Hundreds of Canadians have chosen to die with medical assistance this summer after a new federal law made it legal for adults with terminal illness to end their lives with the assistance of a doctor or nurse practitioner.
And yet right-to-die activists are concerned the federal government isn't adequately tracking the numbers of patients that have chosen a medically-supervised death. The assisted dying law, passed in June, requires the federal government to keep track of the numbers of Canadians who undergo doctor-assisted deaths but it hasn't yet done so.
According to numbers compiled by the CBC, at least 100 Canadians, almost entirely in Ontario and British Columbia, ended their lives with the help of a doctor since a federal law came into effect. Ontario started offering drugs to assist medically-assisted suicide at no cost.
However, the tally is likely much higher as several regions did not provide any current data, and many patients aren't officially tracked. That number, for example, does not include Quebec, which implemented its own law on doctor-assisted death last December before the national law was introduced. A right-to-die group in the province reported in July that 253 patients have requested the procedure since December, and 166 people had died because of it.
While legalizing assisted death has been celebrated by civil liberties advocates, many religious leaders and groups representing people with disabilities have decried the entire practice as an affront to human dignity.
In February 2015, the Supreme Court of Canada struck down the part of the criminal code that banned doctor-assisted suicide, and granted the federal government one year to implement a new law that would allow consenting adults suffering from a "grievous and irremediable" medical ailment to have a doctor help end their life.
There were several months in between the court's ruling and the deadline in which Canadians could request doctor-assisted deaths through the courts. Dozens of Canadians across the country received special permission during that time period.
Shanaaz Gokool, the CEO of Dying with Dignity Canada, told VICE News that the federal government should start counting assisted deaths in the country "sooner rather than later," and also extend the data they collect to include people who are currently in palliative care, and those who have taken it upon themselves to end their own lives because they have been denied medical assistance to do so.
She pointed to a number of examples of people in Quebec ceasing to eat or drink when they didn't qualify to hasten their deaths.
"As more people who thought they were going to qualify under the law find out they don't, they will look at other options," said Gokool. "And these are all important pieces of information that the federal government should track."
The ruling Liberals implemented their law amid fierce criticism from right-to-die advocates who argue that the law violates the charter—and the court's original ruling—for only allowing medical assisted death for Canadians with terminal illnesses whose death is imminent. They say the law should also extend to people who are suffering physically and mentally, even if it's not terminal and they aren't expected to die in the near future.
And for that reason, the British Columbia Civil Liberties Association, which led the previous assisted-death battle at the Supreme Court, is suing the federal government all over again, saying the new law should be repealed and broadened.
Leading the case is a 25-year-old BC woman who has spinal muscular atrophy and uses a wheelchair.
"I am terrified that I could be trapped in a state of physical and mental suffering that could last for months, years or even decades. Having to think about this future causes me immense physical distress," Julia Lamb told reporters at a press conference earlier this summer.
The association's litigation director added that the new law "will have the perverse effect of forcing seriously ill Canadians to resort to violent methods or the 'back alley.'"
The federal justice minister has defended her government's law as being in line with the constitution and one that respects the rights of Canadians by being "principled, cautious and deliberate."
A spokesperson for the Canadian Medical Association told the CBC that its members were content with the law and that "things seem to be proceeding relatively well with respect to availability of physicians and interpretation of federal legislation."
Follow Rachel Browne on Twitter: @rp_browne