text: HALIFAX—Before her planned death earlier this week, a Halifax woman asked Canadian politicians to change the medically assisted dying law so that others like her might live out more days, and responses from Ottawa have been varied. Justice Minister Jody Wilson-Raybould said the government had no plans to amend the two-year-old assisted dying law, but another Liberal parliamentarian said that wasn’t the end of the story. 
   
   Since Audrey Parker’s assisted death on Nov. 1, Canadian politicians have given varied responses to her plea for legislative change. ( Andrew Vaughan / The Canadian Press ) 
   
   “Although the minister may say we’re not imagining any changes right now, I think we have to see what Canadians are thinking of,” said Darren Fisher, MP for Dartmouth—Cole Harbour. “If Canadians are staunchly in favour of something, then that’s our job to go out and try to advocate for those things on behalf of Canadians,” he added. Read more: 
   
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   Thousands sharing, commenting on Audrey Parker’s final public words Advocate dies ‘peacefully’ after plea for changes to Canada’s assisted-death law Fisher’s riding is one of four in the Halifax area where Audrey Parker lived until her death on Nov. 1. Parker, 57, was diagnosed with Stage 4 breast cancer in 2016. When she decided to end her life she was in excruciating pain from tumours in her bones, and had recently learned that the cancer had spread to her brain lining. Since Canada’s medically assisted dying law requires last-minute consent from the patient, Parker chose to go before her condition worsened further. 
   
   If she could have made an advance request, she said she would have stayed until after Christmas. Parker made a public call for the government to amend the law to eliminate late-stage consent in situations like hers. 
   
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   “We’re not considering changing something in the legislation,” Wilson-Raybould told reporters on Nov. 2. In an interview on the same day, Fisher said he felt differently. “(My constituents) are basically saying that they support (Parker) and my personal view is I’m supportive of it as well,” he said. In Parker’s final Facebook post she said the assisted dying law was “poorly thought out,” and asked the public to contact their MPs about changing it. Thousands have responded to Parker’s post, many of them expressing support for her request. In addition to Fisher, the other three Halifax-area MPs were asked for interviews Friday. Geoff Regan and Darrell Samson did not respond to the request. Andy Fillmore responded with an emailed statement, saying in part: “Many constituents have sent me emails containing (Parker’s) final Facebook post, adding their own reflections. It’s clear that she has left an impact on our community, and on the ongoing conversation related to medical assistance in dying.” “We know that medical assistance in dying is a deeply personal choice, and I believe it is important that Canadians have access to it if they choose.” Fillmore’s email went to on to say that he “looked forward” to reading an upcoming report on the issue. When Ottawa first drafted the medically assisted dying law, it asked the Council of Canadian Academies — a non-profit organization that operates on federal funding — to review three unresolved issues, including advance requests. A report on that review is due to be tabled at the House of Commons by the end of this year. Fisher said the report would not offer recommendations, but rather a summary “of the evidence of all the different perspectives.” “I do feel that we could have gone a little bit further on this and I’m looking forward to seeing that report come in December,” he said. Stephen McNeil, Nova Scotia’s Liberal premier, offered his respect to Parker in a statement after her death, calling her “courageous.” He otherwise left her request to the federal government. “This debate will continue at the national level, and she will be a major voice in the conversation that I’m sure Canadians are going to have.” Halifax Mayor Mike Savage echoed McNeil’s response, saying in an interview Friday that he was “impressed at her courage and tenacity,” but that there was nothing he could do at a municipal level to address her plea. With files from Mitchell Kedrosky and The Canadian Press Taryn Grant is a Halifax-based reporter focusing on education. Follow her on Twitter: @tarynalgrant 
   
   Read more about: ||||| Audrey Parker was assessed and approved for medically assisted death, but because federal law requires that she be lucid at the time of death her plans were derailed 
   
   For weeks, Audrey Parker had been organizing what she called her “beautiful death”, carefully planning every detail of her final days, and even writing her own obituary. 
   
