N.W.T. doctors volunteer for assisted dying services, as territory releases guidelines

Several doctors in the Northwest Territories have stepped up to provide physician-assisted dying if Bill C-14 passes. The territory's health department has also released its interim guidelines for patients.

New set of rules outline how medical assistance in dying will be provided if Bill C-14 passes

The Northwest Territories' health department has released its interim guidelines for physician-assisted dying. (AFP/Getty Images)

Several doctors in the Northwest Territories have stepped up to provide physician-assisted dying if Bill C-14 passes.

The federal government's proposed right to die legislation passed in the House of Commons and was sent to the Senate on May 31, where every senator will get the chance to propose amendments. It's the result of a Supreme Court decision last year, which ruled that the law preventing doctor-assisted death was a violation of a patient's rights under the Charter of Rights and Freedoms.

The N.W.T. released interim guidelines on Monday for how the health department will provide the service, should the legislation pass. The guidelines are posted online.

Dr. Sarah Cook, a medical director with the Yellowknife Health and Social Services Authority, says a number of doctors in the N.W.T. have already said they are interested and prepared to provide the service.

Dr. Sarah Cook, with the Yellowknife Health and Social Services Authority, says a number of doctors in the N.W.T. are interested and prepared to provide the service. (CBC)

"This is a very personal decision both for patients and for physicians as well," Cook said.

She said it's the doctor's right to decide what their stance is on assisted dying, though they may not want to broadcast it.

"I think many physicians are not prepared to necessarily have this information on the public record, what their personal, moral convictions are around this," Cook said.

"It does make a difference being in small communities. It definitely has an impact on your personal life."

'Grievous and irremediable' conditions

The N.W.T.'s interim guidelines list the criteria patients must meet to apply for doctor-assisted dying, including that they have a "grievous and irremediable" medical condition.

Cook says that means the patient's condition must be serious and incurable; they must be in an advanced state of irreversible decline; and they must be experiencing intolerable physical or psychological suffering.

The N.W.T. also includes a criteria that natural death has become "reasonably foreseeable" — a criteria that is up in the air after a senate vote removed it on Wednesday.

"As you can imagine, there is some interpretation required by physicians," Cook said. "But it does come down to a very case-by-case situation with patients.

"It's not possible for us to give a list of conditions that are or are not eligible for this."

Challenges in the N.W.T.

Glen Abernethy, the N.W.T.'s health minister, said patients will have to be assessed by two independent doctors.

'It’s all going to be on a case-by-case basis, depending on the condition of the person,' says Health Minister Glen Abernethy. (CBC)
"There are challenges in the Northwest Territories," he said. "There's many of our communities who don't have physicians."

Abernethy said, for now, the Telehealth service can set up appointments with doctors for patients in smaller communities, and programs like medical travel can help make that happen.

But, the health minister says if Bill C-14 passes, the N.W.T. will amend its guidelines to allow other medical practitioners (like nurses and nurse practitioners) to be involved in the process.

Patients will also need two independent witnesses to sign off on their application, and they'll have to provide consent more than once.

"There are several steps along the way where the person, they have to reconfirm that they understand the process that they're going through," Abernethy said.

"It's not just one consent, it's several consents. We want to make sure that the person is conscious and aware of the decision that they're making."

With files from Loren McGinnis