Data Bits
"Data Bit" is a feature that has appeared in Free To Go, the cooperatively-produced newsletter of Canada's anglophone right-to-die
groups, since issue 6:1 (Jan.-Mar. 2004).
RTDSC Newsletter 4:3 - 9:4
The number: over 2000
What it is:
The number of Canadians who have received medical aid in dying (MAID) since it was legalized in June of 2016. The average age of recipients was 73 and the commonest reason for wanting MAID was cancer. In about half the cases the procedure was administered in a hospital; in the remaining cases it was administered in a home or a hospice or an institution such as a longterm-care facility.
Only five cases involved self-administration of the drugs.
Discussion:
The drugs normally used for self-medication outside Canada have hitherto not been practical for use here. For instance, pentobarbital (trade name Nembutal) has been priced at $23,000 per dose by Akorn Pharmaceuticals, the US company which holds the North American rights for it.
However, Americans too have been victims of price-gouging – this time by a Canadian company, Valeant Pharmaceuticals. It holds the North American rights for secobarbital, the traditional drug in the US (where pentobarbital is off the table because sources will not supply it to non-veterinary medical agencies, since it has been used for executions). When Valeant acquired the rights for secobarbital it doubled the price, from $1500 to $3000, which many individuals could not afford and which many insurers refused to pay.
Doctors in states that allow assisted suicide have developed "cocktails" consisting of heart-slowing drugs plus opioids/sedatives, and these have been used by a substantial number of people. The cost is reasonable – about $800 – but the mixtures do not work as rapidly as barbiturates like secobarbital and pentobarbital. The people who are companioning the exiter are told to expect death in 4 hours or less, but in 20% of cases the process has taken much longer – 31 hours in one instance.
In the US, doctors are not obliged to be present during an exit. But Canadian policies (to their credit) stipulate that the doctor must be present and must stay until death occurs. MAID-providing doctors are still quite thin on the ground, are seriously underpaid for their time, and have other patients who need their services: all these facts make slow methods very undesirable.
Fortunately, late in 2017 it was announced that an arrangement had been made to have the ingredients for secobarbital shipped to a Canadian compounding pharmacy, which would combine them into a product that could be used by exiters whose personal style inclined them towards a self-managed death. A doctor who is working with someone like this can contact CAMAP (Canadian Association of MAID Assessors and Providers) to learn more - https://camapcanada.ca/
When published:
October 6, 2017 on CBC News
For more information:
https://camapcanada.ca/