‘In the Presence of a Spoon’ by Karin Wells

In a 28-minute radio documentary, the daughter of Margot Bentley, Katherine Hammond, tells the story of her mother’s end of life period. Margot Bentley was formerly a registered nurse who worked with dementia patients and was adamant that she wanted to avoid an end-of-life marked by a lack of independence. She was also, notably, the daughter of a British Columbia Supreme Court Justice. Margot Bentley wrote a living will in 1991 before her Alzheimer’s disease was diagnosed in 1999 and before her mental state deteriorated to the point that she could no longer recognize her family members, a criterion for withdrawing care as directed by her will. Despite this being included in her living will, her care facility objected to stopping spoon-feeding her meals due to fears around legislation being unclear on the withdrawal of this type of care. Katherine Hammond and her family took the case to court where the BC Supreme Court ruled that spoon-feeding is an act of personal care, not of health care, and that Margot Bentley’s opening her mouth in the presence of a spoon indicated consent to continue being spoon-fed. Margot Bentley ultimately died of natural causes and was spoon-fed until that time.

The documentary was made in the Canadian legislative context before Medical Aid in Dying (MAID) was recognized as a right by the Supreme Court in Carter (2015). The BC Health Care (Consent) and Care Facility (Admission) Act was amended in 1996 to guide persons wishing to write legally enforceable advanced care directives, also known as living wills. However, Margot Bentley’s will was written in 1991 before the law provided a remedy for what is required in an advanced care directive to make it legally enforceable. In a brief to a special committee established in 2016, composed of members from both Houses of Parliament and designed to make legislative recommendations on the Canadian framework for assisted dying, her daughter argued that her mother’s case provided clear proof of the need for provisions for advance consent for physician-assisted dying.