Introduction

Webcast archive: First federal AS/E report

Today, we're discussing the first federal report on assisted suicide in Canada.

Webcast archive: First federal AS/E report

In this episode of Euthanasia & Disability, Amy Hasbrouck and Christian Debray discuss:

  • First federal report on medical assistance in dying is released
  • Researchers appointed to study expansion of euthanasia and assisted suicide

Please note that this text is only a script and that our webcast contains additional commentary.

FIRST FEDERAL REPORT ON MEDICAL ASSISTANCE IN DYING IS RELEASED

  • On April 26, the federal government released its first interim update on Medical Assistance in Dying, covering the period of December 10, 2015 to December 31, 2016.  This includes the six months that Québec’s law was in effect, from December 2015 to June 2016, before the federal law came online.
  • According to the press release issued by Health Canada, two more interim reports will be issued, covering the periods of January to June 2017 and July to December 2017.  After that, the federal government expects its permanent monitoring system to be in place, which will not only report on the number of Canadians accessing the service, but also track how effectively the eligibility requirements and safeguards are operating.
  • The total number of medically assisted deaths in Canada between December 10, 2015 and December 31, 2016 was 970.  This does not include:
    • A small number reported in Yukon and Nunavut, which were not reported due to privacy concerns.
    • The people who were given permission by courts for euthanasia or assisted suicide between January and June, 2016.
    • Euthanasias in Québec between December 9 and December 31, 2016.
  • Of the 970, only three elected to have assisted suicide; the rest were by euthanasia.
  • Of the medical assistance in dying that occurred outside Québec:
    • 50% were performed in Hospitals, 37% were done at home, 6% were done in long-term care facilities, and another 37 procedures were done in palliative care facilities, doctors offices, or at “undisclosed locations.”
    • The average age of people receiving MAiD was 72.27 years old.
    • The gender split among those receiving assisted suicide and euthanasia was 49% men, 51% women.
    • The underlying medical conditions cited were:
      • 56.8% Cancer-related
      • 23.2% Neurodegenerative
      • 10.5% Circulatory/respiratory system
      • 9.5% Other causes (not specified).
      • A footnote in the report further states: “Cases where the underlying medical condition was not reported, approximately 8% of all cases, have not been included in this calculation.”
  • Medically assisted deaths accounted for less than 0.6% of all deaths in Canada from June – December 2016.  That’s more than in the state of Oregon (0.37%) but less than the 2015 figures in Belgium (1.83%) and the Netherlands (3.75%).
  • Neither Ontario nor British Columbia, the two provinces with the largest number of euthanasias / assisted suicides, could document how many requests for assisted suicide were received, and how many were declined.
  • Viewed by itself, the report looks fairly complete.  However, what’s important is what’s missing.  There is no information about the living situation and other circumstances of the people who are killed.  There is also no information about whether a detailed assessment was done to determine whether the person was subject to external pressure, or whether other safeguards were complied with.
  • Health Canada promises more detailed information once regulations for its monitoring program are adopted, stating that future reports will:
    • Include a broader set of data, which will enable:
      • a statistical profile of all requests for medical assistance in dying and their outcomes (i.e. not limited to cases in which the service was provided);
      • further information on the medical circumstances and other characteristics of those requesting and receiving an assisted death;
      • findings regarding the application of eligibility criteria and safeguards; and,
      • trends over time;
    • Be based on data and information provided directly by physicians, nurse practitioners, and pharmacists involved in cases of medical assistance in dying, as required by legislation; and
    • May be supplemented by information from coroners and medical examiners.
  • To view the report, go to https://www.canada.ca/en/health-canada/services/publications/health-system-services/medical-assistance-dying-interim-report-dec-2016.html.

RESEARCHERS APPOINTED TO STUDY EXPANSION OF EUTHANASIA AND ASSISTED SUICIDE.

  • Before Canada has any information about whether the safeguards on Medical Assistance in Dying are being followed, or are effective, research is already underway to expand the program.
  • The Council of Canadian Academies has announced the appointment of its panel on medical assistance in dying, to be chaired by the Honourable Marie Deschamps, former Justice of the Supreme Court of Canada and Adjunct Professor at McGill University and the Université de Sherbrooke.
  • The panel will be divided into three working groups to focus on the three possible areas for extensions of euthanasia and assisted dying.
    • Dr. Dawn Davies, Associate Professor in the Department of Pediatrics at the University of Alberta, will chair the Working Group on requests for medical assistance in dying by mature minors. Dr. Davies is also Associate Professor at the John Dossetor Health Ethics Centre at the University of Alberta.
    • Dr. Kwame McKenzie, Director of Health Equity at the Centre for Addiction and Mental Health (CAMH) will chair the Working Group on requests where mental illness is the sole underlying medical condition. Dr. McKenzie is also Professor of Psychiatry at the University of Toronto and CEO of the Wellesley Institute.
    • Dr. Harvey Schipper, Professor of Medicine at the University of Toronto, will chair the Working Group on advance requests.
  • Several articles have condemned Dr. Schipper’s participation on the panel, as a “strident” opponent of assisted suicide.  However the working group also includes supporters of assisted suicide such as Jocelyn Downie and Joan Gilmour.
  • For a full list of the panel members, visit http://www.scienceadvice.ca/en/assessments/in-progress/medical-assistance-dying/expert-panel.aspx.