Medical Assistance in Dying

Death is a medical choice, but not for everyone

Doctors and some patients in B.C. are learning legalization isn’t perfect

A total of 188 people in B.C. have had a doctor assess their medical condition, help plan when and where, and put them to sleep and give them the drugs that will cause them to die – all since medically assisted death was legalized in Canada.

As one man in the Cowichan Valley put it before his wife died earlier this month, it allows for sick people to die with dignity, in the comfort of their home, care home, hospital or hospice.

RELATED: Crofton couple chooses doctor-assisted death

But many people are still being told they can’t be approved for the procedure because of federal restrictions.

To qualify for medically assisted death, a person must be suffering from grievous or incurable illness, able to consent, registered for MSP, and over the age of 18.

But sticking points remain for Bill C14, such as the reasonably foreseeable future clause, which requires doctors to ensure, without a doubt, that the death of a patient is probable.

Generally, physicians have interpreted that to mean that the patient will die in six months.

“We need an improvement,” said Vancouver-based Dr. Ellen Wiebe. “It means (some people) can expect to suffer for years.”

Wiebe has helped 46 people die and is currently assessing 120 more people living in the Lower Mainland.

She said it’s terrible when she has to turn someone away.

A young patient, for example, diagnosed with a painful and inoperable illness, may not be as probable to die in the next six months.

“Every single one of these people are suffering terribly,” Wiebe said. “In each case that I’ve seen, there’s really no hope in recovery of their terrible condition, and that’s definitely the hardest thing I’ve had to do, is say no.”

All she can do is to help them know where they stand and what about their health needs to change for them to become eligible.

BCCLA awaits trial

When it struck down the prohibition on assisted death two years ago, the Supreme Court of Canada recommended that the procedure should be allowed in cases where “the suffering is intolerable from the perspective of the person who is suffering.”

But with Bill C14’s restrictions, the BC Civil Liberties Association launched a legal action, arguing the reasonably foreseeable death clause violates the rights of those who suffer.

“It has to be a question that that person can answer themselves,” BCCLA lawyer Caily DiPuma said.

The lead plaintiff is Chilliwack resident Julia Lamb, who suffers from spinal muscular atrophy, or SMA, type 2.

Law is too broad, but also too exclusive: advocate

Dr. Jonathon Reggler, based in the Comox Valley and co-chair of the physician advisory committee with the group Dying with Dignity, said the bill leaves too much open to interpretation.

“The law uses language that isn’t particularly medical,” Reggler said. “You won’t hear terms like ‘grievous’ or ‘irremediable’ in a medical textbook.”

One physician might approve assisted death for one patient, while another might not allow it, he said, and that could mean a lack of standardized care.

Reggler’s committee is advocating for the law to include patients whose death might not occur within the foreseeable future, but who are still intensely suffering.

In the meantime, physicians have been relying on each other to mull cases over.

“The way it’s happening is those who early on decided to be providers are talking to each other,” he said. “We do turn to the lawyers to some extent, but the lawyers have a very legalistic approach to this, whereas we believe very strongly we should make this very much apart of our ordinary clinical practice, and bring the same thoughts, and skills and experience to it that we do to any part of medical care.”

And time is ticking for those who aren’t eligible, Reggler said, especially when a patient needs to be well enough to provide consent.

To seek more information about medically assistance in dying, visit here.

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