Advocates and law makers are renewing calls for changes to the rules surrounding doctor-assisted dying after a Montreal man was charged with second degree murder in connection with the death of his long-suffering wife.
Michel Cadotte, 55, is accused of killing his wife, 60-year-old Jocelyne Lizotte. A family member told CBC News she had been living with Alzheimer's disease and her family had recently tried to obtain a medically assisted death, but was refused.
Lizotte was found dead in her long-term care institution on Monday afternoon. The afternoon she died, a post went up on Cadotte's Facebook page.
"I cracked," the post reads, in colloquial French. "Nobody asked me how I'm doing, however, you know, I gave in to her demand for help in dying. I'm waiting for the police."
Other family members told Radio-Canada Lizotte had been ill for many years and had difficulty walking, eating and communicating.
Canada and Quebec currently have two separate laws governing medical assistance in dying. Quebec's law, which is narrower than the recently-passed federal version, requires that applicants "be at the end of life."
The federal law restricts doctor-assisted death to adults with a "foreseeable" death.
Neither law goes far enough, according to Dying with Dignity CEO Shanaaz Gokool. She would like to see a provision to include "advance" consent, allowing terminally ill patients to express their interest in medical aid in dying while they are still cognitively competent.
In cases including patients with Alzheimer's disease and Huntington's disease, this would allow patients to access doctor assisted death even after they've lost their ability to speak.
"We know that Canadians are ready for this provision," said Gokool, "and what they're looking for is leadership in how it can actually happen in practice."
Prior to passing the federal legislation, Ottawa had a joint committee examine the issue of doctor-assisted death. In its report, the committee recommended allowing advance consent in Canada.
One of the chairs of the committee says allowing advance consent could mitigate significant suffering in Canada.
"[Patients] may be suffering intolerably without any ability to communicate with anyone around them," said Conservative Senator Kelvin Ogilvie.
"They know they will not be competent to communicate at a certain point. As a result, they are condemned to suffer under these conditions."
Ogilvie said he anticipates hearing of more cases similar to Cadotte's unless the law is amended.
"If you go on the web, you'll see all sorts of circumstances where people were forced to take their lives when they reached the condition that was simply intolerable or their partner couldn't bear to see them suffering any further," he said.
Legislation being challenged
Shortly after Ottawa's federal assisted dying bill became law in 2016, a B.C. woman with spinal muscular atrophy joined the British Columbia Civil Liberties Association to launch a case challenging its constitutionality.
The lawsuit of Julia Lamb, 25, says the law is unconstitutional because it deliberately excludes those who are suffering with no immediate end in sight.
"Grievously and irremediably ill Canadians who are suffering unbearably should have the right to choose a dignified and compassionate death. This right was confirmed by the Supreme Court of Canada," said Grace Pastine, litigation director for the BCCLA when the suit was launched in June 2016.
Better palliative care the answer, says Alzheimer Society
The Alzheimer Society of Canada says in a statement that people can live with dementia for longer than ten years, and in that time, they may change their mind on doctor-assisted death.
The statement says it's difficult or impossible for caregivers "to know what the person with dementia comes to value over time, especially if those values are at odds with previously expressed desires."
Instead of calling for a broadening of the laws, the organization is calling for better palliative care in Canada.