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

Close to 80 doctors in Alberta say they arewilling to provide physician-assisted dying once the practicecomes into law on June 6.

The decision by the Supreme Court of Canada to strike down laws against the practice has been controversial, outsideand within themedical profession, says Dr. James Silvius, whochairs the Alberta Health Services steering committeeworking on preparations for handlingphysician-assisted deathin the province.

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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,"Silviustold theEyeopenerTuesday 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.

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 atRockyviewGeneralHospital in Calgary.

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

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

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"Mental illness is really a challenge, and it's a challengefor 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, saysSilvius.

"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.'"

Silviussaid 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