Physician-assisted suicide granted to Calgary woman in Canadian 1st outside Quebec

Right to die: Alberta Court of Queen's Bench deems Ms. S has 'grievous and irremediable medical condition'

A Calgary judge has ruled on a right to die case, determining that a retired psychologist met all criteria required to be granted an exemption under current law that prohibits physician-assisted death. (CBC)

A retired Calgary psychologist in the final stages of ALS is believed to be the first person in Canada outside of Quebec to be allowed to legally end her life with help from a doctor.

Alberta Court of Queen's Bench Justice Sheila Martin granted the application in a written decision released on Tuesday after hearing arguments at an in-camera hearing last Thursday.

The woman at the heart of the Calgary case is called Ms. S. in order to protect her privacy. She is in constant pain, almost completely paralyzed and has been told the disease will kill her within about six months.

"I do not wish to have continued suffering and to die of this illness by choking," wrote Ms. S. in one of her two affidavits. "I feel that my time has come to go in peace."

The judge found Ms. S. had met her burden as she is a competent adult with a "grievous and irremediable medical condition" that causes intolerable suffering that can't be alleviated and who clearly consents to the termination of life.

Under Canada's current law, it is still a crime to assist another person in ending their life but two recent decisions at the Supreme Court allow exemptions if certain criteria are met.

In January, the country's highest court granted the constitutional exemption to those who make an application in superior court and are found to have met the criteria until new legislation is crafted in June.

"This is the first application of its kind in this province and no applications from other Canadian jurisdictions have been brought to my attention," Martin writes.

Quebec's provincial assisted dying law came into effect on Dec. 10, 2015. A Quebec City woman who died with the assistance of a doctor became the first known case in January, followed by at least 10 others in that province.

'I would like to pass away peacefully'

A retired clinical psychologist, Ms. S. worked in the health-care system in Calgary for 38 years. She was an avid hiker and an award-winning dancer.

Diagnosed with ALS — a degenerative neurological disease — in April 2013, she is now in its final stages.

"I am not suffering from anxiety or depression or fear of death," wrote Ms. S. in one of two affidavits. "I would like to pass away peacefully and am hoping to have physician-assisted death soon."

Though she is mentally alert, she is almost completely paralyzed, only able to move her left hand slightly. That movement provides her only means to communicate but is quickly slipping away.

"She is in significant pain and requires constant care and support," reads Martin's decision. "She has lost the ability to pursue the independent life she so valued."

Ms. S. wakes several times through the night with bouts of choking on her own saliva.

'I have had a very healthy, productive and fulfilled life'

Evidence considered by Martin included Ms. S.'s two affidavits dated Feb. 16 and 23, 2016, as well as statements from her doctors, medical records and a letter from her best friend of 38 years.

Her only family is her spouse, who is her main caregiver. In her affidavit, she says their nine-year relationship has been the happiest time of her life.

"As I look back upon my life prior to this illness, which began three years ago, I feel happy, as I have had a very healthy, productive and fulfilled life."

Ms. S. plans to die in Vancouver with the help of two B.C. doctors who will provide her with medication to induce death.

News of the Alberta decision has provoked reaction from groups both for and against physician-assisted death.

Rhonda Wiebe, of the Council of Canadians with Disabilities, says that although there appears to be no coercion or abuse in this case, "it doesn't mean that having had this first incidence occur, that there aren't people who might be vulnerable who would also be requesting, or having someone request on their behalf, to have assistance in dying."

"Our concern is that there still needs to be protection for vulnerable persons," she said in an interview.

Shanaaz Gokool, the CEO of Dying with Dignity Canada, expressed sympathy for Ms. S. and her family and said decision puts a human face on the issue.

"The Alberta model can provide an expeditious and a compassionate court process that other jurisdictions can look to until it becomes the law of the land," she said.

Jean-Pierre Ménard, a Montreal-based lawyer specialising in patients' rights, applauded the decision.

"It's a very important judgment and I think a very good judgment," he told CBC, "because there were fears that this process could be extremely complicated and the approach chosen by the judge in this case seems to be quite flexible," he said.

Following the Supreme Court's ruling on the right to physician-assisted death, the federal government has until June 6 to draft legislation.

Alberta seeks input

On Monday, Alberta announced that three MLAs would gather input from the public on new guidelines for physician-assisted death.

Dr. David Swann, leader of the Alberta Liberal Party, will be part of that group. He called the issue "a major change in our healthcare system."

"I don't think many people will use it ... but for those who desperately want it, I think it should be available as the courts have ruled and we now need to sort out the details of how that can be most fairly and transparently done," he added.

The province is also discussing the issue with the College of Physicians and Surgeons and Alberta Health Services.

Clarifications

• An earlier version of this story quoted MLA Dr. David Swann as reacting to the justice's decision in this case. In fact, he was commenting on Alberta's decision to seek input on guidelines for physician-assisted death.
  
  Mar 01, 2016 6:51 PM MT