Since June 2016, when Medical Assistance in Dying (MAiD) became legal, Vancouver Coastal Health (VCH) has had 199 requests and 123 completed deaths, while 25 people are currently in the process.
Speaking to a packed room on Sept. 23 at Coast Hospice’s Let’s Talk: Exploring End-of-Life Issues workshop, Darren Kopetsky of VCH Client Relations and Risk Management said the “requests have been steadily increasing and are greater than” VCH anticipated.
“A full 31 per cent of requests have come from the Sunshine Coast-Powell River-Squamish-Whistler corridor – which is higher, proportional to its population,” he said.
While the average age of a person requesting MAiD is 75, VCH has had requests from people aged 36 to 102. Not surprisingly, 61 per cent of requests come from people dealing with cancer, while those suffering neurological diseases like MS and ALS account for 14 per cent. Another 14 per cent have come from people living with end-stage organ failure. Men accounted for 55 per cent of requests compared to 45 per cent initiated by women.
“This is a very difficult, personal decision,” said Dr. Sara Wadge, a palliative care physician on the Sunshine Coast. “Each request is time-sensitive and it is treated with urgency,” though submitting a request does not necessitate completion.
Typically, there is a 10-day “period of reflection” required from the time a request is filed before MAiD can take place, though the waiting period can be shortened in some circumstances. During this time, the doctors and nurse-practitioners assigned to the patient explore all the options for symptom management and palliative care with their client, in the course of the assessment.
Kopetsky said patients and families need to be aware of the “five minutes to midnight” window – being able to provide informed consent at the time of the request and at the time they have chosen to die. Sometimes, medication can be managed to allow the patient to be clear-headed to affirm their decision; other times, the window will have closed and that person will be given every comfort and care until they die.
The most requests in the province come from Vancouver Island and the VCH catchment area, and the rate of death by MAiD in B.C. is 2.8 per cent – comparable to the three per cent rate in the Netherlands.
A family member complimented VCH on their professionalism and compassion as they navigated the process for her father’s request. “You are doing a difficult task with incredible grace,” she said.
Sunshine Coast Hospice Society president Denis Fafard said, “We are not here to judge anyone’s end-of-life choices. We are here to help you live fully until the day you die.”
More information about MAiD can be found at www.medicalstaff.vch.ca/wp-content/uploads/sites/13/2016/04/Information-for-VCH-staff-13-6-16.pdf. The MAiD Patient Request Record can be found at www2.gov.bc.ca/assets/gov/health/forms/1632fil.pdf or from your doctor.
