Canadians need to get better at talking about death, says pioneer in medically assisted dyingDr. Stefanie Green was one of the first doctors to offer medical assistance in dying (MAID) after it was legalized in 2016. She explores the last six years in her new book.

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Most people have not had the opportunity to openly discuss their end-of-life options, says Dr. Stefanie Green

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After six years working closely with people at the end of life, Green hopes to help people have easier conversations about MAID.

"We're not very good in Canada about talking about death and dying," she told The Current'sMatt Galloway.

"I think we need to get better at this conversation."

Her new book, This is Assisted Dying: A Doctor's Story of Empowering Patients at the End of Life, tells the stories of people she has helped — with names and details changed for privacy — and also looks at how Canadians approach the topic. 

Getting better at talking about death

Green's very first patient was a man she calls Harvey in the book. He was suffering from end-stage liver disease, and had already decided to access MAID when it became legal.

When the time came, he died surrounded by his wife and children as he'd hoped.

In her book, Green recounts a moment between Harvey and his wife: "She tells him to let go, that she's here with him. And as on most nights of his life, hers are the last words he hears, as he falls asleep."

LISTEN | Stefanie Green reads an excerpt from her book about a man receiving MAID

The Current0:47Stefanie Green reads an excerpt from her book, This is Assisted Dying

Harvey had the support of his family, but when that's not forthcoming, Green encourages respectful dialogue, with the help of a counsellor if necessary.

The aim is for a patient to express what they want, but also why they want it. And at the same time, for loved ones to express their fears or concerns about the procedure.

"The majority of times people can come to a respectful resolution together, maybe not agreeing with each other, but agreeing to at least disagree," Green said. 

I will not be bullied into not doing my job and I will not allow my patients to be bullied.- Dr. Stefanie Green

In a minority of cases she has overseen, the family will never agree to the procedure, as happened with a woman Green calls Edna in the book, whose loved ones objected on personal moral grounds.

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"We did have some counselling, but in the end, there was some yelling and screaming and finger pointing — that is never a pleasant situation," Green said.

But the decision ultimately lies with the patient, she said, provided they meet the eligibility, are capable of making the choice, and there is no evidence of coercion.

"I will not be bullied into not doing my job and I will not allow my patients to be bullied," she said. 

"I take my direction from the patient who has the right to make this request."

Disability advocates want support to live

Last year, the federal government passed Bill C-7, which expanded access to MAIDto include those whose deaths are not "reasonably foreseeable" after a 2019 court challenge by two Quebecers.

The changes included a temporary banon accessing MAID solely on the basis of mental illness until March 2023. That delay allows the federal government's expert panel to assess how MAID in cases of mental illness can be safely provided.

WATCH | New law on medically assisted death passes 

New law on medically assisted death passes

1 year agoDuration 5:27The Senate has passed Bill C-7, which expands access to medical assistance in dying, including, eventually, to people suffering solely from mental illnesses.Years after medical assistance in dying became legal, the debate rages on

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