Canada Oct. 24, 2018

Vancouver Island posts Canada’s highest assisted suicide rate

By Agnieszka Ruck

The Vancouver Island Health Authority says within two years of the legalization of assisted suicide, 3.6 per cent of all deaths on the island were assisted. Meanwhile, a national report from the Canadian Institute for Health Information paints a grim picture of the availability of palliative care. (Pixabay photo)

The rate of medically-assisted deaths on Vancouver Island is about five times higher than in the rest of the country.

A new report from the Vancouver Island Health Authority has revealed 3.6 per cent of all 504 deaths on the island in the first two years since Bill C-14 were assisted suicides, and the rate has since increased to four per cent. For the rest of Canada, the rate is less than one per cent.

“British Columbia has been at the forefront of the political move and legal challenges that have resulted in Bill C-14 (allowing) access to assisted dying,” one of the report’s authors, Dr. David Robertson, told the Times Colonist.

Robertson suggested that history is why more people are dying of assisted suicides on Vancouver Island than anywhere else in the country. Sue Rodriguez, a right-to-die activist who had ALS, and Margot Bentley, a woman with Alzheimer’s who became the centre of a famous spoon-feeding debate, were both B.C. residents, and Rodriguez lived on the island.

Robertson also said Vancouver Island has an “unusually high number” of doctors willing to end their patients’ lives, which means more access to assisted death.

The report noted it took the Netherlands 15 years for number of deaths by assisted suicide to rise to 3.9 per cent of total deaths.

The report also said of all islanders who went through with medically assisted suicides, 57 died at home, 26 per cent in acute-care hospitals, 12 per cent in hospices or palliative care units, and three per cent in residential or assisted care.

The top reasons patients gave for requesting assisted deaths were cancer (61 per cent), organ failure (19 per cent) and neurodegenerative disease (8 per cent). The average age was 76.

Also this fall, a report by the Canadian Institute for Health Information has revealed difficult truths about the state of palliative care in this country.

A grim picture of Canadians dying amid the noise and bustle of hospital acute care wards, unable to access quality palliative care, emerged from CIHI’s first comprehensive, national assessment of palliative care here.

Even though three-quarters of Canadians say they want to die at home, most of us don’t, according to the report released in September. Only 15 per cent of people who died in 2016-7 received publicly funded palliative care at home.

Most patients (62 per cent) who had any form of palliative care only received it in an acute care hospital and mostly during the last month of their lives. When hospitals identify patients as palliative, nearly half of those patients (47 per cent) die before they can be discharged to a more appropriate setting.

CIHI estimates 89 per cent of all Canadians could benefit from palliative care during their last year of life. “Home care and palliative care are both not covered under the Canada Health Act and it results in a huge patchwork of programs across the country that are not consistent, well-funded or well-known,” said Nancy Lefebre, the chief clinical executive and senior vice president of St. Elizabeth Health Care in Markham, Ont.

“We’re certainly not where we need to be honouring people’s wishes to be dying at their place of choice and with dignity.”

Meantime, 40 per cent of those who choose so-called medical assistance in dying (or MAID) end their lives at home, under circumstances they control. A clear and accessible choice of palliative care would lead to a completely different conversation, said Carleen Brenneis, director of Covenant Health’s Palliative Institute in Edmonton.

“People need to have good care before they make these kinds of decisions,” said Brenneis.

A private members’ bill calling for a national palliative care strategy was introduced in the House of Commons in 2016 and became law in December 2017. CIHI’s report reveals there is still a long way to go to improve palliative care and access for Canadians.

Assisted suicide has been legal in Canada since June 2016.

With files from Michael Swan at The Catholic Register.