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'life my way': choosing medical assistance in dying (maid)

"the whole process changes you," said sandy freeman, who has been accepted into the maid program, choosing to die with dignity.

by angelica bottaro

jul 10 2024

8 minute read

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sandy freeman lived her life her way, and she's chosen to die her way too. supplied

this article contains sensitive material related to assisted dying, as well as descriptions of abuse, trauma, and serious medical conditions, which may be distressing to some readers. please read at your discretion.

sandy freeman’s life began at the bottom of a tough, uphill road. growing up, she was the youngest of five children, and when sandy’s mother was pregnant with her, she almost chose to have an abortion instead of having another child. knowing this led sandy to use the term “i was a mistake” when sharing the tales of her difficult beginnings.

her upbringing was challenging, and sandy has dealt with her share of traumas, from living with abuse and parents who had alcoholism to running away with and marrying a physically abusive man at the tender age of 18. seven years later, sandy left her abuser and vowed never to marry again, only to find herself with another husband cut from a similar cloth.

her career, which consisted of teaching and creating fitness programs across the globe, was the shining light of sandy’s life. she became someone who could train and coach anyone—from elite athletes and olympians to older adults with mobility issues. she built her fitness business from the ground up and loved every minute of it—so much so that she became an elite athlete herself, partaking in marathons, triathlons, and physical bodybuilder competitions.

“i’ve always been different from my siblings,” sandy said when describing her choice to create her own path in life. “my siblings kind of followed my father’s orders of ‘you’re going to be a lawyer; you’re going to be a doctor.’ i was the black sheep, and i … did life my way.”

while life was far from perfect for sandy, her rebellion led to her creating an authentic business and career that allowed her to find joy and happiness doing what she loved in places she’d always dreamed of going.

then, 15 years ago, sandy got sick. this was the start of her journey towards choosing to utilize medical assistance in dying (maid), a program in canada that allows eligible individuals to receive assistance from a medical practitioner in ending their life, helping them take control of their death due to debilitating or terminal illnesses.

the diagnosis that changed everything

while sandy was at the top of her game, she started experiencing pain so bad that she couldn’t walk. after some investigation, she was diagnosed with avascular necrosis, a disease that develops when blood supply is cut off to the bones. in her case, her hip was affected.

over the course of a year following her diagnosis, sandy was subjected to nine failed hip surgeries, all of which led to no relief from her disease and two near-death experiences.

“i died on the table twice. i’ve had two out-of-body experiences,” sandy said. “i remember them as clear as day.”

during her time in and out of surgery, her hip bone was chiselled down to nearly nothing, leaving her without one of—if not the most—important joints in the body. she had to relearn how to walk, retrofit her home to reflect her newly acquired needs, and deal with excruciating chronic pain that afflicted her daily.

sandy also developed an infection in her blood and bones after the surgeries, leading to a five-year stint with antibiotics. but sandy, even with everything she had been through, wasn’t going to give up that easily.

“i said, ‘not going to happen,’” she said when talking about her new state of health. “i got myself to the gym every day, and i was trying to make alternate muscles assist me to try to walk, and eventually i did. i didn’t walk well … but i did. but every step just is a killer.”

flash forward 15 years, and “it’s just gotten worse and worse.” sandy cannot stand, sit, or lie down comfortably, as no position provides any relief. every second of every day, she is in some measure of pain.

sandy was also diagnosed with two forms of cancer – cervical and vulvar – while she was already fighting a battle with avascular necrosis.

facing the big choice alone

even though sandy has four siblings and a husband, her support system left much to be desired. her siblings, her husband, and her friends all failed to be there for her when she needed them most, and the added stress of abandonment only made matters worse. with no one to turn to and three different diseases to contend with, sandy was forced to make the decision alone.

“i’ve looked at it very practically. i tried to keep emotions out of it, but you can’t,” she said.

even with everything she was going through and what she had already overcome, the decision was not made lightly. sandy created pros and cons lists in a spreadsheet that she added to and subtracted from regularly over the course of three years while she wrestled to choose the right direction for her.

“i didn’t know much about maid,” she said. “i had obviously really researched it, but there was so many questions.”

with her weeks booked up with appointments and her body failing her, sandy began to consider maid as a viable and liberating option that would allow her to choose her own fate.

ultimately, sandy decided to submit her application. during the process of maid, documentation and assessments are used to determine if the person is qualified and competent enough to decide for themselves.

