Alicia Duncan wants the world to know, through her new book, that her late mother, Donna, was, for many years, a woman of “unflinching positivity” and a great deal of fun.

“She was very quirky and silly,” said Duncan, author of The Other Side of the Straitjacket: A Daughter's Story of Mental Health and Assisted Dying. “(And) very childlike and playful. She was the most fun mom to have growing up. And we really developed this incredible friendship as I became an adult and had children of my own. She became a similar role model for her grandkids.”

The longtime psychiatric nurse was a two-time cancer survivor earlier in her life, and her positive nature radiated through her humourous takes on her medical adversity. Donna once reportedly quipped, “nothing like radiation to get four months off of work.”

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Duncan said that in many respects her mother simply did not fit the profile of someone who would seek medical assistance in dying (MAiD).

“It's really frustrating and really sad because my mom was the least likely person to end her life this way.”

But tragically, Donna was euthanized with a lethal injection on Oct. 29, 2021. Duncan, her sister Christie and their mother’s longtime doctor strenuously tried to convince the 61-year-old not to follow through with her desires to end her life.

There were multiple motivations for her to write this book. One was to pay homage to Donna, who once desired to write a book about mental health from a patient’s point of view to engender greater understanding and empathy toward people too often discarded from society.

“Sadly, my mom passed away before she was able to write this book,” said Duncan. “(Due to) the nature of her death, and the fact that it was the only known police-investigated MAiD death in Canadian history, I felt more of a sense of responsibility to write this book for her legacy. Unfortunately, my mom is the patient, and it was through the lens of her mental illness and assisted dying that brought this book to life.”

She emphasized that this book was not written with the intent to “convince people of thinking one way or the other” about MAiD.

“My book was created as a tool for people to look at this issue because it is rapidly evolving and to understand what this legislation means, not just for them, but for other people in their lives,” said Duncan.

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Donna's story is one of a woman with a seemingly irrepressible spirit that manifestly changed following a car accident on Feb. 25, 2020, near her place in Abbotsford, B.C. She was diagnosed with a concussion less than 24 hours later.

However, her care stalled because of the stay-at-home COVID-19 restrictions. She would be diagnosed with post-concussion syndrome and prescribed medication for her mental health but would abandon this treatment because she claimed it did not work. It led her to seek MAiD. Her efforts were at first rebuffed, as it was recommended that she needed mental health treatment instead.

Donna kept pursuing MAiD, and received approval from two practitioners. Duncan and her sister could only keep their mother in a psychiatric unit for 72 hours, and their mother’s life was medically terminated just four hours after her release.                            

Determination by her two daughters to receive answers as to why Donna received approval for MAiD led them to the College of Physicians and Surgeons of British Columbia, a body that would insist this case was a criminal matter. Abbotsford police confirmed an investigation into this MAiD case — the first in Canada — was activated, but Fraser Health denied the police’s request for Donna’s assessment records, insisting that approval was needed from the province’s Office of the Information and Privacy Commissioner (OIPC). After 18 months in limbo, the OIPC upheld Fraser Health’s denial.

“When investigations cannot be completed properly because authorities are refusing to release information, that's a cover-up,” said Duncan. 

Notably, Canadian Catholic News recently reported that an internal B.C. document obtained through a freedom of information request revealed that the province’s euthanasia regime is fraught with errors. According to the "Medical Assistance in Dying (MAiD) Oversight 2024 Year End Report," the “MAiD oversight unit found 2,807 errors among 51.9 per cent of “MAiD case outcomes” requiring corrective ‘follow-up.’

Duncan devotes pages in The Other Side of the Straitjacket to break down this data.

One of the potential evolutions in the offing is permanently pausing the plans to broaden euthanasia access to individuals solely living with mental illness.

Duncan was pleased that the “evidence spoke for itself” and that this recommendation to halt was made by the joint committee. On the other hand, she said “what is concerning for me really is I believe the government is not willing to commit to this and they're leaving it up to the courts once again to decide what's going to happen with the expansion.”

Duncan was alluding to the 2019 Quebec Supreme Court Truchon decision that struck down the natural foreseeable death guardrail. This eligibility criterion was stripped away legislatively via Bill C-7, and the Trudeau government refused any sort of legal pushback against the ruling.

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Time will tell if the potential scenario outlined by Duncan plays out, but it is clear the federal government is not rushing to announce whether it will honour the committee’s conclusion or not. The expansion of MAiD access is currently scheduled for March 17, 2027.

The Other Side of the Straitjacket: A Daughter's Story of Mental Health and Assisted Dying releases on Aug. 18. Visit aliciaduncan.com/ to learn more.