Depending on the perspective, it can be considered a milestone for Canada’s medical community. One year ago, medically assisted dying became legal across the country.
Since then, 31 people in Saskatchewan have chosen that path.
The legislation allows patients to access a medically assisted death if they’re either in an advanced state of irreversible decline or their death is reasonably foreseeable.
Though, the practice has mixed reviews in the medical community.
“There are some physicians that feel this is completely appropriate and is part of medical practice and is part of preventing suffering,” Bryan Salte, associate registrar with the College of Physicians and Surgeons of Saskatchewan, said. “You have other physicians who feel quite strongly this is inappropriate and ought not be part of Canadian law.”
According to a report from Health Canada, as of Dec. 31, the most common underlying issues in Saskatchewan were cancer-related or neurodegenerative diseases.
That same report shows 55 per cent of patients receiving a medically assisted death were men, and 73 per cent of the province’s deaths occurred in hospital.
“This is a deeply personal matter, and can be highly polarizing and can be very sensitive,” said Pauline Rousseau, Saskatchewan Ministry of Health strategy and innovation executive director, said.
The majority of the province’s assisted deaths took place in urban centres; a statistic that can be attributed to the province’s vast geography.
“It’s easier I think in Saskatoon and Regina; you have infrastructure, you have a larger number of physicians,” Salte said. “There appears to be a bit more of a challenge in some of the smaller centres in terms of accessing medical assistance in dying and finding physicians that are willing to participate in this.”
Though there is no formal training in medical school for assisted dying, physicians are expected to know of other resources.
“There’s some significant expectations in the legislation that the physician really be quite aware of what resources are available in the community, what options may be available for the patient that won’t involve medically assisted dying,” Salte said.
Overall, the ministry feels Saskatchewan has done well handling the contentious legislation.
“We’re very grateful for the partnerships we’ve had with physicians, health regions and health authority partners to establish a process that I think has met, so far, the needs of the people accessing the service,” Rousseau said.
A review of the legislation is expected in 2018 and the college as well as the Ministry of Health are expected to voice their concerns.
“It is the law of Canada,” Salte said. “So whether people think the law is appropriate or not appropriate, our task is to make sure that law is being administered appropriately.”
Some of those concerns will be around reporting requirements, accessibility for patients with mental health conditions, and patient self-administration.