Will Canadians with long-term COVID be eligible for medical aid in dying?

Doctors wonder if the long covid duration, a still poorly understood disease, could meet the criteria for obtaining themedical assistance in dying. The case file of a Torontonian with the disease who recently applied may offer one of the first answers.

Tracey Thompson had no idea that she would still have symptoms of COVID-19 in 2022 when he first contracted it in March 2020, before vaccinations and when little was known about the disease. Her first symptoms were mild, she says on the phone: “I didn’t need to be hospitalized, but my situation never got better. »

These days, the Torontonian often spends her days in bed. “My memory is not good; I am sensitive to screens; I have difficulty reading; some days I find it hard to listen,” she says. “My heart rate is also usually elevated. When she first spoke to experts about it, they asked her if she was hiding a substance use problem: “It was scary and discouraging,” she says.

Due to the long-standing effects of COVID, he has been out of work for more than two years, a major factor in his decision to seek medical assistance in dying. This element alone makes his case complex, even worrying, according to the experts consulted by Duty. But Tracey Thompson’s condition itself is just as important.

DThey are looking forare in progressin Canada and around the world, to better understand long-term COVID and the chances of recovery.

According to Toronto physician Kieran Quinn, who is interested in post-COVID syndrome, Tracey Thompson’s case for using medical assistance in dying is primarily based on the “serious and irremediable health problem” criterion and one of its sub-criteria is that the person is in an “advanced state of irreversible decline.” However, long-standing COVID is only two years old and it may be too early to conclude that the disease is “irremediable,” he warns. But the decision will ultimately depend on the assessment made by the specialists consulted by the Torontonian.

Western University professor Grace Parraga, who also studies the disease, agrees. The situation for people with long-term COVID is “dire,” she laments, but there is a “glimmer of hope.” “We have data, unpublished and not yet peer-reviewed, that demonstrate some recovery,” she says.

“Some doctors consulted by the patient may doubt [à lui accorder l’aide médicale à mourir] because they don’t know enough about the disease,” says Dr.re Chantal Perrot, co-chair of the Clinical Advisory Council for Dying with Dignity Canada.

Constant suffering from the disease alone was not the reason for Tracey Thompson’s decision to seek medical assistance in dying. “My story isn’t just about COVID in the long run — it’s also about what happens to poor people who have a disability,” the Torontonian explains. Without income for two years, she sees herself ending her life without a fixed address. Even the $1,169 monthly support, variable depending on the situation and not automatic for long-term COVID, from the Ontario Disability Support Program would not be “sustainable,” she says.

University of Toronto professor Trudo Lemmens, a specialist in health law, protests the situation in which Ms.me Thompson. “We allow medical assistance in dying to people who are not on the verge of death, but who are in a situation of poverty,” she lamented, referring to the new version of the law. In March 2021, the federal government removed the requirement that natural death had to be reasonably foreseeable.

“It is a sign of a system adrift. I think it’s a shame for our society,” says Professor Lemmens. Before a parliamentary commission, in June 2021, he had also accused the federal government of having “put the cart before the horse” by expanding the law even before having made a detailed evaluation of it. Medical assistance in dying is expected to be expanded again in 2023: people with mental health problems can access.

Mr. Lemmens also requests an investigation commission to analyze the “slippage” of the law, as in the case, according to him, of Mr.me Thompson. In addition, the speed with which the law is extended “profoundly violates the precautionary principle in the development of health policies,” he considers.

A person cannot qualify for medical assistance upon death simply because they have financial problems, clarifies the Dre Chantal Perrott. But the doctor admits that these factors can contribute to suffering, which the evaluator cannot ignore, she says.

I’m still waiting

Tracey Thompson submitted a first medical evaluation request a month ago and is still waiting for a response. Two experts, including a long-term COVID specialist, will have to give the green light. The process takes at least three months.

Meanwhile, the Torontonian is still holding out hope that a cure will be found. “If someone told me tomorrow, ‘Try this medicine,’ I’d be happy to do it,” she says. By law, specialists must offer her recovery options, but she can refuse them.

According to the Ontario Ministry of Health, this is the first request for medical assistance in dying related to long-term COVID.

For his part, the D.r Kieran Quinn, who works at two hospitals in Toronto, is concerned to see cases similar to Tracey Thompson’s multiply: “I don’t know what the solution is,” he admits. “We have to ask ourselves why health professionals end the lives of patients because of poverty,” says Professor Lemmens.

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