application and another rejected. Because it was a tie, a third physician reviewed the application and approved it. The third doctor, according to W.V., was the same one who had approved M.V.’s 2021 application.
W.V. learned of the decision Jan. 13 and said M.V.’s death was planned for Jan. 19.
M.V. cancelled that plan because “she hadn’t gone through all of her childhood toy boxes and ‘touched everything,’ ” according to her father’s court filings. He interpreted this as meaning she may have been second-guessing her decision.
W.V. asked a judge to intervene on Jan. 31, the day before M.V. was scheduled to die in the family home.
“I believe M.V. suffers from mental health issues, which to date, have been undiagnosed, untreated and which underpin her wish to access MAID. I believe her mental health issues impact her ability to make decisions in relation to MAID,” W.V. said in an affidavit. “I also believe that M.V.’s decisions may be unduly influenced by other people.”
M.V.’s legal team argued the Supreme Court of Canada protected individual autonomy in medical decisions around dying in a 2015 decision.
“Denying an individual this agency deprives them of their medical autonomy, as well as their dignity,” M.V.’s lawyers said in a filing earlier this month. If the court gave W.V standing, it would negate the 2015 precedent, they said.
Ramona Coelho, a family physician in London, Ont., has been critical of expanding assisted-death eligibility without additional safeguards.
“On cases of such finality – that is death – there should be some sort of mechanism to pause to ensure patient safety,” she said.
Dr. Coelho was recently named to a panel created by the Ontario coroner to review complex MAID cases after the death. But she said that an independent review board is especially necessary in cases such as this one when doctors have disagreed, and the family has concerns.
The role of families in MAID assessments has become more controversial as assisted-dying cases have expanded beyond terminal physical illnesses to situations where patients are more likely to be younger and doctors may disagree in their assessments.
“Families often aren’t trying to create problems,” Dr. Coelho said. “They might have information that the MAID assessors aren’t aware of.”
Clarifying the role of families was one of the issues raised by experts calling for the federal government to delay legislation last year to expand MAID to include people with mental illness as a sole condition. Last month, the federal government announced that it will delay the expansion for another three years, while consultations with doctors and provincial governments continue.
In the Calgary case, Justice Colin Feasby reserved his decision.
Editor’s note: A previous version of this article incorrectly stated that the federal government will delay the expansion of MAID to include people with mental illness for another two years. The expansion will be delayed for another three years, until March 2027.