   Parker, a television makeup artist, was in excruciating pain as cancer crept from her breast into her bones and brain, and intended to end her life before the suffering became too overwhelming. 
   
   But because Canadian federal law required that she was lucid at the time of death – and fearing that the combined effects of cancer and medication could rob her of that clarity – Parker was forced to end her life months before she had intended to die. 
   
   With the help of a nurse, Audrey Parker passed away on 1 November, surrounded by friends and family in her Halifax home. She was 57. 
   
   Parker’s lost battle for greater autonomy in medically assisted death has reignited a debate over Canada’s legislation on medically assisted death, which critics say forces terminally ill people to choose two equally unpalatable choices: a death that is premature, or one that is painful. 
   
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   Parker was not the first to use Canada’s medically assisted death laws – more than 3,700 already have done so since the country’s supreme court paved the way for physician-assisted death in 2015 – but she quickly became one of the country’s most prominent advocates for changes in the law. 
   
   “The world lost a person that had such spirit, who kind of always knew she was going to do something really, really important,” said Kim King, a close friend who was with Parker during her last moments. “And in the end, she did.” 
   
   Legislation passed in 2016 allowed anyone above the age of 18 with a “grievous and irremediable medical condition” to apply for physician-assisted death. Individuals must undergo consultations and be examined by two clinicians in order to gain approval for the process. 
   
   Parker was assessed and approved, but a key provision in the law – that she be of full mental capacity when the decision to terminate life is made – derailed her plans. 
   
   “When we realized the implications of the late-stage consent, it was very disturbing,” said King. “She was so courageous to face her death head on.” 
   
   If she wanted to die on her own terms, it would have to be when she was still mentally sound. While she wanted to live to see another Christmas, she told friends she couldn’t run the risk of waiting too long. 
   
   “She was worried about how this cancer had ravaged her body so aggressively that if she waited too long, she would lose capacity and then she would be completely denied the right to have an assisted death,” said Shanaaz Gokool, head of Dying with Dignity Canada. “And then she would die in a manner she knew will be horrible.” 
   
   For clinicians and bioethicists, Parker’s fight encapsulates an ongoing debate within the medical community surrounding how to best help patients in their final days. 
   
   “A lot of us knew when the legislation came down, that this would be one of the next battle grounds,” said Chris Kaposy, a bioethicist at Memorial University. While the law has produced troubling situations like Parker’s, it also aims to protect vulnerable people, said Kaposy. 
   
   Clinical ethicists often grapple with instances of patients with late-stage dementia, some of whom have requested physician-assisted death – but later forget these wishes and go on to live contented lives, he said. 
   
   “You have to walk that line between honouring legitimate directives, where people are suffering … But also you want to be able to avoid situations where you’re obligated to essentially kill people who are happy.” 
   
   Only three countries permit people to plan their death beforehand, and do not require competency at the moment of death: the Netherlands, Luxembourg and Belgium. 
   
   But according to King, “[Parker] didn’t suffer from dementia, she wasn’t vulnerable. And she was very clear about what she wanted.” 
   
   Parker’s death has prompted a fresh debate on end-of-life planning in Canada, said Dr Jeff Blackmer, vice-president of the Canadian Medical Association. “If you agree with assisted dying or not, one of the silver linings to this has been a more open discussion about death and dying in Canada – and about the choices that we make at the end of our lives,” he said. 
   
   A government panel which is studying the existing legislation will release its full report in December, but will not make any recommendations, and the government will not be required to act. 
   
   The day after Parker’s death, the federal justice minister, Jody Wilson-Raybould, expressed no intention of amending the current law. “We’re not considering changing something in the legislation,” she told reporters, adding that she and the government were “confident in the legislation”. 
   
   While the minister’s position disappointed King and other friends, they see it as a reason to keep pushing hard for changes in the law, continuing the battle Parker fought to the end. 
   
