愛污传媒

W5
W5

    • A rare look at Canada's growing demand for medical assistance in dying

    Share
    Victoria B.C -

    Few Canadians have seen what assisted dying looks like, even though it鈥檚 a legal medical procedure with steadily growing numbers across the country. 

    So Dr. Stefanie Green is opening her practice, offering an intimate look at this new area of medicine, because -- sooner or later -- dying is a part of everyone's life.

    "People should know about this," said Dr. Green near her home in Victoria, B.C. "Pull the curtain back. Here is what I do."

    The family physician spends 90 per cent of her work day helping patients die.

    She's also just written an eye-opening book, , the first in Canada on what it's like to specialize in death.

    And she鈥檚 allowing W5 exclusive access to follow her and meet her patients as she helps them end their lives. 

    "This is legal medical care in this country. There鈥檚 nothing clandestine about what I do. It should not be done behind closed doors or in secret," said Dr. Green.

    From birth to death

    When Medical Assistance in Dying, dubbed MAiD, became legal in Canada in 2016, Dr. Green was exhausted from 20 years of doing maternity work and was looking for a change.  

    "It had become harder for me, just physically, to be doing 24-hour call shifts and to be coming home so tired and then taking a day to recover from that.鈥

    So, she switched from beginning-of-life care to end-of-life care.

    "One's a delivery in. One's a delivery out," said Dr. Green. "They're similar in terms of they're both incredibly intimate moments. They're milestones in someone's life. They are intense."

    Dr. Stefanie Green switched from beginning-of-life care to end-of-life care (Supplied photo)While most physicians initially shied away from performing medically assisted deaths, Dr. Green said she was drawn to it by a combination of curiosity and skepticism.

    It jelled for her at an international meeting on assisted death in Amsterdam, a few months before MAiD became legal in Canada.

    "I thought maybe it would be a little bit kooky, but I was amazed at the professionalism that I encountered. I met people from all over the world -- people who had provided this care. Clinicians with experience, researchers who had 20 years of experience documenting the statistics," she said. "It really called to me."

    Her book details her medical and mental journey assessing patients like Ray Cole.

    The 72-year-old has lung cancer and is hanging on with painkillers.

    鈥淚t's very poor quality of life. I get up, I go to the can. I get back, go to bed, get up, go to the can, get back, go to bed," said Ray from his home on Vancouver Island. "If I was a dog or a horse, I would put me to sleep, OK? I wouldn't let my dog suffer."

    Ray Cole (right), a 72-year-old Vancouver Island man with lung cancer, talks to W5 about why he's chosen a medically-assisted death. Cole had to apply for the right to die. Dr. Green and a second physician agreed that he met the criteria as a Track One patient under the law, meaning his death was "reasonably foreseeable."

    "I've got 10 grandchildren. I got to say goodbye to them all standing up, hug them goodbye. It was wonderful," said Cole.

    "I have no regrets. I have no problem with going to the other side," he added. " I'm really鈥 excited because I'm going to know the answer."

    His relief was something Dr. Green had seen often when she approves a patient for an assisted death.

    "They can stop thinking and worrying about what exactly is going to happen at the end of their life. They can really grab onto those final days or weeks or months that they have left and really focus on living them intently and with purpose," she said. "I'm giving them a gift."

    The MAiD Capital of Canada

    More and more people on Vancouver Island, like Ray Cole, are choosing medical assistance in dying. About 7.5 per cent of all deaths are MAID. That's three times higher than the national average in Canada which is 2.5 per cent.

    Dr. Stefanie Green's book draws attention to this eyebrow-raising statistic.

    The island even surpasses assisted death rates in countries such as Belgium and the Netherlands, which hold steady at about 4 per cent, even after decades of providing assisted dying

    "We are unusual," admitted Dr. David Robertson. He runs the Maid program on Vancouver Island.

    "Is seven-and-a-half per cent the right number? No. It happens to be the right number at the moment for Vancouver Island residents. But it's not something I would wish to translate to any other part of the country. We just provide a service in the way we do, and we find it works for us," said Dr. Robertson.

    While no one has officially studied Vancouver Island's high MAID rate, Dr. Robertson pointed to some clues. The island is a retirement destination with its balmy climate often called the 'Hawaii of Canada.' The retirees there are well educated, well-heeled and socially and politically progressive.

    鈥淲e know that from other research, that people with higher levels of education and higher incomes, tend to choose MAiD more often,鈥 he added.

    Another explanation for the high number of MAiD deaths is the fact that the island has more doctors and nurse practitioners per capita willing to provide assisted dying than most other regions in the county.

    And finally, the health authority decided that all their hospitals and clinics would never refuse to provide MAiD.

