MANITOULIN—No Manitoulin Island patients of the Manitoulin Health Centre (MHC) have chosen to end their lives with medically assisted dying since Bill C-14 was enacted in June 2016, CEO Derek Graham told The Expositor.
The question to Mr. Graham was prompted by a question from the floor during last Tuesday’s All Candidates’ Night held at Manitoulin Secondary School by Little Current’s Sandy McGillivray. Mr. McGillivray asked the candidates how their parties would balance the needs of the patient’s right to choose medically assisted death with the doctors’ right to not be involved in the process due to moral concerns.
Mr. Graham said that since the MHC’s policy on medical assistance in dying has been in place, there have been a few enquiries, but either due to a change in treatment for the patient, or because that patient passed away from their illness, medically assisted dying has not been the outcome.
Should a patient make this choice, there is a stringent list of criteria they must meet before the process can even begin, Mr. Graham explained. The patient must have: a serious or incurable disease or disability; the person is in an advanced state of irreversible decline; the illness, disease or disability or state of decline causes the person enduring physical or physiological suffering that is intolerable to them and cannot be relieved in a manner that the person considers acceptable to them; and the person’s natural death has become reasonably foreseeable due to all of their medical circumstances without requiring that a prognosis has been made as to the length of time that they have remaining.
The MHC has created policy that states, at least now, that all medically assisted dying will be done at the MHC and by one of the MHC physicians. Under the law, nurse practitioners do have the capability perform medically assisted death, but are not as of now included in the MHC policy.
In terms of Mr. McGillivray’s question, Mr. Graham said “because of the way the group works together and practices together, if a physician feels strongly, there’s enough collegial relationships that someone else will step in.”
He added that it was important for the physicians and the MHC to ensure there were no gaps in service for the patients of Manitoulin. “Someone else from the team will step in,” he reiterated.
Mr. Graham said for those who were contemplating medically assisted death, it takes some time to be assessed, and by two physicians, and perhaps a psychiatrist or psychologist if deemed necessary by one or more of the doctors, followed by a 10-day reflection period.
“The board had an in-depth discussion and conversation in asking ‘is this a service MHC should be offering’?” Mr. Graham said. This meeting was preceded by a meeting of the doctors who brought their recommendations to the board.
“It was a yay from the board, but there were certainly strongly held positions by members of the board,” the CEO added.
“We’ve landed at a place that’s reasonable and defensible,” Mr. Graham said.
