Aboriginal communities not ready for 'rushed' assisted-dying regulations: doctor

Northern aboriginal communities are wondering how and if assisted dying will work within a system with limited palliative care services.

'Is this even a conversation that communities are going to want to have?' asks an indigenous health expert

Health experts say there are still many unanswered questions about how remote Northern communities will be able to offer medical assistance in dying — especially since most are already in dire need of proper palliative care and culturally appropriate services.

When the Supreme Court of Canada struck down the ban on physician-assisted dying last year, it triggered a deadline for Parliament to pass a new law, which has since been extended to June 6. 

On Thursday, the long-awaited bill was tabled in Parliament, laying out eligibility requirements and guidelines.

Dr. Carrie Bourassa is an indigenous health studies professor at the First Nations University of Canada. (submitted)

"I think this is something that is very rushed," said Dr. Carrie Bourassa. "I don't know that some of our communities are going to be prepared for this or welcome it."

Two aboriginal witnesses made presentations to a special joint Commons-Senate committee; Bourassa, an indigenous health studies professor at the First Nations University of Canada, was one of them. 

'It may not even be possible'

Bourassa says she made it clear she can't speak on behalf of all aboriginal people, but also tried to impress on lawmakers that while indigenous communities are resilient, they face additional challenges. 

"For some communities it may not even be possible. When we're trying to deal with suicide and multiple loss in communities, is this even a conversation that communities are going to want to have?"

Jack Anawak, a long-time Nunavut politician who is well-versed in Inuit history, says it's unlikely many elders will use this particular service. 

"It would only be considered because it became the law of the land, not because the Inuit have any wish to pursue it," he said.

The challenges of providing culturally appropriate end-of-life care seem to be mounting in Nunavut. But, Anawak says elders are respected and supported in communities. 

Part of pre-settlement Inuit history

In the times before Inuit were settled in communities, Anawak says there were rare occasions where elders would sacrifice themselves for the good of their family. 

"It never happened because of the family. It happened because of the person," he explained. "Only when the person decided that he or she was not assisting well enough."

Jack Anawak, a long-time Nunavut politician who is well-versed in Inuit history, says it's unlikely many Inuit elders will make use of assisted dying legislation. (Sima Sahar Zerehi/CBC)

On occasion, this practice has been overdramatized in popular culture. Yes, elders were left behind, says Anawak. But, no, they were not set adrift on ice floes. 

"It may have been that they were moving on from an igloo to another camping spot or to a better hunting area, [and] the elder might have said 'I will stay here.'"

Now, Anawak says elders are living longer lives, in far better health. 

Territorial governments review bill

All three territorial governments say they are looking into how best to provide the medical assistance in dying. 

In February, N.W.T. Health Minister Glen Abernethy told CBC the territory faces "unique realities" which will have to be explored. Last week, Yukon Justice Minister Brad Cathers said that territory is exploring how to provide services, but doesn't know if Yukon's health care system will be ready for June 6. 

The Nunavut government declined an interview, but in a written statement said the Department of Health has established an internal advisory committee. 

"The committee will develop a process of consultation and feedback with key external stakeholders within Nunavut," wrote Deputy Health Minister Colleen Stockley.

Bourassa says it will be important for governments to follow up plans with funding for programs and culturally sensitive training.