    鈥淢AiD is a charter right of Canadian citizens. And it seemed to me with that philosophy鈥hat it was the health authority鈥檚 job鈥o bring the MAiD to the patient,鈥 said Dr. Robertson.

    But some wonder about the high rate of assisted dying on the island.

    "I do get concerned whenever somebody is, or whenever a place is on the extremes of the bell curve. That makes you wonder what's happening in each of those places," said Dr. Scott Anderson.

    Dr. Anderson is an ICU specialist in London, Ont. He not only saves lives, but he also provides assisted dying. He said parts of Ontario have MAiD rates that are less than 1per cent.

    The most recent  in dying in 2020 said as much.  The report highlights regional disparities across Canada that beg the need for 鈥渇urther study鈥o help clarify differences between access to, and receipt of, MAiD based on geographic location.鈥

    Track Two

    In March 2021, a second group of patients were granted the right seek assisted dying. According to the new legislation, people with serious and incurable illnesses or disabilities, but who aren't actually dying, are allowed to ask for death.

    John Priddle, who has a chronic and progressive neurological disorder called Friedreich鈥檚 Ataxia, speaks with W5.Sixty-nine-year-old John Priddle is an example of one of these cases, called Track Two cases.

    Unlike Ray Cole who is dying of cancer, Priddle has a chronic and progressive neurological disorder called Friedreich鈥檚 Ataxia. It affects his speech, his ability to swallow and it makes walking laborious and slow. Once a world traveller with his wife Jacqui, Priddle is now largely housebound.

    鈥淚 think of it as my world is shrinking.鈥

    A small but growing proportion of patients on Vancouver Island are Track Two cases. Dr. Green has approved a few. But she cautions that in order to qualify people have to have been offered -- and seriously considered -- all care to alleviate their suffering.

    Dr. Green assures him that considering all the factors, including John鈥檚 20 years of treatments that failed to stop the progression of his disease, should the time come when he asks for help to die sooner, he would get approved for MAiD.

    鈥淭here鈥檚 a chance you might live many more years, and you鈥檒l excuse me for saying, die from something else,鈥 she told him.

    鈥淚t鈥檚 going to sound really weird, maybe to some, but I think it makes me feel quite a bit relieved,鈥 Priddle told W5.

    Only 4 per cent of assisted deaths on Vancouver Island were Track Two cases last year 鈥 those who are not imminently dying. It鈥檚 a small number.  But it鈥檚 still much higher than in Ontario, where Dr. Scott Anderson say he and his colleagues have been much more reluctant to approve any Track Two patients because of the complexities of those cases.

    鈥淚f you look at chronic pain, sometimes the main problem may not even be chronic pain. The main problem may be mental health issues where they have suffered from depression, hopelessness -- just a whole litany of things that come with chronic pain,鈥 said Dr. Anderson.

    鈥淪ometimes these patients are vulnerable because they haven鈥檛 been able to get proper pain management or homecare services. They express a wish to die. But really, if you flush it out, a lot of them don鈥檛 want to die.鈥

    Dr. Scott Andersen speaks with W5There鈥檚 one patient who stays with Dr. Anderson, even though the man was approved for MAiD as a Track One case.

    "He came to me with depression, a neurologic condition, a variety of other problems, social problems. I did feel he qualified."

    But on the day of his procedure. He didn't show up.

    "When I tracked him down, he said he was very sorry. But he was at a job interview and couldn't make it," said Dr. Anderson.

    鈥淚t tells you that a patient鈥檚 desire or frustrations or requests for MAiD can fluctuate over time. Once a MAiD has been performed, there鈥檚 no going back. So, if we should be anything, we should be overly careful.鈥 

    Dr. Green said she鈥檚 fully aware of the pitfalls and the variations across the country.

    That鈥檚 why she helped found the . One of the group鈥檚 goals is to standardize assessments and care across the country. With that in mind, Dr. Green is about to launch the first educational program in Canada for doctors and nurse practitioners interested in providing assisted death.

    She hopes the program will help alleviate some of the regional differences.

    鈥淎 Haligonian in Halifax who wants to have MAiD, who has a certain diagnosis and wants to seek an assessment, is treated with the same type of approach and expertise as someone in Manitoba or British Columbia. I think that鈥檚 essential,鈥 said Dr. Green.  

    The death he wanted

    It鈥檚 a February morning, Ray Cole's 47th wedding anniversary, when Dr. Green arrives. His wife Deb is being prepared for what she might see when the procedure begins. Dr. Green will administer drugs to sedate -- to numb any pain -- and then to induce a deep coma that stops Ray鈥檚 breathing and heart.

