Before assisted suicide was legal in Canada, there was a secret society devoted to helping Canadians end their lives on their own terms. As Nicholas Hune-Brown reports at Toronto Life, even though medically assisted death has been legal in Canada for a year, it remains controversial. Although some palliative care doctors — who believe in providing physical and psychological comforts to patients, but not in hastening death — are vehemently opposed to what they view as an immoral act, other doctors are slowly coming to terms with the patient’s new right to die in cases where death is “reasonably foreseeable.”

In April 2016, four months after his diagnosis, Jack went to the hospital with pneumonia. When he got out two weeks later, he needed a feeding tube and a suction machine for his saliva. He could no longer look after himself, so he moved in with April, her partner, Robert, and their two-year-old daughter, in Smiths Falls, Ontario. The man who had always been a blur of activity suddenly needed his daughter to help him out of bed. The professional smooth talker had trouble speaking, a single sentence sometimes stretching out over excruciating minutes as he struggled for breath. On more than one night, he’d begin to choke, and April would have to call an ambulance to help clear the mucus building up in his throat, watching helplessly as a look of utter horror spread across her father’s face. When she took him to the bathroom each morning, he would say the same thing: “I want to die.”

Since Jack Poelstra, Gerald Ashe has overseen nine more deaths. He’s been there as Canadian families have invented new rituals for a new way of dying—reading poetry and listening to favourite pieces of music, watching as family members have taken turns giving their final hugs and kisses. When I asked Ashe if he was ever upset by the process, if it ever felt like a burden, he thought for a moment. “You know, I think I’m a pretty sensitive guy,” he began. “But I don’t feel upset about it.” The patients had been so sure, so appreciative. The families were so relieved. To Ashe, it was clear that it was something that needed to be done, and he was glad that he was able to do it with care and empathy.

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