“Tarra Carlson’s plan for her old age is simple: to die before her husband.” This statement might seem like a light-hearted joke, but Carlson is deadly serious. Should her husband pass before her, Carlson plans on choosing a medically assisted death in Canada to avoid living in poverty while trying to navigate a crumbling healthcare system as a person living with a disability.

“I’m petrified of growing old with a disability,” she says. If her husband dies before her, she may have no way to access financial support. She’ll lose her biggest advocate and support system—and her home. She’s worked in long-term care facilities and never wants to live in one. Applying for disability support programs, such as home care, can be cumbersome. There’s no one-stop shop for disability services; they’re spread across government agencies and ministries. Wait lists are long. Paperwork can be complicated. Carlson doesn’t think she’ll be able to understand how to navigate social assistance programs without her husband to explain them to her. But if she dies first, she reckons, she won’t have to.

Compared with disability support, medical assistance in dying, or MAID, seems relatively easy to request. Written applications differ by province or territory but are fairly straightforward; most are only a few pages long. For some of them, to confirm eligibility, an applicant simply has to sign and initial certain statements—for example, that they have an irremediable and grievous medical condition and are in a state of advanced decline. If any more health conditions were to crop up on top of her disability, eroding her independence completely, says Carlson, she’s pretty sure she’d qualify for MAID. “It’s a one-way ticket,” she says, “because you have no choice.”