So Dr. Stephanie Green opens her practice, offering a familiar look at this new field of medicine, because – sooner or later – death is a part of our lives.
“People need to know this,” she said. Green near her home in Victoria, BC “Pull the curtain back. Here’s what I do.”
The family doctor spends 90 percent of her working day helping patients die.
He has also just written an impressive book, This is Assisted Dying, the first in Canada on what it is like to specialize in death.
And it allows exclusive access to the W5 to follow it and meet its patients as it helps them end their lives.
“This is legal medical care in this country. There is nothing hidden in what I do. It should not be done behind closed doors or secretly,” said Dr. Green.
From birth to death
When Medical Assistance in Dying, called MAiD, became legal in Canada in 2016, Dr. Green was exhausted from 20 years working in motherhood and was looking for a change.
“It was more difficult for me, only physically, to do 24-hour shifts and come home so tired and then need a day to recover from it.”
Thus, she changed from caring for the beginning of life to caring for the end of her life.
“One’s a delivery in. One’s a delivery out,” said Dr. Green. “They are similar in that they are both incredibly familiar moments. They are milestones in someone’s life. They are intense.”
While most doctors initially avoided performing medically assisted deaths, Dr. Green said she was drawn to a combination of curiosity and skepticism.
She suffered at an international meeting on assisted death in Amsterdam, just months before MAiD became legal in Canada.
“I thought it might be a little strange, but I was surprised by the professionalism I faced. I met people from all over the world – people who had provided this care. “Clinicians with experience, researchers who had 20 years of experience in documenting statistics,” he said. “He was really calling me.”
Her book describes in detail her medical and mental journey by evaluating patients like Ray Cole.
The 72-year-old suffers from lung cancer and is stuck with painkillers.
“The quality of life is very poor. I get up, I go to the box. “I’m coming back, I’m going to sleep, I’re getting up, I’re going to the box, I’m coming back, I’re going to sleep,” Ray said from his Vancouver Island home. “If I were a dog or a horse, I would sleep. OKAY? “I would not let my dog suffer.”
Cole had to apply for the right to die. Dr Green and a second doctor agreed that he met the criteria as a Track One patient under the law, which meant that his death was “reasonably predictable”.
“I have 10 grandchildren. I have to say goodbye to them all standing up, hug them goodbye. It was wonderful,” Cole said.
“I have no regrets. I have no problem going the other way,” he added. “I’m really. Excited because I’ll find out the answer.”
His relief was something Dr. Green had often seen when approving a patient for assisted death.
“They can stop thinking and worrying about what exactly is going to happen at the end of their lives. They can really seize these last few days or weeks or months and really focus on living them with dedication and purpose.” , he said. he said. “I give them a gift.”
The MAiD Capital of Canada
More and more people on Vancouver Island, such as Ray Cole, are seeking medical help to die. About 7.5 percent of all deaths are MAID. This is three times higher than the national average in Canada which is 2.5 percent.
The book of Dr. Stefanie Green draws attention to this impressive statistic.
The island even surpasses assisted mortality rates in countries such as Belgium and the Netherlands, which remain stable at around 4 percent, even after decades of assisted death.
“We are unusual,” admitted Dr. David Robertson. The Maid program is running on Vancouver Island.
“Is seven and a half percent the right number? No. It just happens to be the right number for Vancouver Islanders right now. But it’s not something I would translate into any other part of the country. We just provide a service with “The way we do it and find that it works for us,” said Dr. Robertson.
While no one has formally studied the high MAID rate on Vancouver Island, Dr. Robertson has shown some evidence. The island is a destination for retirement with its peaceful climate often referred to as “Hawaii of Canada”. The retirees there are well educated, well-formed and socially and politically progressive.
“We know from other research that people with higher levels of education and higher incomes tend to choose MAiD more often,” he added.
Another explanation for the high number of MAiD deaths is the fact that the island has more doctors and nurses per capita willing to provide assisted deaths than most other areas of the county.
