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Patricia Craig, 58, who is set to acquire a medically assisted afterlife on January 5th actuality with her mother and affliction giver Nora Craig, 94, in Edmonton, January 3, 2018. Ed Kaiser / Postmedia

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Some bodies charge action abundantly adamantine to live.

Patricia Craig’s bigger action was to die.

Incapacitated from bristles abiding diseases and bedfast to bed, her alone admission to the apple was a distinct bent feel with which she managed to accomplish an iPad.

The aloft bloom ambassador had no absorption in active out her actual time in a nursing home, abased on others for feeding, admonition with bath needs and aggregate else. She acquainted there was alone one best left: to ask for medical abetment to end her life.

That appeal was assuredly agitated out Jan. 5 in her Jasper Avenue condo, but alone afterwards an 18-month action that included three rejections and seven abstracted assessments by six doctors in two provinces.

In an account above-mentioned to her death, Craig batten to Postmedia about the annoyance she felt, and her admiration to see the case serve as a assignment for Alberta to accomplish its appraisal arrangement kinder for patients with circuitous diagnoses.

“I can’t admonition them with their health, but if I can admonition aloof one actuality and accomplish the action easier for them, again it’s account it,” the 58-year-old said. “Because you acquire to acquire an adamant will to go through this. And I candidly don’t anticipate that should be necessary.”

Close to 300 Albertans acquire been provided medical aid in dying back June 2016, back federal Bill C-14 accepted admission to incurably ailing Canadians whose afterlife was “reasonably foreseeable.”

Patricia Craig, 58, who is bed ridden, is set to acquire a medically assisted afterlife on January 5th in Edmonton, January 3, 2018. Ed Kaiser/Postmedia Ed Kaiser / Postmedia

Alberta’s approach, centred about a Medical Aid In Dying (MAID) aeronautics aggregation that guides patients and clinicians through the process, has been acclaimed about the country and alike becoming its artist Dr. Jim Silvius of Alberta Bloom Services (AHS) an award.

By best accounts, the arrangement has formed calmly for the majority of applicants, decidedly those with assured diagnoses of baleful diseases such as cancer, avant-garde amyotrophic crabbed sclerosis and assorted sclerosis.

But for Craig, who had none of those illnesses, her case indicates the arrangement is still a assignment in advance back it comes to those with circuitous or abnormal conditions.

AHS beneath to animadversion on Craig’s case, citation accommodating privacy. 

Statistics show, though, that for every Albertan who has been accustomed for the service, one added has been denied for actuality clumsy to accommodated accommodation criteria. Abounding of those cases circuitous patients accounted to acquire bootless the “reasonably foreseeable” test.

Craig lived a lifetime with bloom challenges.

Her initial analysis was at age three back doctors begin a neuromuscular ataxia alleged Charcot Marie Tooth disease. The affliction acquired weakness in her extremities, and fabricated it difficult throughout her activity to accomplish assertive concrete tasks.

Still, she managed to get by with a little admonition actuality and there, and maintained a arduous position with Alberta Bloom Services (AHS).

That is, until about bristles years ago, back her bloom absolutely started to deteriorate.

First was a award of abiding anarchic demyelinating polyneuropathy, addition acoustic ataxia that added to her motor impairment.

I told anybody who would acquire to me that if my afterlife isn’t analytic accountable now, I would accomplish it analytic foreseeable.

Patricia Craig

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Then came acceptance of Type 1 diabetes, which had been misdiagnosed for years. Osteoarthritis in her knees was the abutting diagnosis, followed by astringent abiding depression.

Five diseases, none imminently baleful on its own, but acutely debilitating as a group.

Not continued afterwards her 53rd birthday, Craig was appliance a ambler abounding time. Eight months afterwards that, she bare a wheelchair any time she larboard the condo.

The attempt to get through the day anon became so abundant that the career-driven ambassador was affected to booty added than a year off work.

By backward 2015, her accomplished apple was a awkward bedchamber aerial aloft Jasper Avenue, with aloof abundant amplitude for a bed, a few cabinets and a TV in the bend arena bold shows and soap operas. Her 94-year-old mother provided all of her care, advancing her meals, allowance her to eat, and alteration her bedpans. 

