Doctors help dozens die
Up to four assisted deaths a week in Alberta since new law in June
As many as four Albertans every week are ending their lives with the aid of a physician since federal legislation enshrining it as a right came into force in June.
Dr. James Silvius, Alberta Health Services’ lead for medical assistance in dying preparedness, said officials expected to see high demand once the still-controversial practise was legalized, but didn’t expect it to remain at this level three months later.
“We thought at first we’d see quite a significant uptake and it would eventually tail off. But that hasn’t really happened,” Silvius said.
So far in 2016, 31 Albertans have died with the help of a doctor, some two dozen of those immediately following federal amendments to the Criminal Code on June 6 that legalized physician-assisted death.
The momentum hasn’t slowed much since then, with two to four patients every week ending their lives, including two this week, Silvius said.
Prior to the legislation, a handful of others had to make their cases before judges, based on a February 2015 Supreme Court ruling striking down the federal prohibition against the practise. In two of those cases, patients sought doctors outside of the province and one opted to die in Alberta without the aid of AHS officials, said Silvius.
In late 2015, Silvius, who was the medical director for seniors care for AHS, was tapped to draft a plan alongside the Alberta College of Physicians and Surgeons and the Alberta College of Pharmacists, knowing the Supreme Court ruling would make it necessary to have a strategy in place.
But because the processes are still in their relative infancy, there’s still much to learn and streamline, he said.
“It’s only been a few months but the work that was done beforehand in order to be prepared was intensive,” Silvius said. “We’re still learning as we go.” The level of interest so far is among the surprises, as is the relative comfort level of doctors who have volunteered to perform the procedures, with some uncertain about the administration of lethal drugs and others split on whether they want to provide the service only for longtime patients or strangers exclusively.
“We do have a cadre of physicians across the province who are providing or are willing to provide the service,” Silvius said, noting the number of doctors is between 100 and 200.
“Some physicians may be willing, but are still not comfortable with the process.”
Using numbers from Oregon — chosen for its similar size and demographics to Alberta — officials estimate between 120 and 150 people a year will choose medically assisted death, but Silvius said it will take some time to get a solid grasp on the true demand.
“The numbers are high now because it’s still a new reality,” he said.
“People look at this as it’s still novel, and as we become more mature in terms of how we approach end-of-life care we’ll have a better idea moving forward.”
Bradley Peter, a director with Dying With Dignity Canada based in Edmonton, said while there have been some bumps along the way, the fact suffering Albertans now have a legal option to end their lives is a significant step forward.
“I think it’s wonderful that these people who have endured suffering have some ability to assert control over their end of life,” he said.
“AHS has really done a tremendous job implementing this program, but the process is still not perfect and we’re working on some issues.”
Among the many requirements for patients seeking the procedure is one requiring two independent witnesses, something that is difficult for some who lack family or friends.
Another “kink” in the federal legislation, Peter said, is an edict that requires the patient’s death to be foreseeable, even though those suffering from multiple sclerosis, Huntington’s disease and other debilitating disorders may not be terminal for a long time, but are still coping with tremendous suffering.
Peter said there are provisions in the legislation that leave it open for review, something he expects will be needed as more issues become apparent.
In February, Alberta’s Catholic bishops slammed the Supreme Court ruling, expressing fears for vulnerable members of society when doctor-assisted death was legalized.
Calgary Bishop Fred Henry wasn’t available to comment Tuesday, but signed on with five fellow Alberta bishops in a lengthy letter outlining their concerns.
“We want to be clear that, from a Catholic perspective, the intentional, wilful act of killing oneself or another human being is morally wrong. Therefore, no Catholic may advocate for, or participate in any way, whether by act or omission, in the intentional killing of another human being either by assisted suicide or euthanasia,” the bishops wrote.
“When any life can be taken at will, the dignity of all lives is seriously eroded and respect for human life in our society as a whole is diminished.”