When Canada first passed its assisted dying legislation, also known as the Bill C-14 in 2016, it soon became a landmark in healthcare and personal autonomy. It is officially known as Medical Assistance in Dying (MAID) and was initially available only to those adults who were terminally ill. The eligibility criteria had strict parameters: the person had to be suffering from a "serious and incurable illness", be in an "advanced sate of irreversible decline", experience "intolerable suffering", and crucially their natural death had to be "reasonable foreseeable". This legal threshold was also known as Track 1. This was modeled on end-of-life care and largely served people with terminal cancer or other severe illness who wanted control over their dying process. Track 1 is a relatively swift procedure, with some patients receiving MAID within a day of applying. However, many Canadians live with severe, non-terminal conditions and they felt left out. These were people with degenerative diseases, chronic pain, or spinal injuries. They had and continued to suffer deeply, but were not imminently dying. They also began to request for MAID, however, were routinely denied.ALSO READ: What Are The Dutch Guidelines Of Active Euthanasia And The Countries That Allow ItThis led to a legal challenge by Jean Truchon, reports The New York Times. He is a man with spastic cerebral palsy whose suffering wasn’t deemed terminal. In 2019, a Quebec court ruled that the “reasonably foreseeable death” clause was unconstitutional. This case prompted the introduction of Bill C-7 in 2021, which created Track 2 — extending MAID eligibility to people with serious, incurable conditions causing enduring suffering, even if their deaths weren’t foreseeable.Track 2 includes additional safeguards: a 90-day assessment period, evaluation by two independent clinicians, and consultation with specialists if necessary. Applicants must also be informed of other ways to alleviate their suffering and show they’ve seriously considered those options. While mental illness alone was technically included under Track 2, implementation has been delayed until 2027 due to concerns about inadequate mental health infrastructure.Despite its tighter process and ethical complexities, Track 2 MAID has steadily gained use. In 2023, there were 622 deaths under Track 2 compared to 14,721 under Track 1. Still, Track 2 has ignited national debate, with critics claiming it opens the door to premature death among vulnerable populations — and supporters defending it as a compassionate choice for those trapped in non-terminal agony.Also Read: First Sign Of Diabetes Might Show Up In Your Eyes—Here’s What To Look ForPaula Ritchie And The Doctor Who Stepped Forward To Assess Track 2 PatientsA 52-year-old woman from Smith Falls, Ontario had a far from simple case, assessed by Dr Matt Wonnacott, who agreed to assess Track 2 patients. He believed that these patients too had the right to autonomy and must be able to guide care decision, including the right to choose death when suffering becomes unbearable, reports The New York Times. Paula had a long history of chronic pain and mental health challenges: fibromyalgia, chronic fatigue syndrome, migraines, depression, PTSD, borderline personality disorder, and more. But things got worse in early 2023 after a head injury. She began experiencing vertigo, migraines, uncontrollable muscle movements, and an overwhelming dizziness that made even basic tasks impossible.Doctors failed to find a physical cause. Some attributed her symptoms to psychological distress, while others diagnosed post-concussion syndrome. Treatments ranged from Percocet and Ativan to acupuncture and reiki, but nothing worked. Paula’s life shrank to a single room, her body wracked with pain, her mind spinning. She tried to end her life — and failed.YOU MAY WANT TO READ: Plea of Chilean Woman With Muscular Dystrophy Sparks National Debate on Euthanasia BillFrustrated by her inability to access help or relief, Paula began pursuing MAID. Her first request was denied. But she persisted, calling the regional MAID coordination center daily until she was finally reassessed by Wonnacott and a psychiatrist, Dr. Elspeth MacEwan.During the assessment, Wonnacott asked if she would wait five years for a hypothetical cure. Paula said no — she could barely get through a day. She felt tortured. A veterinarian, she told a friend, would euthanize a dog in better shape.Importantly, Wonnacott found her reasoning sound. She was not acting out of untreated mental illness or impulsivity. She had sought treatment. She had given it time. And she had thought carefully about her request. MacEwan agreed. Paula met the criteria under Track 2.
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