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DIFFICULT CHOICES: What Kelowna doctors are discovering about medically assisted deaths

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February 03, 2017 - 8:00 PM

'IT'S A VERY EMOTIONAL THING, IT'S HARD'

KELOWNA - It’s been six months since patients could legally choose medically-assisted death and the doctor in charge of it for Interior Health says it remains a difficult subject but for none more difficult than for those exploring their options.

So far, 188 people in B.C. have taken the option; 23 of them in the Interior. Dr. Harsh Hundal expects that number to rise.

“There has been a gradual increase in interest since June. I do believe it will continue to increase, but I also think there will a point where it will plateau,” he says.

But he says nine out of ten who pursue the option don't go through with it. It’s not a doctor’s choice to make: They only present options.

“Medical Assistance in Dying is very much driven by the patient’s choices, we provide them with the information but the patient initiates the process, where, when, who…. “

Those conversations are as emotional as you’d imagine, says another doctor who is directly involved with patients. The topic remains controversial, so he has asked to remain anonymous for this story.

“It’s a very emotional thing, it’s hard,” he says. “I’m used to dealing with people whose death is in sight, but to actually sit and discuss with someone who wants to end their own life is very emotionally charged.”

The Kelowna-based physician has been involved in the program since mid December, 2016 but has always been a proponent of medical assisted death.

“I think that life is precious and we should value it, but when it gets to that point where your daily misery outweighs any joy, in the end, you should have that ability to be in control.”

Again, most people don’t go through with it.

“I think for some people, having simply gone through the process and having the option to make that decision gives them the strength to continue dealing with their burden that life brings them.”

The topic of assisted death is a contentious one, with passionate proponents on either side of the debate. Under Canadian legislation that took effect last June, patients must be experiencing intolerable pain and have an illness that ultimately leads to death in the foreseeable future, to be eligible for assisted death.

Most importantly, the patient has to be in control of their thoughts, and not coerced in any way. To ensure this, after the patient is approved for the process, they must have 10 days of reflection, before the procedure can be done. This number is really 12 days as the 10 only refers to legal days.

The measures are aimed at preventing abuse and confronting moral questions.

“As a society we’ve always had an issue with people taking their own lives - always thought it a tragedy, a waste,” he says. “For a long time, helping someone end their own life was legally murder, just because the law has changed, doesn't change peoples opinion.”

However, the physician points out that the discussions surrounding assisted death haven’t changed dramatically.

“When it comes to the elderly, we’ve allowed them to withhold antibiotics when they have pneumonia or not take dialysis or not to take treatment when that has been their choice,” he says. “This has just moved it one step further where we’ve allowed people to make an active decision.”

The average age for assistance in dying is 73, according to Hundal.

'THIS IS A VERY PRIVATE MATTER, NORMALLY DONE IN A PRIVATE PLACE.'

There are two different methods a patient can choose when it comes to assisted death: A syruppy elixir, which takes two to four hours or an intravenous drip, which takes 10 to 17 minutes.

According to both doctors, the majority of people tend to choose the IV.

Patients also have the choice of where they would like to die. Most often, this is from the comfort of their own home.

“This is a very private matter, normally done in a private place,” says Hundal. “One person decided to die in their garden, so they could look outside for the last time.”

Unlike similar programs in Europe, Canada’s medical assistance in dying program is not an option for those suffering from mental illness, such as depression, or cognitive diseases, such as dementia.

For the doctor directly involved in the procedure, he says the program is still evolving and will continue to change with time.

“Just because you suffer from depression doesn’t mean you can’t make rational decisions about your own health and your own care,“ he said. “If you’ve been depressed and on anti depressants, and have gone to therapy for years, but continue to be depressed and continue to suffer and hate your life, I think that in those circumstances it may be an appropriate thing.”

Ultimately, both doctors say the program is about providing a choice for patients. For the rest of us, the choice is academic and theoretical and won’t be real until a choice must be made.

“What are you going to do when that person in front of you, lying in that bed, asks for this,” Hundal says. “What is going to be your response?”


To contact a reporter for this story, email Jenna Hickman or call 250-808-0143 or email the editor. You can also submit photos, videos or news tips to the newsroom and be entered to win a monthly prize draw.

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