    "Sorry if it's so raw," Dr. Green says to Deb as they sit in the living room. "You're probably going to see his mouth become a little slack, a little bit open. His lips might turn a little bit blue. He might become quite pale in those first couple of minutes, so all of that's really normal. If you feel kind of uncomfortable seeing that or don't really want to stay there at any point鈥ou can certainly walk out of the room."

    Then with a gentle smile Stefanie adds, 鈥淭here鈥檚 no medal for staying.鈥

    They walk into the bedroom where Ray Cole is lying in bed listening to his favourite Kenny Rogers song. Deb lies next to him.

    Stefanie hands him the syringe with the first medication.

    "I鈥檓 good to go?鈥 says Cole.

    "Safe travels my friend," says Dr. Green.

    "I love you," Ray says as he kissed Deb on the cheek. 鈥淚 love you too,鈥 she answers back.

    "Thank you," Ray says as he looks at Dr. Green.

    鈥淚t鈥檚 been an honour,鈥 Stefanie says reassuringly.

    Then Ray himself pushes the first medication into his veins. It doesn鈥檛 take long after that.

    Dr. Green has helped some 300 people die in the last five years and says she doesn't feel burned out. Quite the opposite.

     "When I leave the home of someone I've helped. Of course, I'm sad. Somebody's life has just ended. But I feel like I helped facilitate their final wish."

    CTVNews.ca Top Stories

    A teen charged with the murder of another teen on Prince Edward Island last year has pleaded guilty to a lesser charge of manslaughter.

    BREAKING

    BREAKING

    The jury tasked with determining if Canadian musician Jacob Hoggard sexually assaulted a young woman in northeastern Ontario eight years ago began deliberating Friday after nearly two weeks of testimony that saw the singer and his accuser give starkly different accounts of what happened.

    BREAKING

    BREAKING

    A northeastern Ontario jury has started deliberating in Canadian musician Jacob Hoggard's sexual assault trial, we can now tell you what they weren't allowed to hear.

    A 21-year-old man who was charged with attempted murder in the shooting of a Toronto police officer this week was out on bail at the time of the alleged offence, court documents obtained by 愛污传媒 Toronto show.

    Canada

    • The owners of a North York condominium say they are facing a $70,000 special assessment to fix their building's parking garage. '$70,000 is a lot of money. It makes me very nervous and stressed out of nowhere for this huge debt to come in,' said Ligeng Guo.

    • BREAKING

      BREAKING

      A northeastern Ontario jury has started deliberating in Canadian musician Jacob Hoggard's sexual assault trial, we can now tell you what they weren't allowed to hear.

    • The federal Fisheries Department says it is concerned about a "pattern" of violence and threats toward its enforcement officers after two tense incidents off southwestern Nova Scotia last month.

    • The owner of a Gatineau, Que. caf茅 says it's 'silly' that Quebec's language watchdog is telling the business to write its Instagram posts in French.

    • A teen charged with the murder of another teen on Prince Edward Island last year has pleaded guilty to a lesser charge of manslaughter.

    World

    Politics

    Health

    • Staff at Saskatoon's Royal University Hospital are calling for systemic changes just two days after its emergency room was more than three times above its capacity.

    • An Ontario child has died after coming in contact with a rabid bat, a health official confirmed on Wednesday.

    Sci-Tech

    Entertainment

    Business

    Lifestyle

    • A five-seat sushi counter located inside another restaurant is the latest Vancouver eatery to receive a Michelin star.

    • What does New Westminster's t蓹m蓹sew虛tx史 Aquatic and Community Centre have in common with a historic 68,000-seat stadium in Beijing, an NFL stadium and the aquatics venue for the Paris Olympics? They've all been named among the world's most beautiful sports venues for 2024.

    Sports

    Autos

    • A Pickering, Ont., student going to college to be a mechanic is shocked the engine in his two-year-old car will not be repaired under warranty after the dealership claimed he had been 'over-revving' the engine.

    • A group of classic car enthusiasts donated hundreds of blankets to nursing homes in Nova Scotia.

    Local Spotlight

    Chantal Kreviazuk is set to return to Winnipeg to mark a major milestone in her illustrious musical career.

    From the beaches of Cannes to the bustling streets of New York City, a new film by a trio of Manitoba directors has toured the international film festival circuit to much pomp and circumstance.

    A husband and wife have been on the road trip of a lifetime and have decided to stop in Saskatchewan for the winter.

    The grave of a previously unknown Canadian soldier has been identified as a man from Hayfield, Man. who fought in the First World War.

    A group of classic car enthusiasts donated hundreds of blankets to nursing homes in Nova Scotia.

