The number of Canadians who received an assisted death increased by nearly 30 per cent in the second half of last year, according to a new report that comes just after the second anniversary of Ottawa’s medical-aid-in-dying law.
Health Canada’s latest interim report, released on Thursday, found that 1,525 people hastened their deaths with the help of a doctor or nurse between July 1 and Dec. 31, 2017, up 29.3 per cent from 1,179 such deaths in the first half of last year.
“I’d say that’s very consistent with what we were expecting,” said Jeff Blackmer, the vice-president of medical professionalism for the Canadian Medical Association. “If you look at other jurisdictions, in Europe in particular, the trend over time is that as people learn more about [assisted dying,] society in general gets more comfortable with it and you do see an increase over all.”
Medical aid in dying accounted for about 1 per cent of all deaths in the second half of 2017.
Assisted dying has been legal across the country since June 17, 2016, when Ottawa adopted legislation in response to a Supreme Court of Canada decision that struck down the Criminal Code prohibition against helping people take their own lives.
Quebec enacted its own legislation permitting assisted dying six months earlier.
At least 3,714 Canadians have received assisted deaths since the Quebec and federal laws took effect.
The new report is the third interim snapshot of assisted dying released by Health Canada and the first to explore in detail why some requests for assisted death have gone unfulfilled.
Some patients, grievously ill and close to death, lost the capacity to consent to the procedure.
Others were deemed ineligible because their natural deaths were not reasonably foreseeable, a controversial stipulation of the law that is being challenged in at least two lower court cases.
Still others died before the two eligibility assessments required by the law could be completed.
However, more than 90 per cent of patients who sought an assisted death got one – at least in the seven provinces that supplied Health Canada with figures on denials. (British Columbia, Ontario, New Brunswick and the territories did not provide data on the number of cases that were turned down.)
“It should be reassuring for people that the majority of patients asking for this do seem to qualify based on the federal legislation,” Dr. Blackmer said.
In the seven provinces that reported on denials, there were a total of 149 cases in the second half of 2017 in which patients died before the assessment process could be completed – about 14 per cent of all requests.
That is down from 24 per cent in the first half of last year.
Shanaaz Gokool, the chief executive officer of the advocacy group Dying with Dignity Canada, said that while the new data is helpful, it does not explain why some patients died before the assessment process could be completed.
“Is it that the person waited too long?” she asked. “Is it that it took them so long to get the help they needed, that they were on the verge of dying anyway?”
Health Canada is expected to have a more comprehensive, permanent reporting system in place by the fall.
In the meantime, the latest interim report found that the average age of people who chose assisted death was 73. More assisted deaths took place in big cities (56 per cent) than in small towns (42 per cent) and the proportion of men and women receiving the procedure was about even.
Cancer was by far the most common underlying illness (65 per cent), followed by respiratory or circulatory conditions (16 per cent) and neurodegenerative diseases such as multiple sclerosis (10 per cent.)