Doctor-assisted death barriers remain high in absence of clear laws, says MLA

Even though the Supreme Court of Canada declared doctor-assisted death to be legal more than one year ago, the lack of clear government guidelines remains a significant barrier to obtaining the service. 

A Calgary woman with late-stage ALS was granted special permission to end her life with the help of a doctor, but was forced to travel to Vancouver, B.C. because she could not find a local physician who was willing to perform the procedure. 

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"I would say most physicians are not comfortable with it," said Dr. David Swann, Alberta Liberal party leader and member of the three-person panel of MLAs tasked with public consultation on the issue.

In the absence of a clear legal framework, doctors who perform assisted death could be vulnerable to legal consequences, Swann said. 

For example, there are currently no policies about how to report or monitor physician assisted death, or whether a medical examiner would need to perform an autopsy afterward, he said. 

"There may be physicians in Alberta that would have been prepared to do it, but how do you find them? Because there's no system," Swann said.

Besides physicians, the process involves the participation of lawyers, caretakers, nurses, social workers, counsellors and ultimately a pharmacist who is willing to dispense the necessary drugs, he said. 

"Everybody has to come to grips with what this means," he said. 

June 6 deadline 

Alberta Health Services is now consulting with members, patients, clinical experts,and legal and ethics experts to develop a series of potential options that government may want to consider as it prepares to draft legislation concerning assisted death. 

Their focus is on three key areas: equitable access for those who are eligible, the conscience rights of physicians, and safeguards to protect vulnerable individuals, said Dr. Eric Wasylenko, chair of the Physician Assisted Death Preparedness Secretariat at Alberta Health Services.

In Alberta, a person seeking assisted death must receive special permission from a superior court, and applications must demonstrate access to a willing physician, said Wasylenko. 

"There is a sense that there are enough physicians who are willing to participate ... that it should not be a barrier to access," he said.

Wasylenko acknowledged, however, that the financial burden could be considerable, as it is in other jurisdictions where assisted death is legal.

The federal government has until June 6 to draft a new law on the issue, thanks to a four-month extension granted by the Supreme Court.

"We're late in the game," Swann said. 

"We need to make sure that we do this and we do it right, and we've got until June 6 to make sure that we have everything in place."