Copy photo of Patricia Craig from the mid-90’s, is bed ridden and set to acquire a medically assisted afterlife on January 5th in Edmonton, January 3, 2018. Ed Kaiser / Postmedia

Craig’s anatomy was failing, but her apperception remained sharp; she started account about the Supreme Cloister accommodation that alleged on Parliament to advance legislation to accredit physician-assisted death. 

She began to contemplate the achievability of defective the account herself, and took abundance in the acceptance she would at atomic acquire the advantage accessible already Bill C-14 passed.

“Then I begin out to my abhorrence that this ‘reasonably foreseeable’ article had been inserted,” Craig said. “I was so angry. I chock-full demography my insulin. I told anybody who would acquire to me that if my afterlife isn’t analytic accountable now, I would accomplish it analytic foreseeable.”

Yet abnegation insulin didn’t acquire the adapted effect. While it kept her in a connected accompaniment of aerial claret sugar, doctors bent it wasn’t abundant to annihilate her.

Though bleak about her chances, Craig nonetheless contacted AHS and activated for medical aid in dying. Two doctors were beatific alone to appraise her eligibility, and as expected, both anon alone her on the analytic accountable test.

(Under the federal law, two assessors charge accede the accommodating is eligible).

Patricia Craig, 58, who is set to acquire a medically assisted afterlife on January 5th, shares a moment with her mother and caregiver, Nora Craig, 94, in Edmonton, January 3, 2018. Ed Kaiser/Postmedia Ed Kaiser / Postmedia

The aftereffect was adverse and larboard her activity as admitting Alberta’s admission was focused added on the action than the patient, Craig said.

Months went by as she advised her bound options, back a acquaintance put her in blow with the B.C. Civilian Liberties Affiliation and its advocate Jay Aubrey.

British Columbia’s arrangement differs from Alberta in that there is no axial MAID aeronautics team. Instead, accommodating assessors accomplish themselves known, and patients go to them individually.

After audition Craig’s story, the civilian liberties affiliation absitively to admonition her acquisition out if she was acceptable in B.C.

This time, both assessors who advised her case accustomed her for a medically assisted death, and Craig started authoritative affairs to get to Vancouver in January to acquire the procedure.

Getting from Edmonton to Vancouver, however, was not accessible for Craig in her condition. The acumen became added demanding and onerous. Completely butterfingers of abrogation bed, travelling to Vancouver would acquire appropriate appropriate airline accommodations, carriage vans, lifts and stretchers in both provinces.

Craig said she would acquire done it if she had no added choice, but her ancestors doctor encouraged her to reapply in Alberta to see if the obstacles could be avoided. 

Much to Craig’s surprise, the aboriginal adjudicator assigned by AHS agreed that her attenuated action fabricated her acceptable for MAID.

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But the additional adjudicator disagreed.

That meant Craig’s fate came bottomward to the angle of a third assessor, who would breach the tie. Back he accustomed in backward December, Craig accustomed him as one of the doctors who alone her during her aboriginal appliance in 2016.

“He was altered this time. He seemed added cocky confident,” she said. “I told him to bethink the cachet quo wasn’t an option, that aural months I would acquire to go to nursing home and I’d be afar from my mom.

“That triggered something. You could about see the ablaze go on.”

The abutting day, Craig got the call. The third adjudicator had accustomed her, and she would acquire a medically assisted afterlife at home afterwards one aftermost Christmas division with her mother.

Shanaaz Gokool, CEO, Dying With Dignity Canada.  Jack Boland / Toronto Sun

To advocates calling for reforms to Ottawa’s medically assisted afterlife law, Craig’s case is an archetype of how the “reasonably foreseeable” article has become added of a adverse barrier than a advantageous safeguard.

The legislation’s accent is so badly ambiguous and ambagious that it has led to broadly capricious practices from jurisdictions to administration and analyst to clinician, said Shanaaz Gokool, CEO of Dying with Dignity Canada.

“When you acquire accommodation acceptance that is so advisedly blurred … it’s created inconsistent, asperous and biased access, so that depending on area you are in the country, you will get a altered interpretation,” she said.

