Why would my terminally ill father be denied a medically assisted death?

The Globe and Mail

Paul Taylor

The question: My father was in the advanced stages of prostate cancer and wanted a medically assisted death. He was told he needed the approval of two health-care providers. One said yes, but the other said no because he “was not in any distress.” But that decision was so wrong. My father was a very stoic man, and was not one to complain. Did the doctor want him to break down in tears and beg to be put to death? My father died two weeks later in a hospice – instead of his home, the place where he wanted to die.

The answer: It has been over a year and a half since Parliament passed a law that makes medical assistance in dying – called MAID for short – legal across Canada. The story you tell reflects one of the many challenges in creating a standardized system to handle these requests and to ensure that patients and their families are properly informed.

One key failing in your father’s case is that he was not apparently told he could have asked for another assessment after the second MAID assessor turned him down. If another assessor had agreed that he was eligible, he could have proceeded with an assisted death.

It’s impossible to say whether his assessors were unaware he had this option or simply failed to mention it.

Whatever the case, “we need to do a better job educating health-care providers about what they must be disclosing to patients,” says Jocelyn Downie, a professor in the faculties of law and medicine at Dalhousie University in Halifax.

In the meantime, it’s certainly worthwhile reviewing how the process is supposed to work. . . [Full Text]

Canada’s summer of discontent: euthanasia practitioners warn of nationwide “crisis”

Shortage of euthanasia practitioners “a real problem”

Sean Murphy*

There were 803 euthanasia/assisted suicide (EAS) deaths in Canada during the first six months after the procedures were legalized. In the second half of the first year (ending in June, 2017) there were 1,179 — a 46.8% increase, and about 0.9% of all deaths. Health Canada correctly states that the latter figure falls within the range found in other jurisdictions where euthanasia/assisted suicide are legal, but the Canadian EAS death rate in the first year was not reached by Belgium for seven to eight years. The dramatic increase of EAS deaths in the last half of the first year would have had a direct impact on EAS practitioners, and this may be why they ended the first year by sounding the alarm about access to the service. . . .[Full text]

Low fees have B.C. doctors thinking twice about providing assisted dying

‘We’re being paid 50% of what we would doing routine office work. So it’s difficult to justify continuing’

CBC News

Karin Larsen

Medically assisted dying has been legal in Canada for over a year, but one B.C. doctor says he can no longer afford to offer the service, because the costs involved are much greater than the $200 payout from the provincial medical services plan.

In a letter, Dr. Jesse Pewarchuk calls the situation “economically untenable” while outlining a number of steps a physician must follow in the medical assistance in dying (MAID) procedure. . . [Full text]

 

Canadian doctors turn away from assisted dying over fees

Globe and Mail

In a recent letter to some of his colleagues, Vancouver Island doctor Jesse Pewarchuk explained why he won’t be helping any more gravely ill patients to end their lives, despite his fervent support for assisted death.

“It is my deep regret to inform you that I am no longer accepting referrals for Medical Assistance in Dying,” the letter began. “Recent changes to the [Medical Services Plan] physician fee schedule have made MAID economically untenable and I unfortunately can no longer justify including it in my practice.” . . . [Full text]

 

One year after Canada’s medically assisted dying law, patients face uneven access

‘This dying, elderly man was stuck in the back of an ambulance so he could access his dying wishes’

CBC News

Nicole Ireland

“Martha” was stunned when her 78-year-old father told her he wanted a medically assisted death, after battling lung cancer for almost two years.

“It’s something you’ve never contemplated before in your family,” she said. “How do you prepare for this? This date that somebody’s going to pass away. It’s really hard.”

Martha has asked CBC News to use only her middle name, because children in her family don’t know that their grandfather’s death was medically assisted.  A year after Canada’s Medical Assistance in Dying law passed on June 17, 2016, the issue remains highly controversial. . .  [Full text]

 

How to End a Life

A year since assisted suicide became legal, only a small number of physicians are willing to perform the procedure, and their numbers are shrinking. Taking a life is harder than they thought

Toronto Life

Nicholas Hune-Brown

The first thing April Poelstra noticed was the hitch in her father’s shoulder. Jack’s left arm was drooping, hanging limply at his side, as if he didn’t have the muscle to cinch it into alignment. It was the fall of 2015, and Jack was living in Frankville, Ontario, waking up at 4:30 a.m. to plow roads and work odd jobs for a construction company. . . Jack tried to downplay his shoulder problems. He visited his doctor for a battery of tests, but always changed the subject when April pressed for details. . . .In early 2016, her fears were validated: Jack was diagnosed with ALS. Amyotrophic lateral sclerosis, or Lou Gehrig’s disease . . .On June 17, Bill C-14 became law, making medical assistance in dying, or MAID, legal for mentally competent Canadians. Jack Poelstra was overjoyed. . . [Full text]