“there are a lot of medical things on top of other chronic pain that did lead me to this,” she said, “but it did take me four years to actually put my application in.”

sandy has gone through the process and is happy to be approved for the maid program, but she still has lots of life left to live before she sets a date. supplied

applying for maid

the application process for maid isn’t simple. it takes a lot of questions, answers, and the help of a medical team to get all the necessary documentation to provide to the powers that be who gets to choose if a person is allowed to use maid.

to be eligible for maid, a person must meet all the criteria set out by health canada. the criteria a person must meet include:

being eligible for health services funded by a province or territory, or the federal government in the country
be 18 or older and mentally competent enough to make health care decisions for yourself
have a grievous and irremediable medical condition, which includes diseases, illnesses, and disabilities that are in a state of decline that cannot be reversed and cause unbreable physical or mental suffering that cannot be alleviated under conditions that you find acceptable

the condition that you suffer from does not have to be terminal, but it does have to fit into the criteria mentioned above. you will also qualify if you have a mental illness alongside other physical diseases, but not a mental illness on its own. it’s important to note that being eligible for maid does not guarantee acceptance, as each case is assessed on an individual basis.

once someone does get approved for maid, they can choose to set the date, but they do not have to. they have the power to wait as long as they wish to set the date, and if that date does come and they are not ready, they can also decide to wait longer. the power of dying with dignity is entirely in the hands of the person who has chosen this end-of-life route.

while sandy was going through the channels to get approved for maid, she decided that the best way to approach the situation was through positivity—which is typically not an emotion people relate with dying.

“i decided to look at the positive. if i do get approved, for me, what does that mean? and the word freedom kept coming out of it,” she said. “when i am (approved), i can make that phone call anytime i want.”

she continued to feel more positive emotions than negative the more she thought about being approved for maid and the liberation that came along with being able to know the exact day that her life would end.

“it’s hard to explain, but it’s just my heart warmed rather than being so distressed,” she said. “i felt happy.”

medical professionals of various specialties and sandy’s medical care team had to be involved in the collection of documentation and her assessments, which lasted over a year when all was said and done. roughly a month and a half after her last assessment, she was approved for maid.

“the whole process changes you, from deciding to apply to waiting for your assessments. every step of it changes you. there’s anxiety, there’s stress, there’s relief,” she said. “there’s anticipation and stress thinking about the results of that and … everything you went through to finally decide to apply for it and then the feeling of, ‘oh my gosh, i’ve been accepted.’”

“it’s just like it’s like a ticket to paradise,” she said when describing how it makes her feel to know that when she’s ready to say goodbye, she holds the key. “isn’t it wonderful? if we all got to choose the day we die—how awesome is that?”

saying yes to life while on the maid program

other aspects of the maid program that give people their power back after their health has taken it away help those living with chronic and debilitating diseases choose their most authentic way to live and die.

the program allows people to not only choose when they die but also where, so people can avoid taking their last breaths in a “sterile, cold hospital.” and, if their chosen day finally comes and they decide they’re not yet ready to go, they can postpone.

sandy has gone through the process and is happy to be approved for the maid program, but she still has lots of life left to live before she sets a date.

“i want to go away to the caribbean somewhere. and i like that because it reminds me of my business. i love the ocean. i love the water. i want to be there by the ocean. i want to smell it. i want to feel it. all that stuff, it just brings me so much happiness,” she said, continuing, “i want to go on day trips like i used to. i want to continue doing volunteer work for the homeless. i want to go back into my group for women with domestic abuse. i’m doing stuff i love.”

sandy also plans to travel to more places, pick up her clarinet so she can get back into jazz band, and go skydiving. as for when she has chosen to go, sandy believes that the right time will come to her.

“when the right time is there, i will know. i really believe that,” she said later, continuing, “(but) it’s very important to just take it as you come and don’t rush it. make sure you’re ready.”

angelica bottaro

angelica bottaro is the lead editor at healthing.ca, and has been content writing for over a decade, specializing in all things health. her goal as a health journalist is to bring awareness and information to people that they can use as an additional tool toward their own optimal health.

'life my way': choosing medical assistance in dying (maid)

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