Waiver of Final Consent (MAiD) renewal

Specialty: Family Medicine Specialist **<u>Introduction</u>** I met with Mrs. Eleanor Vance at her home on 1 November 2024. Also in attendance were her husband, Mr. Arthur Vance, and her daughter, Ms. Sarah Vance. The purpose of our meeting was to review her Medical Assistance in Dying (MAiD) Waiver of Final Consent. The Agreed Date on the current Waiver is approaching. The Waiver permits me as the named MAiD Provider to carry out an assisted death if the person with whom the Waiver has been agreed has lost capacity, on or before the Agreed Date. Mrs. Eleanor Vance is seeking MAiD because of advanced Amyotrophic Lateral Sclerosis (ALS) but has not yet decided on a date for this to take place. She has expressed a wish to have a new Waiver in place. **<u>Review of events and symptoms since last meeting</u>** Since our last meeting three months ago, Mrs. Vance's ALS symptoms have progressed as anticipated. She reports increased difficulty with swallowing and now requires a pureed diet. Her respiratory function has slightly declined, and she is using her BiPAP machine more frequently, especially at night. Her mobility has significantly reduced, and she is now entirely dependent on her wheelchair for movement. Cognitively, she remains sharp and lucid, expressing continued understanding of her condition and wishes. Her pain is well-managed with her current medication regimen, and she denies any new or escalating pain. **<u>Discussion of Waiver extension</u>** We engaged in a comprehensive discussion regarding the implications of extending the Waiver of Final Consent. Mrs. Vance reiterated her firm understanding that this waiver permits MAiD to proceed even if she loses capacity to consent before the Agreed Date. She confirmed her clear, consistent, and unequivocal wish to pursue MAiD when her suffering becomes intolerable. We discussed the specific timeframe of the extension, acknowledging the progressive nature of her ALS and the importance of having this safeguard in place. Her husband and daughter were present and actively participated in the discussion, confirming their support for Mrs. Vance's decision and understanding of the waiver's purpose. All parties confirmed there was no coercion or undue influence. **<u>Decision</u>** Following the thorough discussion, Mrs. Vance has formally decided to renew her Waiver of Final Consent. A new Agreed Date has been established for 1 November 2025, providing a further 12-month period. She expressed a sense of relief and peace of mind knowing this provision is in place. We agreed to schedule another follow-up meeting in approximately six months, or sooner if her condition significantly changes or she wishes to discuss a specific MAiD date. She understands that she can revoke this waiver at any time while she retains capacity.