Denied medical assistance in dying in Ottawa, she is going to Brampton

An Ottawa woman who's tried for years to get approved for medical assistance in dying says the long wait has significantly reduced her quality of life, and she hopes others will face fewer barriers as she prepares to travel five hours away for the procedure next week.

Margaret (Maggie) Bristow describes her chronic pain as "intolerable" and "paralyzing," living with degenerative disc disease, fibromyalgia, spinal stenosis, arthritis in the spine as well as bulging discs and bone spurs.

"It feels like people are taking ice picks and shoving them into my chest.… My skin feels like it's being burned off my body 24/7," said Bristow from her couch, sitting as still as she could.

She said for two decades, she has slept sitting because of her back pain.

"For the last little while, it just feels like my bottom of my spine is going to come out of my skin," said Bristow, wincing in pain.

Bristow describes her successful career decades ago in the aerospace industry as "one of the best times of my life." She was also passionate about fostering shelter dogs, and fondly tells stories about falling in love with each of them.

But starting in 1998, the pain began and her health started to decline significantly.

WATCH | Bristow describes her journey: 

After seeing a neurologist, neurosurgeons, pain specialists and trying various therapies and opioid medications for her chronic pain, Bristow said "nothing really worked on me."

Bristow said she applied for medical assistance in dying, also called MAID, three times since the procedure was decriminalized in 2016 — twice prior and once after the recent legislative changes in 2021 broadened the eligibility criteria for patients.

All three times, she said, her Ottawa assessors declared her ineligible.

"I could have followed another route, instead of [them] dragging me and making me wait, making me hopeful. They chose to make my life horrible," said Bristow.

When she inquired why she got denied recently, Bristow said she was told her assessor wasn't "comfortable" approving her.

"They left me, tossed to the side, like, suffer."

Forced to turn elsewhere

A patient must have "a grievous and irremediable medical condition" to be eligible for MAID, according to the federal framework — which means they have a serious and incurable illness, disease or disability; are in an advanced state of irreversible decline in capability; and are enduring physical or psychological suffering that's intolerable to them and can't be relieved under conditions that they consider acceptable. Since 2021, patients like Bristow are eligible even if "natural death is not reasonably foreseeable."

Bristow said her family doctor connected her with MAID assessors in the Toronto area this spring.

Last month, Bristow got news she was approved.

"[I'm] just over the moon that I finally, after all those years of fighting, that I finally get to get what I need," she said.

Her procedure will take place on Aug. 10. She will travel to Brampton, Ont., where her provider is — taking strong pain killers to help her get there. She chose to do it at a hospital because she wants to donate her organs.

"I thought Ottawa's the capital city of Canada. Why do they not give me the same thing? Why did they force me to go pretty much over their heads and make me travel," said Bristow, who's been housebound for years.

"Shame on Ottawa."

Eligibility results can differ per clinician

Dr. Chantal Perrot, a Toronto family physician and MAID provider, said she's assessed a few patients from Ottawa who had difficulty finding an assessor in a timely manner.

"That's part of the challenge," she said. "There aren't that many of us across the country."

Perrot explained how MAID co-ordination is not standardized across the country; for instance, while Ottawa has a regional network, there's no network like that in Toronto.

It's not uncommon to hear about patients travelling to get MAID in Ontario, she said, because there may not be health-care professionals close by, willing or able to provide MAID in some areas. Some even travel from province to province.

Each assessor comes to a clinical decision regarding a patient's eligibility on a case-by-case basis, based on their interpretation of the legislation, the patient's history and conditions, she explained.

"It happens not infrequently that a person will be found ineligible by one assessor, but found eligible by somebody else," Perrot said.

Ottawa MAID respects doctors' rights to refuse

Champlain Regional MAID Network, which runs through The Ottawa Hospital, declined an interview.

In an email, the network said all health-care professionals take part on a voluntary basis.

If a doctor or nurse practitioner is "unavailable or uncomfortable" during the process, the network said it makes "all efforts" to refer patients to other providers who can support them.

"The right to conscientious objection is a core value and principle of MAID," the statement reads. "If a provider is not willing to accept a case, we respect that right."

The province's Ministry of Health also declined an interview. It said should a regional network decline a patient, its care co-ordination service helps connect them to alterative clinicians.

A regional network may have its own issues with capacity, resources or internal policies that may prevent it from providing MAID to some patients, the ministry said.

The world losing 'a gem,' says friend

Ann Marie Gaudon met Bristow through the Chronic Pain Association of Canada, and calls her a good friend.

"I have seen an incredibly proud woman, I have seen grace, I have seen thoughtfulness, generosity, plenty of love and even moments of humour despite the situation," said Gaudon.

She calls Bristow a "survivor, through and through."

"Maggie is a gem and we're all going to lose her. The world is going to lose her," Gaudon said.

Bristow said she wants to share her story in hopes others won't experience similar barriers in the future.

For people who have been denied MAID, she recommends seeking help from a family physician, a specialist or advocate, or the province's care co-ordination team.

While holding a photo of her and her late fiancé Brian, Bristow said she's looking forward to reuniting with her "soulmate."

"This is the love of my life," she said.

"Not many people get to meet their true love. And I have and I had him for four-and-a-half years.… And I hope to see him soon."