Sixty-seven Nova Scotians have requested medical assistance to die since Canada's assisted dying legislation was passed last June.

But of those 67 applicants, only 31 actually received medical help to die.

The Nova Scotia Health Authority, which oversees assisted dying in the province, said there are several reasons why the remaining applicants may have not received the help they requested.

Those 36 applicants may have died while waiting for approval, may not have met the criteria, may have withdrawn their application or may still have an application in progress.

The health authority could not immediately provide a breakdown of how many of the 36 applicants fell into each of those categories.

Meeting the requirements

The Nova Scotia statistics on medical assistance with death include applications filed between June 17, 2016, and March 31, 2017.

Sheilia Sperry, the Nova Scotia co-ordinator of Dying with Dignity Canada, said she's not surprised that more than half the applicants did not receive the help they requested.

In order to be eligible, applicants must, among other criteria, be in an advanced state of decline and be enduring intolerable suffering. Their death must also be "reasonably foreseeable."

Sheilia Sperry

Sheilia Sperry is the co-ordinator for the Nova Scotia chapter of Dying With Dignity Canada. (Submitted by Sheilia Sperry)

Sperry believes those criteria are too restrictive. 

"You have to be what is called actively dying. In other words, you have to be close to death before they will even consider an application," Sperry said.

"I would expect quite a number of those 30-some people would have died natural deaths simply because they were so far down the process of dying when the application actually went in."

Adjusting legislation

Sperry would like to see the legislation allow people to apply well before death is imminent. 

She said on the very day her husband was diagnosed with ALS, he knew he did not want to end up on life-support.

"He told me, 'I do not want to be hooked up to any artificial support — no feeding tube, no respiratory support. I want to just be left on my own. I don't want to end up gasping like a fish on a wharf, trapped inside my own body.'"

Sperry's husband died eight years after that diagnosis — years before the legislation came into effect. But if the current legislation had been in existence then, he never would have had the peace of mind during those eight years that his life would end the way he wanted.

Sylvia Henshaw agrees that Canada's laws on medically assisted death are too rigid. The Berwick, N.S., woman's husband, Douglas Henshaw, received medical help to die in September 2016.

Like Sperry, Henshaw would like the law to accept advanced care directives — instructions that outline the conditions under which a person would prefer not to continue living and that specify the person's wishes for the end of life. She also said the rules about what constitutes "reasonably foreseeable" death should be clearer.

Laws are 'a start'

But Henshaw is glad the legislation is in place. 

"I think it's important that people know about it, know it's an option," she said. "As a beginning program, I am just so grateful that it came out when it did."

Sperry said despite the legislation's shortcomings, she's also glad Canada now has a law allowing medical assistance with death.

"At least it's a start," she said. "For those who are suffering at the end of life, it's just such relief to know that you're still in control. It's the last little bit of control that you have at the end of your life."