Docs in northeast first to get provincially funded training in medically assisted dying

Northeastern Ontario will be the first region in the province to offer provincially funded training to doctors and nurse practitioners to provide medical assistance in dying (MAID). It will be offered through the North East Local Health Integration Network at the end of September in Sudbury.

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Dr. Paul Preston had a patient 20 years ago who begged daily for him to help her end her life.

Cancer treatments had left her with a deformed head and she wanted the emotional toil of her terminal illness to be over.

Preston, whose medical practice is in North Bay, Ont., couldn't do anything, except offer her palliative care and treatment for the pain.

He still gets emotional talking about the patient who he says deeply affected him.

"She was dying. She was in that advanced state of deformity as a consequence of her disease and of the treatments she'd received. So you could argue that the medical treatments had put her in a state of very advanced unnatural death."

That's why when the Supreme Court of Canada ruled that medically assisted death was a constitutional right, under Bill C-14, Preston began to provide the service to those terminally ill patients who requested it.

Under the legislation, patients who request Medical Assistance in Dying (MAID) must be assessed by two independent physicians or nurse practitioner to determine their eligibility.

The majority of patients who choose this aren't doing it because of the pain but rather, the emotional toll the illness takes says Preston.
North Bay physician Dr Paul Preston offers medically assisted death for his terminal patients because of a patient he couldn't help 20 years ago. (North East LHIN)

"Certainly we always make sure that if it is related to [pain] that they've explored all palliative options and are also aware of palliative sedation. Sometimes it's just ... how much suffering is acceptable, and that's a personal decision."

He says he can see relief on a patient's face once he tells them this is an option for them. Adding that it's an emotional relief for patients who don't want to keep putting up with symptoms, medications or treatment.

Preston, who is the clinical vice president at the North East Local Health Integration Network, says there is a gross under capacity for access to medically assisted dying in northeastern Ontario.

According to the North East LHIN just ten doctors and nurse practitioners provide MAID in the region. But that should change in the near future.

The Ministry of Health and Long Term Care is providing funding for training for more doctors and nurse practitioners to provide MAID. The North East will be the first site to offer this.

The comprehensive training will be provided from the Canadian Medical Association, and will include assessment, technical aspects, law, self care, social impacts and managing family.

The training will be held at the Northern Ontario School of Medicine in Sudbury on September 29.

Preston says medical assistance in dying is about putting the patient back in control of their life, at the end of their life.

"It's a beautiful death for people to choose."