A British Columbia Supreme Court judge has taken the extraordinary step of protecting a 77-year-old woman with advanced Alzheimer's disease from what the court described as the "likelihood of death at the hands of her husband." The ruling centers on the husband's openly discussed "Death Plan" for his wife, which he intended to enact if she became ineligible for Medical Assistance in Dying (MAID).
The "Death Plan" and a Husband's Advocacy
Court documents identify the woman as E.W. and her husband as T.S. Justice B. Smith's written judgment reveals that T.S. is a strong proponent of MAID. He spoke openly to family, friends, and healthcare workers about his intention to "end" his wife's life if she lost eligibility for the procedure, and then take his own life. E.W. was diagnosed with Alzheimer's in 2017.
The court found that E.W. never agreed to this plan. On the contrary, she was distressed by it and told the couple's daughter, identified as S.T., that she believed her husband was "trying to kill her." This profound disagreement formed the core of the legal conflict.
A Legal Safeguard Triggered by Healthcare Providers
The situation reached the B.C. Supreme Court after the Vancouver Island Health Authority (Island Health) raised serious concerns for E.W.'s well-being. The public health authority filed a petition for her protection.
The case has a complex legal history. In November 2018, as E.W.'s illness progressed, the couple and their daughter created a representation agreement. This legal document, under B.C. law, appointed T.S. as E.W.'s authorized representative for future care decisions, with their daughter as the alternative.
E.W. was initially deemed eligible for MAID in the summer of 2020. However, in a critical turn of events in September 2021, she told one of her assessing doctors she was "not interested in receiving MAID" in circumstances related to worsening memory or confusion. A subsequent medical report to Island Health concluded she was incapable of providing the requisite consent and was therefore ineligible.
Court Intervention to Protect a "Vulnerable Adult"
The doctor's report to Island Health stated that if T.S. learned of his wife's ineligibility, he planned to carry out the "Death Plan," which he referred to as a "dignicide." The report also noted that E.W. had "expressed that she was not ready to die" and, due to her cognitive impairment, was a "vulnerable adult at risk of abuse and neglect."
In his judgment, Justice Smith noted that while Island Health did not believe E.W. was currently being abused or neglected, officials were gravely concerned that E.W.'s lack of awareness of her own cognitive limitations left her unable to protect herself from the threat posed by the plan.
The court's decision grants E.W. protection from her husband's stated intentions. This ruling highlights the challenging ethical and legal intersections between personal advocacy for MAID, patient autonomy, and the protection of vulnerable individuals who can no longer speak clearly for themselves.
