Ishita Roy

What Are The Dutch Guidelines Of Active Euthanasia And The Countries That Allow It

Dutch Guidelines of Euthanasia, is it different form the UK bill?

A new bill has been proposed in Britain and lawmakers are expected to vote Friday. This bill aims to legalize <span>assisted dying</span>, which was introduced on Wednesday. This is the first time in almost a decade that the House of Commons will debate. The debate will discuss if doctors should be allowed to help end people's lives.

Labour politician Kim Leadbeater in the House of Commons read out the bill that grants terminally ill people in England and Wales a way to allow physicians to help them die.

The bill is called the Terminally Ill Adults (End of Life) Bill. This bill has not been debated since 2015.

<h4>Is it the same as <span rel="noindex">Euthanasia</span>?</h4>

Many countries allow euthanasia, which is referred to as <span>mercy killing</span>. However, the practice of the same varies legally.

Euthanasia is an act of ending a patient's life to limit the patient's suffering. Here, a patient would be a terminally ill person or someone who is experiencing great pain or suffering.

The word euthanasia comes from the Greek words "ey" good and "Thanatos" death. The idea behind euthanasia comes from the idea of a dignified death that condemns someone to a slow, painful, or undignified death.

The bill proposes that only those who are 18 years old and older in England and Wales and those who are expected to die within six months can request assisted dying. The bill states that the person requesting for this must have the mental capacity to make a choice about the end of their life and will be required to make two separate declarations about their wish to die. This two-step declaration along with "robust safeguards" with "three layers of scrutiny", with two independent doctors and High Court Judge to allow the signed off decision is to protect anyone from being pressured or coerced into ending their life.

If anyone is found to dishonestly get someone to take their life through this decision, that person will face up to 14 years in prison.

Assisted suicide is banned in England, Wales and Northern Ireland and anyone who helps a person end their life can be prosecuted and face up to 14 years in prison.

<strong>ALSO READ:<a href="https://www.healthandme.com/health-news/uk-presents-bill-to-allow-assisted-dying-what-it-means-and-how-is-it-different-from-euthanasia-article-151100656" data-type="tilCustomLink"> UK Presents Bill To Allow 'Assisted Dying': What It Means And How Is It Different From Euthanasia</a></strong>

For administrating medication, the bill provides that the patient must self-administer the life-ending medication. No doctor is allowed to give the medication. The bill also does not allow any health professional to provide assistance to the patient to ensure that the act is committed with patient's will.

However, one of the provisions of the bill does allow doctors to take part by ensuring that they are satisfied that the patient has made their own decision and has done so voluntarily.

<h4>How is Euthanasia different in practice?</h4>

There are many types of euthanasia, which differs in practice and legality and approval from the state. The types are:

<strong>Active Euthanasia</strong>: Where a patient is injected with a lethal dose of the drug, also known as "aggressive" euthanasia.

<strong>Passive Euthanasia</strong>: Where the patient's artificial life support such as a ventilator or feeding tube is withheld.

<strong>Voluntary Euthanasia</strong>: This happens when the patient consents to it.

<strong>Involuntary Euthanasia</strong>: This happens when the patient is not in the state to consent to euthanasia. In such cases, the patient's family makes the decision.

<h4>Dutch Guidelines of Active Euthanasia</h4>

Active Euthanasia is done by giving a fatal dose of a sleeping drug or a lethal drug is injected. After the patient is given a local anaesthetic, Lidocaine is administered, followed by intravenous injection or a coma-inducing drug. After the person falls into a coma, an injection of Rocuronium bromide is given that paralyses all muscles including the ones used to breathe. Shortly after this injection, the patient is declared dead. These steps are as per the Dutch guidelines for active Euthanasia.

The main difference from what the UK is proposing is the involvement of the medical professional in the Ditch guidelines, accepted by many countries. Here, the medical professional administers the lethal drug, whereas the bill proposed in the UK does not allow doctors or any healthcare professional to do so. The patient has to administer the medicine himself, after the two independent doctors and the High Court Judge verifies that it is done so voluntarily.