   “Until she took her last breath yesterday, she never wavered,” said King. “It was just so beautiful.” ||||| Open this photo in gallery Friends massage Audrey Parker's hands and feet at the end of her last party. (Photojournalist Chris Donovan has a family relationship with Audrey Parker) Chris Donovan/The Globe and Mail 
   
   After a decadent breakfast of lobster eggs Benedict prepared by a friend in her modern high-rise kitchen Thursday morning, Audrey Parker plans to tidy up, climb back into her king-sized bed and receive a lethal injection. 
   
   Ms. Parker, who lives in Halifax, is three years into a battle with Stage 4 breast cancer she chose to “lean into” rather than resist because of its ravenous spread to her bones and brain. A former ballroom dancer and makeup artist with an affinity for the brand Chanel, Ms. Parker decided immediately after her diagnosis that she wanted to end her life on her own terms. She qualified to do so under Canada’s assisted-dying legislation. That law requires patients to be lucid enough to consent to their own deaths – and Ms. Parker feared she wouldn’t be if she waited too long. 
   
   The 57-year-old effervescent divorcee has taken pleasure in scripting what she calls her “dream death,” with the exception of one key element: choosing the actual day she will die. On this, Ms. Parker says her pen was unfairly forced by federal legislation requiring patients to be able to confirm their wish to die moments before a fatal injection is administered. 
   
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   “All I wanted to do was have a fabulous end-of-life experience on my own terms,” said Ms. Parker, who plans to die Thursday, holding her elderly mother’s hand and surrounded by her best friends, even though she is still full of life. “I would have liked to have really lived until Christmas. But I can’t take the chance of losing my window.” 
   
   Ms. Parker’s predicament highlights what some physicians and supporters of assisted dying see as a defect in Canada’s law and it is one Ms. Parker is bent on altering, if only posthumously. 
   
   Patients ending their lives are required to give what is known as “late stage consent,” meaning they must be lucid enough to agree to their own death immediately before a doctor or nurse practitioner administers the cocktail of life-ending drugs. If patients cannot give late-stage consent, they cannot, under the law, receive an assisted death. 
   
   Open this photo in gallery Audrey Parker is comforted by her friend Denise Doucet as they say goodbye at the end of night. Chris Donovan/The Globe and Mail 
   
   Intended as a safeguard, the rule has had unintended consequences. Ms. Parker said it seemed to force early death on her before it really feels like her time is up. 
   
   “They’ve literally taken my ability to die on my own terms away from me,” Ms. Parker said of lawmakers. “I have cancer in the lining of my brain. I could wake up tomorrow and I might not be myself. I just don’t know,” she said, adding: “It defies the whole point of the law. People are dying sooner than they need to.” 
   
   To avoid that fate, some patients choose to dial back their painkillers before receiving an assisted death to ensure they are fit to consent, a decision that leads to increased suffering, said Jeff Blackmer, the vice-president of medical professionalism for the Canadian Medical Association, which represents doctors across the country. 
   
   “That’s obviously a challenge that clinicians are concerned about,” he said. “They don’t want patients to undergo any sort of pain or suffering that could otherwise be avoided.” 
   
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   Cutting back her cocktail of pain medication – heavy doses of Dilaudid and cannabis – was something Ms. Parker said she could not endure. 
   
   “I’m picking to die over going through that pain again,” she said in an interview with The Globe and Mail one afternoon last week between sips of Red Bull, her walls filled with framed art she chose for her funeral, including a depiction of a nearly empty hourglass. "But if they would just let me die on my own terms … I’d figure out the right day.” 
   
   Ms. Parker reluctantly but firmly chose Nov. 1. She is haunted by cases of terminally ill patients who were approved for an assisted death but didn’t get one after losing their capacity to consent. 
   