Finally, the health authority decided that all hospitals and their clinics would never refuse to provide MAiD.
“MAiD is a right of Canadian citizens. “And it seemed to me with that philosophy… that it was the job of the health authority… to bring the MAiD to the patient,” said Dr. Robertson.
But some are wondering about the high rate of assisted deaths on the island.
“I’m worried whenever someone is or when a place is at the edge of the bell curve. It makes you wonder what ‘s going on in each of these places,” said Dr. Scott Anderson.
Dr Anderson is an ICU specialist in London, Ont. Not only does it save lives, but it also provides assisted death. He said parts of Ontario have MAiD rates that are less than 1 percent.
The most recent federal report on medical assistance in death in 2020 said the same. The report highlights regional disparities across Canada that require “further study… to clarify the differences between accessing and receiving MAiD by geographical location”.
Piece two
In March 2021, a second group of patients were granted the right to seek assisted death. Under the new law, people with serious and incurable diseases or disabilities, but who do not actually die, are allowed to seek death.
Sixty-nine-year-old John Priddle is an example of one of these cases, called Track Two case.
Unlike Ray Cole, who is dying of cancer, Priddle has a chronic and progressive neurological disorder called Friedreich’s disorder. It affects his speech, his ability to swallow and makes walking painful and slow. Once a world traveler with Jacqui’s wife, Priddle is now largely confined to home.
“I think about it as my world shrinks.”
A small but growing percentage of patients on Vancouver Island are Track Two cases. Dr. Green has approved some. But he warns that in order for people to qualify, all care must be offered – and taken seriously – to alleviate their pain.
Dr. Green assures him that taking into account all the factors, including John’s 20 years of treatment that failed to stop the progression of his disease, if the time comes for him to seek help to die earlier, he will receive MAiD approval.
“There is a possibility that you will live for many years and you will forgive me for saying that you are dying for something else,” she told him.
“It may sound weird, maybe to some, but I think it makes me feel quite relieved,” Priddle told W5.
Only 4 percent of Vancouver Island assisted deaths were Track Two cases last year – those that do not die immediately. It is a small number. However, it is still much higher than in Ontario, where Dr. Scott Anderson says he and his colleagues were much more reluctant to approve any Track Two patient because of the complexity of these cases.
“If you look at chronic pain, sometimes the main problem may not even be chronic pain. “The main problem may be mental health issues where they have suffered from depression, despair – just a whole litany of things that accompany chronic pain,” said Dr. Anderson.
“Sometimes these patients are vulnerable because they have not been able to get proper pain management or home care services. They express the desire to die. “But really, if you rinse it off, a lot of them don’t want to die.”
There is a patient who lives with Dr. Anderson, although the man was approved for MAiD as a Track One case.
“He came to me with depression, neurological disease, various other problems, social problems. I felt he had the right qualifications.”
But on the day of his trial. Not appeared.
“When I found him, he said he was very sorry. But he was in a job interview and he did not succeed,” said Dr Anderson.
“It tells you that a patient’s desire or frustration or requests for MAiD can fluctuate over time. Once an MAiD is executed, there is no return. “So if we have to be anything, we have to be very careful.”
Dr Green said she was fully aware of the pitfalls and variations across the country.
That’s why he helped found the Canadian Association of Assessors and Providers MAiD. One of the goals of the team is to standardize assessments and care across the country. With this in mind, Dr. Green is about to launch the first training program in Canada for doctors and nurses interested in providing assisted death.
Stephanie hopes the program will help bridge some of the regional differences.
“A Halifonian in Halifax who wants to have an MAiD, who has a specific diagnosis and wants to seek evaluation is treated with the same type of approach and know-how as someone in Manitoba or British Columbia. “I think this is necessary,” said Dr. Green.
The death he wanted
It’s one February morning, the 47th anniversary of Ray Cole’s wedding, when Dr. Green arrives. Of…
