Alberta doctors prepare for 'culture shift' created by physician-assisted death

Close to 80 doctors in Alberta say they are willing to provide physician-assisted dying once the practice comes into law on June 6.

'It is very important for us to get it right' once practice comes into effect on June 6

Adjusting to the new reality of physician-assisted death will require a culture shift within the medical profession, says Dr. James Silvius. (CBC)

Close to 80 doctors in Alberta say they are willing to provide physician-assisted dying once the practice comes into law on June 6. 

The decision by the Supreme Court of Canada to strike down laws against the practice has been controversial, outside and within the medical profession, says Dr. James Silvius, who chairs the Alberta Health Services steering committee working on preparations for handling physician-assisted death in the province.

He says it's going to take a "culture shift" within the profession to adjust to the new reality.

"We have very much been taught — as I was in our training and all through our professional career — to help people," Silvius told the Eyeopener Tuesday morning. "Sometimes we know that people are dying and we don't necessarily help them die but we help them to have a good death. This is simply an extension of that as we go forward."

"What's different is that we are playing an active role," he added.

Dr. James Silvius is leading the AHS steering committee working on preparations for handling physician-assisted death in the province. (AHS)

Mental health challenges

It's not known how many people in Alberta are currently seeking assisted dying.

"We don't have a sense at this point as to how large the demand may or may not be," said Silvius, a geriatrician at Rockyview General Hospital in Calgary. 

The Supreme Court ruling only applies to competent adults with enduring, intolerable suffering who clearly consent to ending their lives.

That leaves a number of questions about whether or not mature minors will eventually be included, as well as how to handle cases involving mental illness.

"Mental illness is really a challenge, and it's a challenge for me as well in terms of the leadership of this work because it is very important for us to get it right," Silvius said. 

"The issue for me is that where an individual does not have a life-limiting illness, we need to think very carefully about what the assessments need to be and to be sure that at the time an individual is asking and consenting for physician- assisted death, that this really is what they're looking for and is in their best interest."

'Part of our practice'

It's important to "normalize" the conversation around physician-assisted death, both inside and outside of the profession, says Silvius.

"The medical community has opinions that are as broad as those that are seen in the general population," he said.

"So we've heard everything from, 'How could you?' and 'This should be fought,' to, 'This is something that should have happened a long time ago.'"

Silvius said the doctors who have come forward are doing so for a number of reasons.

"One is because they believe in human rights," he said. "Another is because they believe that, for some patients, this is right and therefore there needs to be a mechanism for it to be provided."

"And for others, it's still seen as being an extension of what they are providing for their patients."

With files from the Calgary Eyeopener


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