    Moving into the second week of October, the eastern half of Canada can expect some brisker fall air to break down from the north

    What does New Westminster's t蓹m蓹sew虛tx史 Aquatic and Community Centre have in common with a historic 68,000-seat stadium in Beijing, an NFL stadium and the aquatics venue for the Paris Olympics? They've all been named among the world's most beautiful sports venues for 2024.

    The last living member of the legendary Vancouver Asahi baseball team, Kaye Kaminishi, died on Saturday, Sept. 28, surrounded by family. He was 102 years old.

    New data from Greater Vancouver and the Fraser Valley shows a surge in supply and drop in demand in the region's historically hot real estate market.

    • NDP Leader David Eby is vowing to raise British Columbia's speculation and vacancy tax on empty homes if re-elected premier this month.

    • One day after a man was stabbed to death in East Vancouver, a 27-year-old woman has been charged with murder.

    • A Vancouver tenant is at war with his former landlord over what he calls an exorbitant charge for bent blinds.

    • Police have arrested a Toronto woman in connection with three recent homicides and investigators say that they believe two of the victims may have been 鈥渞andomly targeted.鈥

    • A 21-year-old man who was charged with attempted murder in the shooting of a Toronto police officer this week was out on bail at the time of the alleged offence, court documents obtained by 愛污传媒 Toronto show.

    • Police forces in the Toronto area have stepped up their presence in Jewish and Muslim communities as the one-year anniversary of the deadly Oct. 7 terror attack on Israel inches closer.

    • Martha Hart, the widow of Calgary wrestler Owen Hart, is speaking out after the release of Netflix's 'Mr. McMahon' documentary series, which she says inaccurately portrays her husband's death as an accident.

    • Authorities say two Calgarians were arrested and charged in "a complex scheme" involving stolen vehicles.

    • Rural Albertans say they鈥檙e being penalized by high utility fees and some municipalities are asking the government to step in and equalize costs throughout the province.

    • The owner of a Gatineau, Que. caf茅 says it's 'silly' that Quebec's language watchdog is telling the business to write its Instagram posts in French.

    • The O-Train will be out of service all day on Saturday and for two additional hours on Sunday as part of work to integrate the Stage 2 East extension with the existing LRT line.

    • There was a decrease in the amount of waste heading to the City of Ottawa's landfill in the two months leading up to the city's new three-item garbage limit.

    • At least two people are dead and others are injured after a fire ripped through a century-old building near Montreal's City Hall, sources told Noovo Info.

    • Classes and campus activities at CEGEP de Valleyfield were cancelled Friday morning as a result of a police operation.

    • Public transport users who regularly use Fabre, d'Iberville and Saint-Michel stations on the Montreal metro's blue line will have to be patient, as the emergency closure of the three stations announced on Thursday evening could stretch out over 'a few days, or even a few weeks.'

    • Following the Alberta government鈥檚 recent announcement of capital funding to build charter and independent schools, the Investigative Journalism Foundation has found that several consultants with ties to the United Conservative Party (UCP) have been lobbying on behalf of charter schools and associated organizations over the past year.

    • Rural Albertans say they鈥檙e being penalized by high utility fees and some municipalities are asking the government to step in and equalize costs throughout the province.

    • The Rural Municipalities of Alberta (RMA) says a series of Government of Alberta policy decisions have cost its members $332 million in tax revenue over the last three years, and the group is urging the province to make changes to ease the financial strain on rural communities.

    • A teen charged with the murder of another teen on Prince Edward Island last year has pleaded guilty to a lesser charge of manslaughter.

    • The federal Fisheries Department says it is concerned about a "pattern" of violence and threats toward its enforcement officers after two tense incidents off southwestern Nova Scotia last month.

    • A 31-year-old man is facing theft and break-in charges in connection to a vandalism incident at the Fredericton Public Library that caused tens of thousands of dollars of damages over the weekend.

    • The Opposition Tories introduced a motion to get the justice system to take another look at the case of Jordyn Reimer.

    • Chantal Kreviazuk is set to return to Winnipeg to mark a major milestone in her illustrious musical career.

    • Police say a 16-year-old boy has died after an assault outside a northern Manitoba home.

    • NDP Leader Carla Beck says she would cut $58 million in spending during her first year as premier should her party win the Saskatchewan election set for Oct. 28.

    • Saskatchewan Party Leader Scott Moe says if re-elected, his government would introduce a Saskatchewan Home Renovation Tax Credit aimed at making renovations more affordable.

    • As pressure grows on the oil and gas sector to reduce its emissions, one Calgary-based company is banking on the potential to convert waste gas from oil wells into valuable electricity for nearby communities.

