An N.W.T. doctor and the chair of the Stanton Territorial Health Authority Elders' Advisory Council both agree: there are still too many unanswered questions about physician-assisted dying and how it will work in the Northwest Territories.

Last February, the Supreme Court of Canada said it was unconstitutional for the federal government to ban physician-assisted death — and is giving Ottawa until June to pass a new law.

While the federal government is in charge of drafting the new legislation, it will be up to the provinces and territories to actually implement and manage the practice — creating guidelines for things such as how and where physician-assisted dying will be delivered, and the health care providers involved.

"We're not ready at all," says Amy Hendricks, a doctor who's worked in the Northwest Territories for 14 years.

According to Hendricks, there are fundamental questions integral to the unique geographical and cultural aspects of the N.W.T. that still need to be answered.

Remote communities have no physicians

"I have not seen any consideration of what some First Nations and Inuit perspectives might be on this issue, or what it might look like in remote health care settings."

In November, a provincial-territorial expert advisory group published a final report with advice and recommendations for the provinces and territories on the implementation of physician-assisted dying, but Hendricks says those national recommendations don't reflect the reality of the N.W.T.  

"What would this look like in a community with no on-site physician? Would we be medevacing people for this? If that seems unreasonable, then who would be doing this? How would they be doing it? And what kind of expertise and other support would need to be involved?"

Hendricks says the issue of geography and the uneven distribution of health care professionals needs to be looked at "very soon."

"The GNWT is only just beginning to try and solicit opinions from stakeholders. That's work that could have been done a year ago."

Indigenous perspectives 

"Traditionally, that is not part of our system of life," says Francois Paulette, chair of the Stanton Territorial Health Authority Elders' Advisory Council and the Dene Nation Elders Council chair.    

"We have a very high standard of looking after our people that are sick."

hi-francois-paulette

'I hope either the federal or territorial government provides assistance and money to bring leaders together,' says Francois Paulette.

Like Hendricks, Paulette says indigenous perspectives have been left out of both the national and territorial conversation about physician-assisted dying, and need to be included.

"I think the leadership really needs to get on top of this and find a way for indigenous people to have a seat at the table so legislation respects and honours the UN Declaration of Indigenous People's Rights and treaty rights."

But Paulette says the onus is really on the government to consult, and "the sooner the better."

"I hope either the federal or territorial government provides assistance and money to bring leaders together.

"If that happens, it will keep traditional people like myself more comfortable with assisted suicide."

Paulette says insofar as physician-assisted dying is going to become legal across Canada, he wants to see legislation and guidelines that are "respectful of traditional values and principles."

However, Paulette recognizes that will mean different things to different people.

"I'm just one voice. There are other traditional people out there, and we can start by all sitting together and talking about the values that we have."

The N.W.T. government has begun to solicit opinions from people in the territory. It has sent letters to stakeholders, and is accepting public feedback on its website until Monday, Feb. 15. 

No one from the Department of Health was available for a comment.