Albertans grapple with issues surrounding physician-assisted death

If Alexandra Anderson ever gets a degenerative disease, one that would significantly decrease her quality of life, she wants to know she can make the decision to die.

"I want to be able to make that call," said Anderson, "that, you know, I golfed enough and I can't do those things that I enjoy anymore.

"That I would want to go on to the happy hunting ground and the next life."

In February of 2015, the Supreme Court of Canada struck down a ban on physician-assisted dying meaning the practice will soon be legal countrywide.

Lawmakers now have to decide how to provide it and who can access it. Health Minister Sarah Hoffman has said consultations with organizations representing these professional groups will begin this month.

Anderson, alongside hundreds of others, made her way to a forum put on by the Edmonton Lifelong Learners Association to gain a better understanding of the controversial issue.

A confusing situation

Dr. Brendan Leier, a Clinical Ethicist at the University of Alberta and speaker at the conference, feels the Supreme Court of Canada's foray into medicine, which falls under provincial jurisdiction, is unorthodox.

"In this case, I would argue that there has been a significant breach of court interference into the very practice of medicine, which is very very unusual."

The deadline for provincial governments to draft new guidelines is June 6th. Leier said this deadline has created a "fairly confusing situation" for provincial governments.

"What the supreme court did was break down a piece of criminal code," said Leier. "However, on the positive side of things, all the provinces typically are responsible for their own health legislation.

"So you have a federal government that strikes down a criminal code, and yet it's not traditionally the role of the federal government to describe how health care services are going to function.

"Everyone in every province, every college of physicians, every health organization is scrambling to put in provisional rules and regulations."

Preparing your wills

A major topic of conversation discussed during the two-hour forum was preparing wills for the worst possible situation.

The topic was a personal one for Jon Rossall a lawyer specializing in health care law and one of the day's speakers.

"We have legislation in the province right now," said Rossall, "and we have policies in place in institutions that allow for personal directives to be prepared.

"In theory, if they're done properly, they should provide a lot of guidance to health care providers."

Rossall's father was a physician and understood the possible consequences for medical procedures first hand. He stressed the importance of having a legal directive in place if you are in a situation where you can't make a decision.

When Alberta finally drafts its rules governing physician-assisted dying they may very well be governed similarly to current do not resuscitate directives.

Rossall feels physicians should prepare themselves accordingly.

"I think what has to happen is the medical profession, and health professions generally, has to learn to have a comfort level in accepting those instructions and not doing the heroic things they otherwise might do," said Rossall.

The impact on physicians

Another topic touched upon at the conference was the impact physician-assisted death will, and can have, on the actual physicians partaking in the procedure.

Leier works intimately with health care professionals and worries about the effect helping someone die will have on those carrying it out.

"My heart's with the clinicians and the bedside [nurses] who are going to be asked to do this and faced to do this in uncharted territory with significant degree of uncertainty and a lack of clarity for what constitutes expert practice.

"This will be very challenging for physicians and their teams going ahead," said Leier.

In anticipation of Justin Trudeau's visit to Alberta last week, CBC asked Dr. Carl Nohr, the president of the Alberta Medical Association, about what he would want to ask the prime minister. His answer was in regards to this very issue.

"In contemplating possible legislation arising from your current consultation," wrote Nohr, "do you plan to reconcile the respective rights of patients and physicians under the Charter of Rights and Freedoms?

"Certainly we must ensure that patients have access to this service, yet at the same time, no physician should be required to participate against her or his will."