    • Waterloo Regional Police have laid charges after a car crashed into the side of a Kitchener home at 3:30 a.m.

    • A DoorDash driver who was caught on camera appearing to spit into an Ontario man鈥檚 drink has been removed from the platform, the food delivery company has confirmed.

    • Two serious crashes shut down Highway 401 early Friday morning in Puslinch, Ont.

    • Saskatoon police arrested a homeless person at the scene of an encampment underneath the University Bridge on Friday morning.

    • NDP Leader Carla Beck says she would cut $58 million in spending during her first year as premier should her party win the Saskatchewan election set for Oct. 28.

    • The mayor of Loon Lake is appealing to both provincial and federal government leaders for assistance in dealing with rising crime in the village, which has seen an increase in vandalism, theft, and property damage.

    • BREAKING

      BREAKING

      A northeastern Ontario jury has started deliberating in Canadian musician Jacob Hoggard's sexual assault trial, we can now tell you what they weren't allowed to hear.

    • An outfitter in Kenora, Ont., and two individuals have been fined a total of $9,500 for bear hunting offences, including abandoning a bear they shot and using it as bait to hunt another bear.

    • A suspect who accused Thunder Bay police of being responsible for his throat injury actually hurt himself when he swallowed a large amount of drugs.

    • The London Police Service said that it鈥檚 stepping up police presence around Jewish and Muslim places of worship as the October 7 anniversary of the start of the Israel Hamas war draws near.

    • A ceremony was held inside the Wolseley Barracks on Friday, honouring the family of Officer Cadet Brett Cameron who died by suicide at the Royal Military College in Kingston, Ont. in 2016.

    • According to police, officers responded to the 600 block of Tennent Avenue for a, "report of a possible stabbing" around 9 p.m. on Thursday.

    • Police in Barrie allegedly seized a semi-automatic pistol and drugs during an overnight investigation that resulted in the arrest of three men downtown.

    • The Ministry of Labour is investigating a workplace incident that claimed the lives of two people in Georgian Bluffs, south of Owen Sound.

    • A Midland woman is facing several charges after police say she bit an officer while being arrested for an alleged armed confrontation.

    • A London, Ont. man, who pleaded guilty earlier this year in a harassment case, has been sentenced to two months in jail for criminal harassment of a Windsor, Ont. family.

    • The Windsor Police Service (WPS) are looking for a witness to a collision between a pedestrian and vehicle in September.

    • Brian Masse, Windsor-West鈥檚 Member of Parliament (MP), stood before the House of Commons on Friday, criticizing the eased hazardous material restrictions at the Ambassador Bridge.

    • NDP Leader David Eby is vowing to raise British Columbia's speculation and vacancy tax on empty homes if re-elected premier this month.

    • Politicians are continuing to promote their promises across British Columbia as the provincial election campaign nears its midway point.

    • One person is dead after a floatplane carrying three people crashed Wednesday evening in a remote inlet on British Columbia's central coast.

    • Three young suspects have been arrested in connection with a swarming attack on a teenager in B.C.'s Okanagan last week 鈥 and authorities have asked the public to stop circulating disturbing videos of the incident.

    • A father in Kelowna is furious after his 13-year-old daughter was brutally beaten on Gyro Beach. He is calling for criminal charges in the devastating attack, which was caught on video by multiple bystanders.

    • The officer who shot and killed a forcible confinement suspect in Kamloops two years ago was justified in doing so, according to the Independent Investigations Office of B.C.

    • WestJet has changed its operations at the Lethbridge Airport, and it means there's now only a single daily flight from Lethbridge to Calgary, down from three flights a day, as offered previously.

    • Archie's Exotic Pet Rescue has been open about six years and, like many other animal rescues, it has seen a surge in surrenders.

    • It鈥檚 almost deadline day for Lethbridge residents interested in becoming members of one of the city鈥檚 boards, commissions and committees (BCCs).

    • BREAKING

      BREAKING

      A northeastern Ontario jury has started deliberating in Canadian musician Jacob Hoggard's sexual assault trial, we can now tell you what they weren't allowed to hear.

    • A suspect who accused Thunder Bay police of being responsible for his throat injury actually hurt himself when he swallowed a large amount of drugs.

    • An outfitter in Kenora, Ont., and two individuals have been fined a total of $9,500 for bear hunting offences, including abandoning a bear they shot and using it as bait to hunt another bear.

    N.L.

    Shopping Trends

    The Shopping Trends team is independent of the journalists at 愛污传媒. We may earn a commission when you use our links to shop.聽Read about us.

    Stay Connected
    Follow 愛污传媒