   According to Health Canada’s most recent interim report on medically assisted dying, 3,714 legal assisted deaths have been carried out in Canada as of the end of last year. An analysis of why requests for the procedure are turned down in six provinces found that loss of capacity was the reason cited most frequently, followed by the patient’s death not being deemed “reasonably foreseeable,” as the law requires. 
   
   Some of the experts who helped to inform Canada’s assisted dying law predicted that prohibiting advance requests would lead to situations such as Ms. Parker’s. 
   
   Open this photo in gallery An ex-husband of Audrey Parker comes to say goodbye during her last party at her apartment in Halifax. Chris Donovan/The Globe and Mail 
   
   After the Supreme Court of Canada struck down the Criminal Code prohibition against helping others take their own lives in 2015, a special joint committee of the House and Senate and a provincial-territorial expert advisory group were set up to make recommendations about how the new assisted-dying law should work. 
   
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   Both groups recommended that the federal legislation allow for advance requests for assisted death in limited circumstances. The panels felt that patients such as Ms. Parker – those whose cases have already been rigorously assessed by two doctors and approved for an assisted death – should be allowed to make advance requests that set out the future terms for their death that wouldn’t be jeopardized as their mental capacity deteriorated. 
   
   The panels also recommended that the same permission be extended to people diagnosed with diseases such as dementia, a category of patients that raises difficult ethical concerns. 
   
   However, no advance requests of any kind were allowed under the legislation passed by Prime Minister Justin Trudeau’s Liberal government in June of 2016. The legislation included a provision that independent reviewers would be asked to study whether the law should be expanded to cover three types of patients currently excluded: mature patients under the age of 18; patients whose sole reason for seeking an assisted death is mental illness and patients who want to make advance requests to have doctors hasten their deaths. 
   
   The Council of Canadian Academies, a federally funded not-for-profit organization, is expected to publish a review of the evidence for all three situations in December. However, the reports won’t make any formal recommendations. They will only summarize the evidence. 
   
   Those advocating for changes that would allow advance directives say it is important to distinguish between cases such as Ms. Parker’s and those that involve patients who have been diagnosed with dementia. The latter involve more complex practical and philosophical challenges, including which version of a patient should have the final say, said Hilary Young, a University of New Brunswick law professor with an expertise in health law and informed consent. 
   
   “Is it the [predementia] person who didn’t want to be a burden and who valued her cognitive faculties very highly, or the present person who’s quite happy to read the same page of a book every day or watch television?” 
   
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   Open this photo in gallery Chris Donovan/The Globe and Mail 
   
   Canada is not the only country grappling with these questions. The Netherlands, Belgium, Luxembourg and Colombia all allow advance requests for assisted death but some have specific rules that limit their use. 
   
   However, the complexities wrought by dementia are not a concern in cases such as Ms. Parker’s, which some argue ought to be given more expansive consideration. 
   
   “She’s presently suffering and has a good sense of what she’s facing," Prof. Young said. "In that context, it seems almost arbitrary to deny her the ability to make that decision.” 
   
   The advocacy group Dying with Dignity Canada agrees. Although the organization also supports advance requests for assisted death for people with dementia, its leaders, along with Ms. Parker’s friends and family, are launching a campaign to change the federal law so that patients who have been approved for an assisted death can get one, even if they aren’t able to consent at the moment of death. 
   
   Chief executive Shanaaz Gokool, said they want any amendment to be named Audrey’s Law, in Ms. Parker’s honour. 
   
   Ms. Parker would like that too. 
   
   “I’m not doing this for me. I’m already out of here. I’m doing this for you guys,” she said. “Let’s all be proactive now. If people just demand this ... we don’t need a debate. Just an amendment to the legislation.” 
   
   Ms. Parker said she gave that message to Justice Department officials in a telephone conversation facilitated by Dying with Dignity Canada last week. 
   