<h4>Countries Where Euthanasia Is Legal</h4>

<ul><li>Australia</li><li>Belgium</li><li>Canada</li><li>Colombia</li><li>Ecuador</li><li>Luxembourg</li><li>The Netherlands</li><li>New Zealand</li><li>Portugal</li><li>Spain</li></ul>

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A new bill has been proposed in Britain and lawmakers are expected to vote Friday. This bill aims to legalize assisted dying, which was introduced on Wednesday. This is the first time in almost a decade that the House of Commons will debate. The debate will discuss if doctors should be allowed to help end people's lives.History of the BillLabour politician Kim Leadbeater in the House of Commons read out the bill that grants terminally ill people in England and Wales a way to allow physicians to help them die.The bill is called the Terminally Ill Adults (End of Life) Bill. This bill has not been debated since 2015.Is it the same as Euthanasia?Many countries allow euthanasia, which is referred to as mercy killing. However, the practice of the same varies legally.Euthanasia is an act of ending a patient's life to limit the patient's suffering. Here, a patient would be a terminally ill person or someone who is experiencing great pain or suffering.The word euthanasia comes from the Greek words "ey" good and "Thanatos" death. The idea behind euthanasia comes from the idea of a dignified death that condemns someone to a slow, painful, or undignified death.What does the UK bill propose?The bill proposes that only those who are 18 years old and older in England and Wales and those who are expected to die within six months can request assisted dying. The bill states that the person requesting for this must have the mental capacity to make a choice about the end of their life and will be required to make two separate declarations about their wish to die. This two-step declaration along with "robust safeguards" with "three layers of scrutiny", with two independent doctors and High Court Judge to allow the signed off decision is to protect anyone from being pressured or coerced into ending their life.If anyone is found to dishonestly get someone to take their life through this decision, that person will face up to 14 years in prison.Assisted suicide is banned in England, Wales and Northern Ireland and anyone who helps a person end their life can be prosecuted and face up to 14 years in prison.ALSO READ: UK Presents Bill To Allow 'Assisted Dying': What It Means And How Is It Different From EuthanasiaFor administrating medication, the bill provides that the patient must self-administer the life-ending medication. No doctor is allowed to give the medication. The bill also does not allow any health professional to provide assistance to the patient to ensure that the act is committed with patient's will.However, one of the provisions of the bill does allow doctors to take part by ensuring that they are satisfied that the patient has made their own decision and has done so voluntarily.How is Euthanasia different in practice?There are many types of euthanasia, which differs in practice and legality and approval from the state. The types are:Active Euthanasia: Where a patient is injected with a lethal dose of the drug, also known as "aggressive" euthanasia.Passive Euthanasia: Where the patient's artificial life support such as a ventilator or feeding tube is withheld.Voluntary Euthanasia: This happens when the patient consents to it.Involuntary Euthanasia: This happens when the patient is not in the state to consent to euthanasia. In such cases, the patient's family makes the decision.Dutch Guidelines of Active EuthanasiaActive Euthanasia is done by giving a fatal dose of a sleeping drug or a lethal drug is injected. After the patient is given a local anaesthetic, Lidocaine is administered, followed by intravenous injection or a coma-inducing drug. After the person falls into a coma, an injection of Rocuronium bromide is given that paralyses all muscles including the ones used to breathe. Shortly after this injection, the patient is declared dead. These steps are as per the Dutch guidelines for active Euthanasia.The main difference from what the UK is proposing is the involvement of the medical professional in the Ditch guidelines, accepted by many countries. Here, the medical professional administers the lethal drug, whereas the bill proposed in the UK does not allow doctors or any healthcare professional to do so. The patient has to administer the medicine himself, after the two independent doctors and the High Court Judge verifies that it is done so voluntarily.Countries Where Euthanasia Is LegalAustraliaBelgiumCanadaColombiaEcuadorLuxembourgThe NetherlandsNew ZealandPortugalSpain

what are the dutch guidelines of active euthanasia and the countries that allow it

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If you have ever had a <span>migraine</span> then you would know that it is not just a <span>headache</span>, but it comes in phases. It starts with you being sensitive to all noise, smell, and even taste, feeling a bit dizzy, and losing out on your energy. Then there is a throbbing pain, this is when you know your migraine has reached its peak. 

<h4>What Are The <span rel="noindex">Stages Of Migraine</span>?</h4>

There are four main stages of migraine, which starts from predrome, aura, headache, and then postdrome. 

