A Dene leader says doctor-assisted suicide is not part of Aboriginal culture and he's calling on the federal government to consult with Indigenous people before passing new legislation.

Francois Paulette, who's also chair of Yellowknife's Stanton Territorial Health Authority Elders' Advisory Council, says Indigenous people are bound by spiritual law, not man-made law.

"We don't play God," he said. "God is responsible for bringing us into this world, and taking our life. It is pretty straightforward."

Under proposed legislation tabled in Ottawa earlier this month, doctor-assisted death will be accessible to mentally competent adults who have a serious and incurable illness, disease or disability.  

'There's a lot of fear'

The president of the Indigenous Physicians Association agrees that more consultation is needed about how physician-assisted dying will be delivered in remote and Indigenous communities.

"I think there's a lot of fear about how things will be implemented," said Dr. Alika Lafontaine.  

Lafontaine said, so far, there's been no meaningful consultation with Indigenous groups.

He's worried there will be different or lower standards of care in Indigenous communities compared with other parts of the country, saying he's already heard talks about having registered nurses, rather than physicians, provide the service in some places.  

"Even before the rules are written we are already hearing discussion about a lower scope of practice," he said.

Alika Lafontaine

Dr. Alika Lafontaine, the president of the Indigenous Physicians Association, says more consultation is needed about how physician-assisted dying will be delivered in remote and Indigenous communities. (University of Alberta)

It's just one of the issues Lafontaine raised when he appeared before a parliamentary committee that studied physician-assisted dying earlier this year. He believes there could be plenty at stake if the unique needs of remote and Indigenous communities aren't thoroughly considered.

"There's a higher burden of disease in many of these places, and many of them tend to be more advanced," he said, citing cancer as one example.

He also points out that many rural and Indigenous communities use nursing stations as acute care centres. Lafontaine says based on an audit done in northern Ontario, professionals at those stations may not have training in basic procedures, such as resuscitation.

"We're talking about introducing a new patient service that is required by law.  And we don't have a quality control mechanism to make sure that the people working there are able to provide the service in a way that is equitable and consistent with other places in southern Canada."

Not too late for change

But Lafontaine doesn't believe the answer is sending people away from their home communities to die. He says people shouldn't have to move to urban centres to get equal access to care.

"The worst thing we can do is start to implement a program that is designed in the city and just assume that is going to work in our Indigenous communities," he said.

Lafontaine says even though the new legislation has been tabled, it isn't too late.

"Even if these regulations are written up, there is still an opportunity to create our own in-house solutions when it comes to medically-assisted dying in our communities."

Paulette will speak to the issue at a Dene leadership meeting in Yellowknife on Wednesday.

with files from The Trailbreaker