   “I really pleaded with them. I begged them to lift that late stage consent,” Ms. Parker said. “Life just worked out for me. Everything went my way. It really did. So I want my death to go my way too. I’m not going to rest easy until it’s done." ||||| HALIFAX—On her final day alive, Audrey Parker shared a stirring message online about the right to a medically assisted death, and her post is receiving support from thousands. The 57-year-old Halifax woman died at her home on Nov. 1 after a lethal injection — a choice that was made possible by a two-year-old Canadian law that allows adults to request medical assistance to die. 
   
   Audrey Parker, who died on Thursday, said before passing away that she was forced to die early due to the current assisted dying laws in Canada. ( Andrew Vaughan / The Canadian Press ) 
   
   Hours before her death, Parker said in a Facebook post that she loved her life and had no regrets, but still wished she could have lived until Christmas. She said she was forced to die sooner than she wanted because of “a poorly thought out federal law.” As of Friday morning, the post had been shared more than 4,000 times, was approaching 5,000 reactions, and had almost 2,000 comments. “Peace be with you and thank you for the courage to post your thoughts,” wrote Facebook user Glynis Humber. 
   
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   Read more: Halifax woman plans to die on Thursday, saying Ottawa is forcing early death on her Advocate dies 'peacefully' after plea for changes to Canada's assisted-death law “I will share this and I fully believe you should be able to go when you want…the late stage clause has to be removed,” Frances Power-Stone commented. Parker was diagnosed with Stage 4 breast cancer in 2016, which eventually spread to her bones, causing her excruciating pain, and to her brain lining, which made her worry that she would eventually lose her lucidity. 
   
   Her final request was for the public to maintain pressure on legislators to amend the medical assistance in dying (MAID) law. “In the spirit of teaching and sharing, I’d like to leave you with some words that explain my position with MAID. You can copy and paste them into an email or text them to your MP asking for Ottawa to amend and remove late stage consent on MAID candidates in Audrey Parker’s category of Assessed and Approved MAID users,” she wrote. 
   
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   The law stipulates that people who want to die must be able to give late-stage consent. In other words, they must reassure the doctor of their choice immediately before going through with it. 
   
   Parker said that stipulation cut her life short. “As I near my death today, it is even more evident than ever before, that late stage consent has got to be amended and removed from MAID in Canada for my category of end users,” she said in the post. “Dying is a messy business. I can’t predict when cancer will move into my brain matter or when something else big happens to make me more unwell. I and only I can make that decision for myself.” Parker’s friends and family will host a public celebration of life at Pier 21 in Halifax on Nov. 9 at 2 p.m. Taryn Grant is a Halifax-based reporter focusing on education. Follow her on Twitter: @tarynalgrant 
   
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target: – Audrey Parker used Canada's medically assisted death law to legally end her life—but a provision in that law forced her to do so months earlier than she wanted to. The Guardian looks at the 57-year-old's case and the debate it has generated: Parker's stage 4 breast cancer was painful and advanced enough that she qualified as having a "grievous and irremediable medical condition," as determined by two doctors. But the law requires that one be of sound mind at the time of his or her death—and with the Toronto Star reporting the cancer had moved into Parker's brain lining, she feared that if she held off, her lucidity might erode. "I would have liked to have really lived until Christmas. But I can't take the chance of losing my window," she told the Globe and Mail. So she opted for a premature death on Nov. 1. The Globe and Mail reports the provision was put in as a "safeguard," with the Guardian noting cases of dementia patients who request death but then forget they have done so and happily live out their last days. On the flip side, the provision has also forced others to reel in their painkiller dosage at the end, resulting in increased pain. Before Parker's death, she publicly advocated to have the law changed, and the Guardian reports federal justice minister Jody Wilson-Raybould responded in the negative: "We're not considering changing something in the legislation." Parker discusses her experience in a lengthy obituary she wrote herself, which is filled with gratitude, features 10 pieces of advice, and ends with this: "Until we meet again, I leave you with a simple message: Be kind ... because you can." (This man had issues with the way he had to end his life.)