This stage is like a warning stage where there may be certain physical and mental changes. These include feeling tired, excessive yawning, food cravings, changes in your mood. You may feel low or irritated. Your body feels dehydrated and you might feel thirsty, have stiffness around your neck and may pass more urine. 

This happens to a third of people with migraine, notes The Migraine Trust. There are various neurological symptoms that happens in this stage, which includes changes in sight. This means, one may see dark spots, coloured spots or sparkles, often described as stars and zigzag lines. There could also be numbness, feeling like pins and needles on your body, you may also feel weakness, dizziness, and have problems with speech and hearing. 

The Migraine Trust notes that aura is the result of wave of nerve activity that spreads over the brain, it is also known as cortical spreading depression. When this electrical wave spreads, the nerves fire in an abnormal way and this range of reversible neurological symptoms develop. 

This can last from five minutes to 60 minutes. 

As per the American Migraine Foundation, the headache phrase of a migraine attack is characterized by pain on one or both sides of the head. This phase lasts from several hours to up to three days. 

This phase can vary from person to person. While some can experience mild pain, for others it could be a debilitating pain. 

The pain, in this phase, also shifts from one side of the person's head to other. In this phase, doing everyday activity like walking, turning on the lights, or any slight change, movement, sensory actions can aggravate the pain. 

This phase is also called "migraine hangover". This happens during the end of headache phase. The American Migraine Foundation notes that not everyone experiences this phase, however, it occurs in most cases, in about 80% of people. 

In this phase, the headache could be debilitating, but then it follows with fatigue, body aches, and trouble concentrating, dizziness and sensitivity to light. While in this phase the headache is ending, however, people could still be sensitive to smells, tastes and sensory actions. 

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If you have ever had a migraine then you would know that it is not just a headache, but it comes in phases. It starts with you being sensitive to all noise, smell, and even taste, feeling a bit dizzy, and losing out on your energy. Then there is a throbbing pain, this is when you know your migraine has reached its peak. What Are The Stages Of Migraine?There are four main stages of migraine, which starts from predrome, aura, headache, and then postdrome. What Do These Stages Mean?Predrome This stage is like a warning stage where there may be certain physical and mental changes. These include feeling tired, excessive yawning, food cravings, changes in your mood. You may feel low or irritated. Your body feels dehydrated and you might feel thirsty, have stiffness around your neck and may pass more urine. This can last for 24 hours.AuraThis happens to a third of people with migraine, notes The Migraine Trust. There are various neurological symptoms that happens in this stage, which includes changes in sight. This means, one may see dark spots, coloured spots or sparkles, often described as stars and zigzag lines. There could also be numbness, feeling like pins and needles on your body, you may also feel weakness, dizziness, and have problems with speech and hearing. The Migraine Trust notes that aura is the result of wave of nerve activity that spreads over the brain, it is also known as cortical spreading depression. When this electrical wave spreads, the nerves fire in an abnormal way and this range of reversible neurological symptoms develop. This can last from five minutes to 60 minutes. HeadacheAs per the American Migraine Foundation, the headache phrase of a migraine attack is characterized by pain on one or both sides of the head. This phase lasts from several hours to up to three days. This phase can vary from person to person. While some can experience mild pain, for others it could be a debilitating pain. The pain, in this phase, also shifts from one side of the person's head to other. In this phase, doing everyday activity like walking, turning on the lights, or any slight change, movement, sensory actions can aggravate the pain. PostdromeThis phase is also called "migraine hangover". This happens during the end of headache phase. The American Migraine Foundation notes that not everyone experiences this phase, however, it occurs in most cases, in about 80% of people. In this phase, the headache could be debilitating, but then it follows with fatigue, body aches, and trouble concentrating, dizziness and sensitivity to light. While in this phase the headache is ending, however, people could still be sensitive to smells, tastes and sensory actions. 

the four phases of a migraine

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Things are constantly changing and revolutionising in the health system. Thanks to technologies, there are now new ways to "heal". One such way is by indulging yourself in to the world of virtual reality and gaming, writes Dr Sathyanarayana LD, Consultant neurosurgeon at Narayana Health, Bengaluru for South First. 

