Former Peninsula Healthcare Provider Advocates for Change in Medical Assistance in Dying (MAiD) Regulations

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Sue Buckton with her children and grandchildren. As her illness worsened she still found enjoyment in reading books, bird watching, watching televised NHL games with her husband, and trading pictures on her phone with family and grandchildren.

Submitted by Cory Buckton

You perhaps knew my mother Sue Buckton or have crossed ripples of her wake in the local health care system. She  was a local nurse and mother of three boys. Her career started at the Owen Sound Hospital close to her humble childhood home, born and raised. She started in the emergency department and it carried her throughout Ontario as a nurse or a manager in many roles and facilities which include: Brooke Medical in Owen Sound, Fergus Memorial Hospital, Public Health for Handicapped Kids in Milton, the emergency department in Milton, Wiarton Hospital, Tobermory emergency clinic and Hyperbaric Chamber, Lion’s Head Hospital where she oversaw the major renovation, CCAC, Manitoulin Health Center, and Gateway Haven in Wiarton. In addition to all of this she raised 3 boys and all the sports and friends that go with it.

Sue Buckton passed away peacefully at the age of 68 on November 16th, 2018 with Medical Assistance in Dying (MAiD). She had her loving family at her side.

Those who met Sue in healthcare knew her for her compassion and dedication to quality care: things were done right with the patient’s best interests at the forefront. Gracefully, Sue listened and responded. She instilled worth and comfort while providing help when people were at their weakest or worst. She could put on a band-aid or restart your heart. Likewise, Sue had the same compassion and drive for excellence when she did not have the nursing hat on. She helped as many people off duty as on duty: anything from lending a needed ear to someone after church, to pretty much adopting a fourth son. I did not fully grasp her relentless selflessness until after her passing, when numerous people made a point of telling me, that she was the nicest person they’d ever met.

In her last year of work, Sue had self diagnosed herself with Parkinson’s disease, which was confirmed two years later by a doctor. Nurses do in fact make the worst patients, I can attest to that. She compared her own illness to what she had seen others experience and would say, “There is much worse out there.” Sue would laugh at her Parkinson’s symptoms with her grandchildren, such as when her hand seized uncontrollably in a Hawaiian “hang loose” sign. Sue was also diagnosed with breast cancer. After breast surgery she denied chemotherapy and radiation as chose quality of life and enjoying family time. She felt that there would be a dramatic or catastrophic decline in the quality of her remaining time to undergo those treatments with Parkinson’s. Sue did not want to be denied the full enjoyment and family involvement with her unknown remaining time. The cancer did spread to her bones and body, yet even in a wheelchair, she found enjoyment in reading books, bird watching, watching televised NHL games with her husband, and trading pictures on her phone with family and grandchildren. I asked my mother of her mental state and she replied, “There is far worse out there Cory, I am good.”

We also discussed her wishes. One of her wishes was to have Medical Assistance in Dying (MAiD.) We talked at length about it and her entire family was in agreement that it would be done. As a nurse of 42 years in many fields and roles, Sue had seen almost every possible demise that could happen to a person. She did not agree with someone having to suffer through slowly dying, not having any quality of life or the chance to regain any quality of life. Nor did she agree with the family’s suffering; watching a loved one slowly dying and enduring the indecency of futile tests, tubes, lines, breathing machines, and drugs. Please do not misinterpret, she was absolutely in favour of saving people’s lives, and indeed she did.

Sue did not want to become what she had seen. She did not want to suffer needlessly, nor have her family endure, what she knew from experience, was dreadful and inhumane. She chose to have Medical Assistance in Dying.

Sue Buckton with her three sons.

MAiD gave Sue an opportunity to enjoy her remaining time until she saw fit to be done with her life here on earth. That choice was hers and could be activated, changed, or deactivated at anytime. She saw the opportunity to have loved ones near her as she drifted off to sleep and to the next part of her life. “Dr. Graeme Bock will take me to my angels,” was something she said many times in her last month and she beamed with a smile each time it was spoken. Perhaps the smile was because of his quality of care, old fashioned charm, or genuine concern, but I think it was their shared idealism of compassion and humaneness, a graceful peaceful passing.

The only potential flaw to her peaceful plan was that she, by the law, must:

-“Personally consent to Medical Assistance in Dying. Another person often called a substitute decision maker, cannot consent to Medical Assistance in Dying on your behalf, or make the request for you.”

-“You cannot give consent in advance. You must be able to provide consent until the moment you receive Medical Assistance in Dying.”

This posed a potential grave hiccup to Sue’s final wishes. If by ill chance she had a stroke or any other event rendering her unable to comply with the above requirements, she would be unable to have Medical Assistance in Dying, and thus endure what she loathed. Her power of attorney would be paralyzed behind these laws.

It was her belief that this is wrong.

She believed that the power of attorney acting on her behalf, if she became unable to, should have the power to activate this decision. The power of attorney in contrast can activate the removal of life support; so what is the difference between removing electricity to a machine or infusing drugs? Both of these methods technically stop breathing and thus the patient’s life. In Sue’s words, “It is stupid; when you are really suffering and can’t convey your pain is the most ideal time to use MAiD. It’s when you would really need it. There is nothing worse than looking into a patient’s eyes and knowing they hurt but they are unable to communicate.” She also discussed how we are sometimes more humane to our animals in their final moments than people. If all we get from a dying horse is a sad painful look to communicate then why can’t we do the same for people when they have asked and signed for compassion in MAiD?

Another issue that Sue was fortunate to avoid was a premature decision to activate MAiD in fear of missing the opportunity due to the laws. Her timing and experience was nothing short of perfection as her body was crucially failing but her mind was sharp. Sue thought that if the power of attorney had the ability to activate MAiD, it might give someone an extra few weeks or months before deciding they are ready rather than making a premature decision to have MAiD out of fear of ineligibility. If the laws were changed, a person could maximize their time spent with family and loved ones until the point they are uncommunicative and then have MAiD activated by their power of attorney rather than cutting that precious time short due to the unknown. This was not her circumstance, but she could see its benefit to others.

In her last week my mother conveyed to us that she wanted to be an advocate for Medical Assistance in Dying. She truly believed in it from experiential knowledge of being a nurse to dying people. She easily could have chosen to fall asleep and pass peacefully in the palliative care unit in the Saugeen Memorial Hospital. However, she did not. She fought to get to the procedure and to spend time with loved ones with the help of the amazing medical staff who kept her comfortable. She was selfless to the end in thinking that her story would help people see the compassion and grace of Medical Assistance in Dying. I am hoping that her story will aid in changing its flaws by pacing the program through a process improvement cycle, just as my health care manager mom would. The laws have to change for the better for those to come.

In my own experience I can attest that knowing you only have 5 days left with someone you love sifts extraordinary moments. The right thing is always harder to do. It was the hardest and best thing I have ever done, yet the hard will erode and the best will remain.

On behalf of my family, I would like to thank Dr. Graeme Bock and all of the delightful staff at the palliative care facility within the Saugeen Memorial Hospital. Their palliative program and care was impeccable. Sue was the first person at their facility to have MAiD and she wanted to promote it through education to the public. Any donation in her memory could be made to the Saugeen Memorial Hospital for the palliative care program to aid this wonderful program in a marvelous facility.

Donations can be made on the hospital’s website in the memory of Sue Buckton. https://interland3.donorperfect.net/weblink/weblink.aspx?name=E920252QE&id=1

For more information on Medical Assistance in Dying in Ontario, please visit: http://www.health.gov.on.ca/en/pro/programs/maid/