Doctor-assisted death is often portrayed as a rapid, peaceful, and comfortable process, but potential complications are a recognized risk that some experts worry are not being fully discussed with patients as a routine part of obtaining informed consent.
Failed MAID Cases Highlight Risks
The possibility of 'failed MAID' was highlighted last week in media reports of the 2024 death of Bradley Stewart, an Ontario man with liver cancer who resumed breathing after being pronounced dead by a London, Ont., family doctor and MAID provider. The doctor, James MacLean, did not administer the customary sequence of drugs and left before Stewart resumed breathing. This traumatic experience has left his siblings, who witnessed the mishandled death, still recovering.
Another case reviewed by the Ontario coroner's office describes the anonymized death of 'Mr. D.,' an 87-year-old man with congestive heart failure who uttered 'help me' while undergoing MAID in 2023. Two assessors agreed that Mr. D met all eligibility for MAID, but during the procedure, he experienced signs of physical and psychological distress, including groaning, guarding, and grimacing, and did not experience expected sedation from the first drug. His distress escalated to repeated verbalizations of 'help me' until sedation was achieved with propofol.
Informed Consent Concerns
Dr. Ramona Coelho, a family physician and former member of the Office of the Chief Coroner of Ontario's MAID death review committee, stated that no medical procedure has zero risk of complications. 'Yet some MAID clinicians publicly portray MAID deaths as uniformly peaceful, beautiful, and free of complications,' she said. 'This does not present an accurate picture of reality and risks influencing decisions about MAID based on an idealized portrayal of assisted death.'
The case of Mr. D, whose family witnessed his suffering, highlights the profound distress that can occur. 'They witnessed their father suffering with physical and psychological distress and these final memories stay with them,' reads the case report.
Experts argue that these complications must be routinely discussed with patients and families to ensure truly informed consent and to avoid traumatic end-of-life experiences.
