It might come as a surprise to some that Alberta has the leading standard for the provision of medical aid in dying in Canada.
During a talk in St. Albert, Dr. David Amies, a member of the Dying With Dignity Canada Physicians Advisory Council, and author and award-winning journalist Sandra Martin praised the province’s approach to providing the controversial procedure.
“Alberta is a pretty conservative place generally,” said Amies. “I was really quite surprised and heartened to hear how they worked.”
According to Dr. James Silvius, Alberta Health Services lead for medical aid in dying preparedness, it’s not despite the province’s conservatism, but because of it that Alberta currently has the best system in place to handle medical aid in dying requests.
“We recognized right off the bat that we had to put something in place that was going to be respectful of everybody,” said Silvius.
In Alberta, requests and inquiries can be made either through a physician or by contacting the province’s medical aid in dying care coordination service team, a centralized navigation system manned by four nurses whose job it is to connect patients and doctors to resources and provide them with information.
This open access navigation system is unique in Canada, said Silvius.
While some provinces, like Ontario and Nova Scotia have public enquiry lines or emails, physicians are meant to be the first point of contact for those contemplating the procedure – regardless of whether they are conscientious objectors or not.
Alberta’s centralized system does not require a health care provider to be involved if they don’t wish to be, while still allowing Albertans “irrespective of the circumstances” to access the service.
Extensive consultations and the willingness to listen to all viewpoints allowed AHS to come up with a system that is “respectful of everybody.”
“That led us to putting in place a system that actually met the needs of people across the province without infringing the rights of providers because we understood the issues,” said Silvius.
Other jurisdictions also lack public information about the procedure, said Martin, who wrote A Good Death, a chronicle of medical aid in dying in Canada and the world.
This is in part because of the reliance on physicians to inform patients, but mostly due to the fact that many jurisdictions are still scrambling to establish guidelines following the royal ascent of Bill C-14 in June.
“They’re all slowly lumbering into place,” said Amies. “Alberta is at the head of the pack.”
According to Silvius, there have been discussions at the provincial levels about standardizing what information should be public and how to access it. Other jurisdictions are also looking at Alberta’s centralized system as a best practice.
By the numbers:
• 51 Albertans have received medical aid in dying this year.
• 6 of those deaths occurred between Feb. 6, 2016 and June 17, 2016, when federal legislation removed the need to attain a court order prior to undergoing medical assistance in dying.
• 24 procedures have been performed in the Edmonton zone.
• 16 procedures have been performed in the Calgary/Central zone.
• Six procedures have been performed in the South zone.
• Five procedures have been performed in the North zone.
• 70 is the average age of people receiving medical aid in dying in the Edmonton zone.
• 69 is the average age of people receiving medical aid in dying in the Calgary/Central zone.
• 71 is the average age of people receiving medical aid in dying in the South zone.
• 66 is the average age of people receiving medical aid in dying in the North zone.
• 28 requests for medical in dying were rejected.
• 35 procedures were administered in a facility.
• 16 procedures were administered in the community.
• Six patients were transferred from Covenant Health to an AHS facility for medical assistance in dying.