Aubrey, the B.C. Civilian Liberties Affiliation advocate who helped Craig with her appliance in that province, agreed that the analytic accountable article should go.

She said Alberta’s admission to the legislation has led to a alert and bourgeois arrangement that may additionally be anytime authoritative or scripted. Patients such as Craig with circuitous altitude are acceptable bigger served by B.C.’s decentralized action that seems to accord clinicians added discretion, Aubrey said.

Silvius, AHS’s medical administrator for seniors’ health, offered a altered take.

While it’s a nice abstraction to anticipate that every arena ability advance a agnate approach, civic differences from bank to bank will acceptable consistently advance to some variations in how medical aid in dying is applied, he said.

“If you attending at the aberration amid B.C. and Alberta, I anticipate you would admit Alberta is actual abundant added of a small-c bourgeois province,” Silvius said. 

“So I don’t see it as a arrangement issue. At the end of the day, I anticipate what we are seeing is added conservatism, perhaps, on the allotment of the assessors in this province.”

As such, the alone way to get anybody on the aforementioned folio would be for Ottawa to abstract the law to be acutely absolute in its criteria, and all but abolish the acumen of clinicians, he said.

Dr. Jim Silvius poses for a photo at his appointment in Calgary on Thursday June 8, 2017. Leah Hennel / Postmedia

Silvius acclaimed the assisted afterlife legislation is still beneath than 20 months old, but alike aural that time Alberta has aesthetic its approach.

He said a cloister accommodation appear aftermost June in Ontario — involving a woman accepted alone as AB — has afflicted the landscape.

The adjudicator in that case disqualified that a “reasonably foreseeable” afterlife doesn’t beggarly an appellant charge be dying aural a specific time anatomy from a specific baleful condition. Rather, the accumulation of their affairs charge be considered.

A book angel of Patricia Craig taken on Feb. 29, 2012, from her appointment at Alberta Bloom Services address in Edmonton.

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That cardinal has fabricated a aberration for clinicians in Alberta, abounding of whom ahead based their assessments on whether a accommodating had a distinct baleful diagnosis, Silvius said.

This may explain why Craig’s aftermost adjudicator accomplished a altered cessation than he did the aboriginal time he evaluated her case.

“I anticipate it’s fair to say (assisted death) has been greeted adequately carefully by the medical community,” Silvius said. “But as it evolves — and it will advance — we will see abundance advance with it that isn’t there at this stage.”

For Craig, abounding of her final thoughts centred on hopes that her case could advance to change and additional others the aforementioned frustration. But if such change is apathetic or fails to materialize, patients charge to apperceive to accumulate fighting, she said.

“I knew my way about the medical arrangement and I am not afraid by these people, but what about the association who are abashed by the white coat?” she said. “My admonition is to adjust yourself with as abundant abutment as you can get. Ask questions and don’t acquire the aboriginal ‘no’ you get.”

[email protected]

twitter.com/keithgerein

• 274: Deaths performed in Alberta, as of Dec. 31, 2017.

• 105: Deaths performed in the Edmonton region, as of Dec. 31, 2017.

• 95: Deaths performed in the Calgary region, as of Dec. 31, 2017.

• 29: Deaths performed in the South zone, as of Dec. 31, 2017.

• 22: Deaths performed in the Axial zone, as of Dec. 31, 2017.

• 15: Deaths performed in the North zone, as of Dec. 31, 2017.

• 65: Percentage of deaths performed in a bloom facility.

• 35: Percentage of deaths performed in the community, including a patient’s home.

• 71: Average age of patients who accustomed a medically assisted afterlife in the Edmonton region.

• 98: Applicants who acquire been denied a medically assisted afterlife for declining to accommodated criteria.

• 37: Patients who had to be transferred from the affliction of a faith-based agency, such as Covenant Health, to acquire a medically assisted death.

• 5: Patients transferred from addition non-participating (non-faith-based) ability to acquire a medically assisted death.

• 93: Percentage of deaths performed by a physician, amid January and June, 2017.

•7: Percentage of deaths performed by a assistant practitioner, amid January and June, 2017.

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• 50.1: Percentage of patients accepting a medically assisted afterlife who were women, amid January and June, 2017.

Source: Alberta Bloom Services, Statistics Canada

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