Alberta Health Services struggling to keep up with demand for physician-assisted deaths

Since February almost 30 Albertans have made the decision to end their lives with the help of a physician. 

Some deciding to conduct the procedures in their homes, others in the hospital. Some suffer from ALS, others rare forms of cancer. No two of these choices are the same. 

The only constant that exists is the decision.

It's a decision that is being made more than was expected in the province. Alberta Health Service officials are struggling to keep up with the demand for physician-assisted deaths.

In total, 29 people in Alberta have ended their lives through physician-assisted death this year, according to numbers provided by Alberta Health Services. Fourteen of those deaths occurred in Edmonton which is the highest number in the province.

We thought that there would be a significant number that would then kind of settle down a bit but we're actually seeing that the numbers are steady...- James Silvius

Dr. James Silvius, the lead for medical assistance in dying preparedness for AHS, said the amount of people who have made this decision surprised him. 

"We knew that people would be waiting to ask after June the sixth," said Silvius.

"We thought that there would be a significant number that would then kind of settle down a bit, but we're actually seeing that the numbers are steady and haven't settled down at all. The [numbers are] about the same — between two and four a week.

"We are looking at what the resource needs are. The numbers are taxing for the individuals that are doing this work."

On Feb 6, the Supreme Court of Canada struck down the federal prohibition on physician-assisted court orders, which made medically-assisted dying possible through an application to the court. 

On June 17, the federal law governing medical aid in dying came into effect. AHS said seven patients have ended their lives this way in Calgary, while a total of eight people used the procedure elsewhere in the province.

Procedures were carried out in homes as well as hospitals and long-term and continuing care facilities. There are two ways to carry out the procedure: self-administration and physician administration. So far everyone has chosen to have a physician present.

Authorities denied 23 requests from people wanting to end their lives because they didn't meet federal criteria. 

This criteria includes the person suffering from an irremediable medical condition that causes them considerable suffering, their death to be reasonably foreseeable, and the ability to provide informed consent.

AHS said the average age of the Albertans who chose to end their lives with doctor assistance is 67, with the most cited health conditions being multiple sclerosis, cancer or amyotrophic lateral sclerosis (ALS).

'Emotionally difficult decisions'

Physicians and nurses make the call whether or not a patient will receive this type of care. Silvius said these "emotionally difficult decisions" play into the lack of resources and is one of the biggest challenges facing AHS. 

Each of those numbers represents someone who was experiencing suffering someone whose death was foreseeable.- Brad Peter

"So what we're seeing is that there are certain physicians who have come forward who are more than willing, but they find they just can't do more than a certain number. We're looking to actually find an increased pool of physicians who are able to assist us."

Silvius said they are looking at strategies to meet the demand for medically-assisted death in Alberta. 

Brad Peter, director of Dying with Dignity Canada, said he believes that AHS has done a "great job" implementing the program. 

"Each of those numbers represents someone who was experiencing suffering someone whose death was foreseeable," said Peter.

"So I'm really pleased these people are able to avail themselves of this legislation that they're able to take control of their suffering."