He notes that many people undergo surgery to remove brain tumors, which are one of the most complex and could be life-altering conditions for someone to face. Brain tumors could be benign or malignant, however, both affects the person's speech, motor function, memory, and their ability to perform day-to-day activities. This is the reason why, post-surgery, patients may be left with impairments, including physical, cognitive, and emotional. But thanks to technological advancement in the field of health, virtual reality (VR) and gaming have become "powerful tools for neurorehabilitation". 

Dr Sathyanarayana notes that these means are not just for entertainment anymore. Since these means offer a more immersive and interactive experience, they have the potential to enhance the effectiveness of the treatment and also speed up the healing process, post-surgery. 

The doctor notes that recovering from brain surgery is an intricate and lengthy journey. The brain does not return to full function immediately after the procedure; instead, it must gradually rebuild and rewire itself to regain what was lost.

This remarkable ability of the brain to reorganize and adapt, shaped by continuous learning and experience, is called neuroplasticity. It is through neuroplasticity that the brain creates new neural pathways to compensate for damaged areas and restore lost capabilities. In this complex process of rebuilding, gaming and virtual reality (VR) are emerging as powerful allies.

VR places patients in immersive, computer-generated environments that stimulate multiple senses at once—sight, sound, and even body awareness, known as proprioception. These rich sensory experiences actively engage different areas of the brain, sparking changes at the synaptic level, where neurons communicate with each other.

By simultaneously activating motor, sensory, and cognitive regions of the brain, VR encourages synaptic plasticity and broader neural reorganization. This multi-layered engagement fosters a more cohesive and efficient path to recovery, helping the brain rebuild its networks in a meaningful and impactful way.

<h4>Relearning Movement Through Virtual Play</h4>

Post-surgery, many patients face motor impairments like weakness or poor coordination. Virtual reality offers a safe and stimulating space to relearn movement through repetition and task-specific training—key elements for motor recovery.

For instance, VR games that simulate cricket—batting, catching, or goalkeeping—encourage repeated use of the shoulder, arm, and hand, helping restore motor skills. These games also adapt in difficulty and provide real-time feedback, keeping patients motivated while preventing fatigue.

Watching and participating in virtual activities also stimulates mirror neurons—cells involved in motor learning—which may strengthen communication between remaining healthy brain circuits and support recovery.

<h4>Training the Brain to Think Again</h4>

Beyond physical rehabilitation, brain surgery often impacts attention, memory, decision-making, and problem-solving. Gaming and VR can simulate real-life tasks in a structured, repeatable way, challenging cognitive functions in an enjoyable format.

Games involving memory recall, puzzles, and strategic decision-making push the brain to stay active. Over time, this improves working memory, executive function, and mental sharpness—key components of cognitive healing.

<h4>Emotional Healing in a Virtual World</h4>

Recovery is not just physical or cognitive—it’s deeply emotional too. Patients may feel anxious, depressed, or lose confidence. Immersive VR experiences can provide psychological comfort by offering calming spaces or achievement-oriented challenges.

These environments give patients a chance to see their progress, rebuild self-esteem, and stay hopeful—factors that are vital for long-term motivation and adherence to recovery routines.

<h4>Why VR and Gaming Work in Neurorehab</h4>

<strong>Repetition with engagement</strong>: Games make repetitive rehab feel enjoyable, which is essential for promoting neuroplasticity.

<strong>Customized progress: </strong>VR systems offer real-time biofeedback and adaptive difficulty, ensuring that challenges remain effective and engaging without overwhelming the patient.

<strong>Affordable and scalable: </strong>Innovations from institutions like IIIT Hyderabad’s Serious Games Lab are making VR solutions accessible and low-cost, even for rural and public healthcare settings.

