Woman given MAiD 'against her will' because her husband had 'caregiver burnout'

CALGARY — A woman in her 80s was euthanized through Canada's medical assistance in dying program (MAiD) with the help of her elderly husband who was "experiencing caregiver burnout," and experts question whether it was coerced. According to a report released by the Ontario MAiD Death Review Committee, a woman referred to as Mrs. B experienced complications after a coronary artery bypass graft surgery.Reported by the Daily Mail, she then opted for palliative care after going into a severe decline, and her husband began taking care of her. While most MAiD patients have to wait weeks to receive it after being approved, Mrs. B was an exceptional case — within the span of one day, she was assessed, approved, and given MAiD. .This is how it happened — after Mrs. B had been discharged from palliative care and returned to her home, she later requested a MAiD assessment.Her MAiD assessor noted she still preferred palliative care based on her personal and religious beliefs, and she "wanted to withdraw her request."The next day, her husband took her to the emergency department because, according to the report, he was "struggling from caregiver burnout."Despite this, Mrs. B was discharged and sent home..Her husband had also requested placement in a hospice palliative care centre, but was also denied.Mrs. B's spouse then contacted the provincial MAiD coordinator for an urgent assessment.The new assessor ruled her eligible for MAiD, disregarding the concerns of the first practitioner, who questioned the new practitioner's urgency, the sudden shift in patient perspective, and the influence of caregiver burnout."This MAiD practitioner expressed concerns regarding the necessity for 'urgency' and shared belief for the need for more comprehensive evaluation, the seemingly drastic change in perspective of end-of-life goals, and the possibility of coercion or undue influence (i.e., due to caregiver burnout)," the report stated. .The MAiD practitioner had then requested to meet Mrs. B the next day, but was denied due to "the clinical circumstances necessitated an urgent provision."Instead, a third practitioner was sent to evaluate Mrs. B's eligibility, she was approved that third practitioner, and Mrs. B was euthanized that evening.Some members of the Ontario MAiD Death Review Committee deemed that "urgency is not a required consideration to inform the MAiD process.""Nonetheless, most members were concerned that there was no clinical indication for the MAiD assessments and provision to occur within the same day, with identifiable complex circumstances that may have benefitted from additional opportunity to explore and navigate,"stated the report..The report also claims some members question whether the second and third practitioners had a sufficient approach and enough time to determine the complete eligibility of Mrs. B.Members expressed concern about potential coercion of Mrs. B to receive MAiD because of her husband's "experience of burnout and lack of access to palliative care in an in-patient or hospice setting.""Members noted that Mrs. B’s spouse was primary in advocating and navigating access to MAiD with limited documentation of the process being self-directed. Moreover, the MAiD assessments were completed with the spouse present."Dr. Ramona Coelho, a family physician and member of the committee, wrote a review of the report criticising the case for the Macdonald-Laurier Institute.."The focus should have been on ensuring adequate palliative care and support for Mrs B and her spouse," Coelho wrote."Hospice and palliative care teams should have been urgently re-engaged, given the severity of the situation.""Additionally, the MAiD provider expedited the process despite the first assessor's and Mrs. B's concerns without fully considering the impact of her spouse's burnout."