Vancouver Island a leader in medically assisted death

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Sue Rodriguez, of North Saanich, on March 8, 1993. Rodriguez lost her legal challenge to the Criminal Code’s prohibition on assisted death, but died in 1994 with assistance from an anonymous physician.

By Amy Smart

Seventy-seven people on Vancouver Island died with medical assistance in 2016, more than any other region in B.C. — and most other provinces.

Some speculate the high number might be the result of demographics and a long history of advocacy for the right to assisted death.

For each assisted death performed, between five and 10 patients are deemed ineligible, Island Health said.

A Times Colonist survey of provincial coroners, health ministries and health authories found that British Columbia ranked among the highest of medical assistance in dying, with 188 assisted deaths recorded. That was one more than Ontario, where the chief coroner recorded 187 deaths.

Prince Edward Island, with a population of 148,600, recorded the lowest number of assisted deaths at zero.

Within B.C., the most deaths were recorded in the Vancouver Island Health Authority’s jurisdiction, followed by Vancouver Coastal Health at 58, Fraser Health at 24, Interior Health at 23 and Northern Health at six.

Dr. David Robertson, Island Health’s executive lead on medical assistance in dying, said there seems to be a strong base of supporters for assisted dying, including physicians willing to deliver the procedure.

“They have made the service, medical assistance in dying, probably more available than it might be in other parts of the country,” he said.

Robertson said some support on the Island likely comes in part from the fact that Sue Rodriguez lived in North Saanich.

Rodriguez suffered from amyotrophic lateral sclerosis and wanted the legal right to end her life with the help of a physician. She lost her legal challenge to the Criminal Code’s prohibition on assisted death, but died in 1994 with assistance from an anonymous physician.

“Many of the other high-profile patients who’ve been part of the history of the change of the law come from B.C. too,” Robertson said.

He also noted that there seems to be an older, fairly well-off population on the Island.

“This is just my observation as a citizen, but we have an older population, many of whom have moved here to retire. And these are people used to making decisions that control their lives. And it seems to me not very surprising that they want to make a decision, too, about the end of their lives.”

High demand on Vancouver Island doesn’t mean there isn’t also opposition, said Eike-Henner Kluge, a biomedical ethics professor at the University of Victoria whom Rodriguez consulted before pursuing her lawsuit.

“There will always be individuals who say life is sacred and under no circumstances may you artificially end a life,” he said.

He also pointed to Victoria’s aging population as a reason for the higher demand on Vancouver Island.

“Whenever you look at why a particular medical intervention is at a certain level, you want to look at the population in question,” he said.

“You may recall Victoria used to be described as the ‘newlywed and nearly dead.’ As the population gets older, it gets more susceptible to disease and more moribund and, that being the case, you will find more individuals who don’t want to die unpleasant deaths.”

Cory Ruf, communications co-ordinator for Dying with Dignity Canada, said he couldn’t speculate on the cultural reasons why Vancouver Island might have a higher rate of assisted deaths than other parts of the country.

“But we can say that we’re in touch with at least as many assisted-dying providers on Vancouver Island as we are in Toronto,” he said. According to the 2011 census, the most recent year available, 2.6 million people live in Toronto, compared with 759,366 on Vancouver Island.

“It suggests that resources and supports for physicians on Vancouver Island may be better than they were in other parts of the country [when assisted dying was legalized]. We do know that Island Health was very proactive in devleoping its policies for medical assistance in dying,” Ruf said.

“There may be underlying reasons we can’t fully grasp in terms of culture and demographics, but I think that … in some places more than others, decision-makers have created a climate where physicians feel supported [on Vancouver Island].”

Data was not available for all provinces, including Quebec and New Brunswick.

Alberta Health Services had the most complete data, reporting that cancer, multiple sclerosis and ALS were the most cited health conditions. Some of the reasons applicants were found ineligible included a loss of capacity or competency, mental illness or death was not deemed “reasonably foreseeable.”

Four patients in Alberta were transferred from faith-based facilities for the procedure.

In Manitoba, ages ranged from 29 to 100 and averaged 70. Nine died in hospital, one in hospice and 14 at home.

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