MAiD buys April Hubbard time to keep living

Medical assistance in dying (MAiD) is given to those who apply and are found to have a “grievous and irremediable medical condition.” They can then receive medical assistance to end their life. 

Since being approved for MAiD, April Hubbard has used the program as a way to keep living.

Hubbard, 40, was born with spina bifida, among other disabilities, and at 17 was diagnosed with a tethered spinal cord. The tumours at the base of her spine cause chronic debilitating pain and the condition is degenerative. 

Hubbard applied for MAiD in early 2023 after her quality of life worsened the year before and she was approved in the fall. Two and a half years later, she continues to live.

“For me, I kind of used it more as, ‘I need this safety net so that I can continue to live and push a little further than I thought I could,’ ” Hubbard says.

Hubbard was approved for MAiD under Track 2, which indicates a person’s natural death is not “reasonably foreseeable.” In 2024, it made up only 4.4 per cent of people who received MAiD. Track 1 is more common and relates to people whose natural death is “reasonably foreseeable,” such as cancer and cardiovascular conditions. 

In Nova Scotia, a person seeking MAiD must be enduring intolerable suffering that cannot be relieved under acceptable conditions.

Quebec is the only Canadian province where someone can receive an advanced MAiD request. This means they’ve been diagnosed with a “grievous and irremediable medical condition” but haven’t met all the eligibility criteria.

This excludes people with early-onset dementia and Alzheimer’s disease from applying for MAiD in Nova Scotia before they’ve experienced a significant decline in their health.

Hubbard has spent the last two and a half years seeing how far she can push her life ahead of her planned death.

“The approach I had been taking for a very long time was kind of setting the next goal I wanted to make it towards … I wanted to make it to my 40th birthday. I wanted to be able to do that one last dance show with my circus partner, Vanessa.”

Setting goals isn’t working for her anymore, but she’s still not ready to set the official procedure date. 

“It’s a really weird space to be in to try to continue to live in some way while trying to figure out how to die,” Hubbard says. She said she feels a lack of support from MAiD Nova Scotia. 

Dianne Cleveland’s father used MAiD to end his life under Track 1 three months after being diagnosed with terminal brain cancer in September 2021. 

As a family member, Cleveland found the MAiD experience extremely positive. She says she has “nothing but praise for everyone involved.”

“I had never really experienced a death in person,” Cleveland says, “and to me, it was amazing. It was just so peaceful.”

Hubbard says the MAiD system was never updated to properly support people under Track 2. It became available in 2021, five years after MAiD was legalized. 

“I don’t qualify for most of the supports for end of life care that somebody on Track 1 would. I don’t qualify for any mental health supports. The average person would get a few free sessions with mental health and even that is a very long wait list.” 

Gord Gubitz is a physician and clinical lead of MAiD Nova Scotia. He does MAiD assessments, provisions, and clinical work.

He says MAiD Nova Scotia has two social workers who help patients prepare for their medically assisted death and provide support to their families and friends. 

“The medically assisted dying program does not take care of patients’ health care,” Gubitz says.

“So we do not treat people, do not provide additional anything like that. If there’s a recommendation that the person should receive counselling, or palliative care, or some other disability support services, we can certainly recommend that to the health-care providers looking after the person.”

Gubitz says not everyone who is approved for MAiD ends up using it, but the program follows people as they are approved until they make their decision.

When asked if she had a good life, Hubbard says she lived as well as she could.

“I don’t think I can say that my life was good or bad. It just was what it was supposed to be, and I’m getting closer to being ready to say goodbye.”