Medically assisted death numbers on the rise in Alberta

By GILLIAN SLADE on March 6, 2019.

gslade@medicinehatnews.com@MHNGillianSlade

The number of Medical Assistance In Dying cases in Alberta has now reached 600, with 70 in the south zone, according to Alberta Health Services data.

It works out at 4.6 cases a week averaged over the past two-and-a-half years for the province – 5.9 per week in 2018, which had a total of 307.

AHS medical director Dr. Jim Silvius attributes the increase last year to more awareness among Albertans.

“More comfort that people had with the whole idea and probably greater awareness that this is an option and that there is a service out there to support people to do this,” said Silvius.

Increasingly, people know someone who has been through MAID with a family member and they are talking about the experience, said Silvius.

From Feb. 6 to June 17, 2016, medically assisted death was only possible with a court order. During this time there were six assisted deaths in Alberta.

Federal legislation kicked in on June 17, 2016 removing the need for a court order. From that point to the end of December that year there were a total of 63 MAID deaths in Alberta. There were 205 in 2017.

Silvius says since the initial AHS guide for MAID, first published in the fall of 2016, there have been a number of changes including how AHS responds to inquiries. People are in different stages of thought about MAID. Some want basic information while others are ready to proceed.

Silvius says, particularly among people who have cancers, the decision for MAID is being made quite late and that has meant trying to respond quickly.

“We are not really structured to do that,” said Silvius. “We do not have assessors and provisioners on call. If you are outside of a major centre it can take a few days to find somebody to come and do the assessment.”

Ideally there would be assessors and provisioners to call on in every area of the province but we are not there yet, said Silvius. The number of people providing these services is fairly small but is slowly increasing. Those willing to do assessments is increasing with a number of family physicians comfortable doing so even if they have not officially identified themselves as such to the MAID program.

Silvius says he believes one of the reasons some may not be comfortable being a provisioner of the service is due to their lack of familiarity and comfort level with the drugs that are used.

“That’s my guess. I do think there are others who have not come around in their thinking to be prepared to cause somebody’s death,” said Silvius.

The number of provisioners who have publicly identified themselves is limited and that is a decision left up to them, he said.

One of the big changes to MAID criteria in Alberta is that the body of the deceased no longer has to be transported to the medical examiner, said Silvius. This change was made last fall.

Of the 600 cases so far, 379 were carried out in a facility and 221 in the community, according to the AHS report. A total of 64 patients were transferred from mainly faith-based facilities in order to receive MAID and 12 were transferred from non-faith-based facilities to a participating facility or to the patient’s home.

Silvius says some facilities do not participate in MAID even though they are not faith-based.

According to AHS data there continue to be four main health conditions that contribute to those seeking MAID: cancer, multiple sclerosis (MS), amyotrophic lateral sclerosis (ALS) and advanced lung disease.