Helping patients end suffering 'rewarding,' Brockville doctor says

A Brockville, Ont., doctor who advocated for doctor-assisted death has now helped his first patient die under the relatively new legislation, and he wants other doctors to know it's a peaceful and even rewarding process.

Dr. Gerry Ashe drove from Brockville to Smiths Falls, Ont., to perform the procedure due to a scarcity of willing physicians. Assisted dying became legal less than two months ago, on June 17.

Last fall, Smiths Falls resident J.P. Campbell was diagnosed with amyotrophic lateral sclerosis — also known as ALS or Lou Gehrig's Disease — and decided early on that he wanted to die with help from a doctor.

He had difficulty speaking but could still express himself clearly, Ashe said. Campbell also lost weight, couldn't swallow and needed a tube into his stomach, and also experienced some paralysis. He was most recently living with his eldest daughter, April Poelstra, who was providing excellent care, Ashe said.

'He wanted this over'

"But he was very adamant, right from the first time I saw him, that he wanted this over and that he wanted it over as soon as possible," Ashe told CBC Radio's Ottawa Morning.

"I would say it was a very clear-cut case. He was very competent, and he met all of the requirements of the law, so it was very clear that I had to try and help him to make this happen."

Patients interested in finding doctors to help them die can ask their family doctors, who have access to a list of willing physicians. That's something Poelstra wants other families to know. They tried to find doctors on their own at first, but due to the newness of the legislation, they were told by doctors who didn't know the procedures yet that they had to wait, Poelstra said.

After being referred to Ashe by their family doctor, an intravenous method was chosen to end Campbell's life. An Ottawa pharmacy supplied the necessary drugs and a date was set for July 27, the birthday of Campbell's father, who died before Campbell could get to know him.

Ashe admits that though he advocated for doctor-assisted dying, he was nervous beforehand.

"I was very anxious, in fact I was anxious pretty well all day. That decision that I made, to not just advocate for assisted dying but to help people out by the administration [of it], was one that I felt was arrived at after a lot of thought and was the right decision. But nevertheless, I was nervous. Because you just don't know, is it going to go well? And I wanted this to be a good death.

"And, fortunately, it was."

'A smile on his face'

Poelstra, another of Campbell's daughters and his brother were at his side when he died, Poelstra said.

"We were holding his hands and honestly, he was asleep and into the coma before they even finished the coma medication. His face was peaceful," she said.

"I would rather ... have my father here but I understand what he wanted and it's a lot better for him. He's at peace, I am so glad, and I'm at peace with the fact that he went peacefully."

The alternative natural death would have come soon, Poelstra believes. She had seen Campbell unable to breathe several times, remembers the terror on his face, and said he feared choking to death.

Instead, Ashe said Poelstra died with a smile on his face 

"... [He] had, literally, had a smile on his face, as hard as that is to believe. And it was a very quick process. I would say that he died within about seven minutes, and that's probably the total time you take to administer the medication," Ashe said.

"There was not the slightest bit of anxiety in his face, [or] suffering. He just looked totally at peace. Naturally there were a bunch of tears, but you had a feeling when it was over that it truly was what he wanted, and that he was at peace."

While some doctors believe helping patients die goes against the tenets of their profession, Ashe said he believes it's a patient's right to choose and that helping them is part of his contract with them.

'It really is rewarding'

He wants other doctors to know it can be a gratifying experience.

"I want them to know that it's achievable, that it is a peaceful process, and that it's rewarding. It really is rewarding to realize that we have this ability to relieve suffering in individuals who've made that decision," Ashe said.

"It's not for everybody — there's not going to be a lot of [patients] who are going to decide this. In my palliative care experience, people put up with the most unbelievable suffering until they die a natural death, and they have no desire to die any earlier than that last natural breath. But I have had people, and it's a small percentage, who do not want to go through that. And I've had patients who've actually committed suicide in violent ways.

"So I'm hoping that this will at least be a way to at least give individuals the solace knowing that they have this permission."