A dozen Islanders per month opted for assisted death: review

VANCOUVER — Two per cent of dying individuals on Vancouver Island chose medically assisted deaths in the first six months after it was made legal, and the rate is climbing, according to a case review.

Data collected for the period from June to December 2016 show there were 72 medically assisted deaths in patients ages 49 to 96, according to the report in the B.C. Medical Journal. Of the 72 cases, 47 were males and 35 were females.

Most patients chose their homes for such deaths (64 per cent), followed by acute-care hospitals (21 per cent), hospice (12 per cent) and residential care (three per cent.) Island Health and other health authorities have developed policies for admission to hospital specifically for medical assistance in dying when patients can’t access such assistance where they live.

Most controversially, many faith-based hospitals and residential care facilities do not allow medical assistance in dying and insist on transfers. Article co-author Dr. Jonathan Reggler resigned from the ethics committee of St. Joseph’s General Hospital in Comox because of the hospital’s prohibition on medical assistance in dying.

The majority of patients in the case review had cancer (57 per cent), followed by organ failure (25 per cent), neurodegenerative diseases (11 per cent), and other unspecified conditions (seven per cent).

The vast majority of patients (96 per cent) were given intravenous medications, while the remainder swallowed pills. There are about three dozen doctors who have received training on medical assistance in dying on Vancouver Island.

The six-month sum (72) reported in the case review varies slightly from information reported by Island Health, which stated that 77 people on Vancouver Island used medically assisted deaths in the last half of 2016.

Nevertheless, Vancouver Island appears to have the highest number of medical assistance in dying cases of all health regions, and B.C. would appear to be leading all other provinces. The B.C. Coroners Service said across B.C., 435 patients have chosen medically assisted deaths from the period Jan. 1, 2016 to May 31, 2017.

According to news reports, medical assistance in dying has picking up steam and at the time of the first year anniversary last month, Vancouver Island had recorded 186 MAID deaths, the vast majority in the South Island region where most of the doctors providing the service live.

The first year sum represents two per cent of all deaths on Vancouver Island. The jurisdiction would have more medical assistance in dying cases but for each assisted death performed, there are between five and 10 patients deemed ineligible, according to previous reports.

Authors of the BCMJ article say demand is rising steadily for medically assisted deaths.

“While the data we have gathered do not provide an explanation for the large number of cases relative to population size on Vancouver Island, this is likely the result of demographic factors…,” the article says.

They cite education, a high proportion of older citizens, socio-economic factors and the greater awareness of assisted death issues because of so many high-profile cases and associated media coverage.

“Sue Rodriguez lived in Victoria; Kay Carter, Margot Bentley and Gillian Bennett were all from B.C., and the first local chapter of Dying With Dignity was established on Salt Spring Island,” the article says.

The authors conclude that access to medical assistance in dying is neither uniform nor sufficient to meet demand and “there is a need for co-ordination in all aspects of provision, data-gathering and governance.”