Manitoba court grants woman with ALS physician-assisted death

A Manitoba woman whose ALS has rendered her almost completely unable to move has been granted a physician-assisted death.

Court of Queen's Bench Justice Shawn Greenberg granted the woman, identified only as Patient No. 2, a constitutional exception on Friday allowing her to access a physician-assisted death.

A court-imposed publication ban means the patient and her family cannot be named, and her age and location cannot be published.

"My life feels completely unnatural. The care I am receiving in the hospital is excellent, but all it is doing is suppressing my symptoms and keeping me comfortable," the woman stated in her court affidavit.

"Without the pain management currently available to me, the total anguish I feel is soul-crushing. It is both enduring and intolerable to me."

The woman becomes the second patient in Manitoba to have successfully applied for a physician-assisted death.

The first application came from a patient who had less than one month to live due to two health conditions. That patient, who also wanted to remain anonymous, died in early April.

• Manitoban granted right to die with help from doctors
• 1st Manitoban granted physician-assisted death, dies

In issuing her decision, Greenberg said she is satisfied that Patient No. 2 has met the needed criteria.

"In my view, this is a long-thought-out decision made by the applicant by her own free will," Greenberg told court.

The judge noted that the patient is losing her ability to speak, she cannot swallow food that is not pureed, and she chokes on her own saliva.

The woman, once a strong independent woman, now relies on others for everything, Greenberg added.

Both the woman and her spouse released statements after the decision was released.

"Because of my ALS, I have no control over my life — I would like the peace and satisfaction of some control over my death. I feel like I am in a perpetual state of saying goodbye to the people I love and I have had enough," the patient's statement reads in part.

"I will miss my family and friends but I am completely at peace with the decision I have made to seek out a physician-assisted death — it is the best option for me."

Her spouse's statement reads, "This is the hardest experience we have ever been through. It has been difficult to watch as my spouse suffers. It will also be difficult for me to be without her. However, I understand her wishes for a physician-assisted death. I believe everyone should have a say as to how much pain and suffering is enough for them."

Survival rate of 3-5 years

Patient No. 2 was diagnosed with amyotrophic lateral sclerosis (ALS) in September 2013, according to her court affidavit.

Also known as Lou Gehrig's Disease, ALS is an incurable neurodegenerative disease that gradually degrades a person's muscle control.

According to doctors, Patient No. 2 has a survival rate of three to five years, court was told.

"I am already unable to move, save for some very limited movements in my arms," the woman stated in her court affidavit.

"I do not want to become completely incapacitated physically, without the ability to move, talk, chew or swallow. My health has declined to the point where it is no longer safe for me to have a G-Tube inserted, which would allow me to be fed through a tube inserted directly into my stomach."

'Terrified of choking to death'

The woman said she tried to keep walking as long as she could after she was diagnosed, using a cane and later a walker. Eventually, she was wheelchair-bound, she said.

"I did not want to suffer the severe, disabling effects of ALS," her affidavit states in part.

"I am terrified of choking to death. Because of the weakness I have in my swallowing muscles, choking is a real risk to me. I have had a number of choking incidents at home and the possibility of another is a nightmare to me."

Affording to her affidavit, the woman had contacted an agency in Switzerland that offers physician-assisted death, but she was worried she would not be in good enough shape to travel there.

In 2015, the Supreme Court of Canada ruled that people with grievous and irremediable medical conditions should be able to access a doctor-assisted death.

Now, the federal government is drafting legislation to deal with the ruling, which is due in June.

In the meantime, patients can apply for physician-assisted death exemptions to allow them to access it earlier.