Category: Euthanasia

Quebec euthanasia statistics: 67% increase in euthanasia deaths in second year

Introduction

Since 10 December, 2015, euthanasia has been provided by physicians in Quebec under the terms of An Act Respecting End of Life Care (ARELC).  Health and social services agencies established by the government throughout the province are state agencies responsible for the delivery and coordination of health care in the province administrative regions. These are called Centres intégrés de santé et de services sociaux (CISSS) and Centres intégrés universitaires de santé et de services sociaux [CIUSSS).  Some administrative regions (like Montreal and the Quebec City region) have more than one CISSS or CIUSSS.

These agencies are responsible for the delivery of euthanasia.  For two years beginning 10 December, 2015, they were required to make reports twice yearly to a commission established by the law to monitor the administration of euthanasia (the Commission sur les soins de fin de vie) and publish them on their websites.  These twice-yearly reports will apparently cease to be published after that time.  The Commission draws from these and other reports to make its required summary of activity to the legislature (National Assembly).

The Project has compiled the statistics provided in these reports from10 December, 2015 to 10 December, 2017.  The compilation includes tables and charts, some of which are reproduced below.

Euthanasia Requests in Quebec, 2016-2017
Euthanasia Requests in Quebec, 2016-2017

Note that, in some cases, the number of patients lethally infused is higher than the number of requests because euthanasia was provided in response to a request made in the previous reporting period.  In addition, not all euthanasia deaths are captured in these reports, as some regions with low populations do not publish reports, and euthanasia may be provided by private entities that are not subject to the statutory twice-yearly reporting requirement.

  • The number of euthanasia requests made weekly in the province increased from about 14 in 2016 to about 23 in 2017. In Montérégie the number of requests weekly doubled; they more than tripled in Bas-Saint-Laurent.
  • Euthanasia was provided about 9 times weekly in the province during 2016 and 14 times weekly in 2017.
  • The number of euthanasia deaths increased by about 67% from 454 in 2016 to 757 in 2017.  This is about 1.1% of deaths from all causes, a rate not reached by Belgium for 9 years after legalization.
    • In Outaouais the number of euthanasia deaths almost doubled (11 to 21)
    • In Chaudière-Appalaches the number more than doubled (18 to 40)
    • The number of euthanaia deaths more than tripled in Saguenay-Lac-Staint-Jean (6 to 19)
    • The number of euthanasia deaths quadrupled in Côte-Nord (2 to 8), and more than quadrupled in Abitibi-Témiscamingue (4 to 18).
  • 434 requests for euthanasia were not acted upon in 2017, up from 263 in 2016.  However, the percentage of all requests not acted upon remained constant at 37%.
    • In 11% of the cases the patient died of natural causes before euthanasia was provided, up from 9% in 2016.
    • About 8% of the patients did not qualify for the procedure, down from 11% in 2016.
  • Marked increases in rates of continuous palliative sedation occurred in a couple of regions, notably Laurentides (a 2017 reate almost six times that of 2016) 

See: full statistical summary with downloadable Excel file

Medically assisted death allows couple married almost 73 years to die together

The Brickendens are one of the few couples in Canada to receive a doctor-assisted death together, and the first to speak about it publicly

The Globe and Mail

Kelly Grant

When George and Shirley Brickenden tell the story of how they met, it’s like watching a charming little play unfold – one the couple might have workshopped for seven decades.

It was Christmas in Halifax, 1944. He was in the Navy and she was in the Air Force. Mr. Brickenden’s mother had tried to set them up earlier, but the timing didn’t pan out.

Mr. Brickenden, 95, grinned as he explained why.

“I said, ‘I haven’t got time for her for a few days because I’ve got a few dates.'”

Three of the couple’s four children, sitting nearby, groaned and laughed. They had heard this before.

Mrs. Brickenden, 94, interjected. “I was engaged to somebody else!”

“He’s always saying that he had to break his dates and he never mentions that I already had a ring.”

The Brickendens were reminiscing in a recent interview with The Globe and Mail about their first date – a fairy-tale evening that led Mr. Brickenden to propose marriage six days later – knowing that less than a week after the interview, they would be dead. . . [Full Text]

B.C. doctor cleared of wrongdoing for providing assisted death to woman who starved herself

Globe and Mail

Kelly Grant

British Columbia’s physician regulator has cleared a doctor of any wrongdoing for providing medical aid in dying to a woman who did not qualify for the procedure until she starved herself to the brink of death.

A committee of the College of Physicians and Surgeons of British Columbia (CPSBC) found that Ellen Wiebe did not break the regulator’s rules when she helped a 56-year-old patient known as Ms. S to die last year.

The case is the first to be made public in which a medical regulator has ruled on the contentious question of whether doctors should grant assisted deaths to patients who only satisfy all the criteria of the federal law after they stop eating and drinking.

“It was determined that Ms. S met the requisite criteria and was indeed eligible for medical assistance in dying, despite the fact that her refusal of medical treatment, food, and water, undoubtedly hastened her death and contributed to its ‘reasonable foreseeability,'” the college’s inquiry committee wrote in a Feb. 13 report. . . . [Full text]

 

Has stopping eating and drinking become a path to assisted dying?

Policy Options

Jocelyn Downie

Can patients, by stopping eating and drinking, make themselves meet the criteria for a “grievous and irremediable medical condition,” the requirement to access MAiD?

Ms. S. was a 56-year-old woman with advanced multiple sclerosis. In June 2016, when her suffering became intolerable and her state of decline was advanced as a result of her incurable medical condition, she asked Dr. Ellen Wiebe for medical assistance in dying (MAiD). Ms. S. had earlier declined potentially effective treatment. Dr. Wiebe concluded that Ms. S. met most of the eligibility criteria for MAiD in Canada: incurable condition, advanced state of decline in capability, and enduring and intolerable suffering not remediable by any means acceptable to her. However, as she did not believe that Ms. S. would die “in the foreseeable future,” she deemed her not to meet the final eligibility criterion for MAiD: “natural death has become reasonably foreseeable.” Ms. S. asked again for MAiD in December 2016 and January 2017 and each time she was deemed ineligible on the same grounds. . . [Full Text]

Nurse practitioners not always compensated for providing medical assistance in dying

Ministry of Health and Long Term Care does not provide fee-for-service the way it does for physicians

CBC News

Angela Gemmill

The Nurse Practitioners Association of Ontario says some of its members are helping to provide their patients with medically assisted deaths without compensation.

It wasn’t until April of 2017 that nurse practitioners (NPs) in Ontario could prescribe the controlled substances used for medical assistance in dying (MAID).

Since then about 40 NPs across the province have provided either patient assessments or the procedure itself.

A patient must be assessed by two independent health care providers. This can be either a physician or a nurse practitioner. The procedure is the same regardless of who provides it.

One nurse practitioner in Sudbury, Ont. says it’s important for her to provide support to patients who want to take this step. She admits that medical assistance in dying is rather limited in Sudbury, in that not a lot of physicians or nurse practitioners are willing to provide it for patients. . . [Full text]