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brain tumor

VR and gaming for brain healing

can gaming help after brain surgery

Things are constantly changing and revolutionising in the health system. Thanks to technologies, there are now new ways to "heal". One such way is by indulging yourself in to the world of virtual reality and gaming, writes Dr Sathyanarayana LD, Consultant neurosurgeon at Narayana Health, Bengaluru for South First. He notes that many people undergo surgery to remove brain tumors, which are one of the most complex and could be life-altering conditions for someone to face. Brain tumors could be benign or malignant, however, both affects the person's speech, motor function, memory, and their ability to perform day-to-day activities. This is the reason why, post-surgery, patients may be left with impairments, including physical, cognitive, and emotional. But thanks to technological advancement in the field of health, virtual reality (VR) and gaming have become "powerful tools for neurorehabilitation". Dr Sathyanarayana notes that these means are not just for entertainment anymore. Since these means offer a more immersive and interactive experience, they have the potential to enhance the effectiveness of the treatment and also speed up the healing process, post-surgery. How Does It Work? Why Does It Work?The doctor notes that recovering from brain surgery is an intricate and lengthy journey. The brain does not return to full function immediately after the procedure; instead, it must gradually rebuild and rewire itself to regain what was lost.This remarkable ability of the brain to reorganize and adapt, shaped by continuous learning and experience, is called neuroplasticity. It is through neuroplasticity that the brain creates new neural pathways to compensate for damaged areas and restore lost capabilities. In this complex process of rebuilding, gaming and virtual reality (VR) are emerging as powerful allies.VR places patients in immersive, computer-generated environments that stimulate multiple senses at once—sight, sound, and even body awareness, known as proprioception. These rich sensory experiences actively engage different areas of the brain, sparking changes at the synaptic level, where neurons communicate with each other.By simultaneously activating motor, sensory, and cognitive regions of the brain, VR encourages synaptic plasticity and broader neural reorganization. This multi-layered engagement fosters a more cohesive and efficient path to recovery, helping the brain rebuild its networks in a meaningful and impactful way.Relearning Movement Through Virtual PlayPost-surgery, many patients face motor impairments like weakness or poor coordination. Virtual reality offers a safe and stimulating space to relearn movement through repetition and task-specific training—key elements for motor recovery.For instance, VR games that simulate cricket—batting, catching, or goalkeeping—encourage repeated use of the shoulder, arm, and hand, helping restore motor skills. These games also adapt in difficulty and provide real-time feedback, keeping patients motivated while preventing fatigue.Watching and participating in virtual activities also stimulates mirror neurons—cells involved in motor learning—which may strengthen communication between remaining healthy brain circuits and support recovery.Training the Brain to Think AgainBeyond physical rehabilitation, brain surgery often impacts attention, memory, decision-making, and problem-solving. Gaming and VR can simulate real-life tasks in a structured, repeatable way, challenging cognitive functions in an enjoyable format.Games involving memory recall, puzzles, and strategic decision-making push the brain to stay active. Over time, this improves working memory, executive function, and mental sharpness—key components of cognitive healing.Emotional Healing in a Virtual WorldRecovery is not just physical or cognitive—it’s deeply emotional too. Patients may feel anxious, depressed, or lose confidence. Immersive VR experiences can provide psychological comfort by offering calming spaces or achievement-oriented challenges.These environments give patients a chance to see their progress, rebuild self-esteem, and stay hopeful—factors that are vital for long-term motivation and adherence to recovery routines.Why VR and Gaming Work in NeurorehabRepetition with engagement: Games make repetitive rehab feel enjoyable, which is essential for promoting neuroplasticity.Customized progress: VR systems offer real-time biofeedback and adaptive difficulty, ensuring that challenges remain effective and engaging without overwhelming the patient.Affordable and scalable: Innovations from institutions like IIIT Hyderabad’s Serious Games Lab are making VR solutions accessible and low-cost, even for rural and public healthcare settings.

how vr and gaming aid in brain surgery rehab

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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.

<strong>ALSO READ: <a href="https://www.healthandme.com/health-wellness/what-are-the-dutch-guidelines-of-active-euthanasia-and-the-countries-that-allow-it-article-151101970" data-type="tilCustomLink">What Are The Dutch Guidelines Of Active Euthanasia And The Countries That Allow It</a></strong>

This 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.

<h4>Paula Ritchie And The Doctor Who Stepped Forward To Assess Track 2 Patients</h4>

A 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.

<strong>YOU MAY WANT TO READ: <a href="https://www.healthandme.com/health-wellness/plea-of-chilean-woman-with-muscular-dystrophy-sparks-national-debate-on-euthanasia-bill-article-151554844" data-type="tilCustomLink">Plea of Chilean Woman With Muscular Dystrophy Sparks National Debate on Euthanasia Bill</a></strong>

Frustrated 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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right to die

right to die with dignity

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.Paula 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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