Prince George, B.C. – A landmark Supreme Court of Canada decision last year could have some major implications for nurses in rural communities moving forward.

Catharine Schiller – photo courtesy UNBC

In February 2015, the high court unanimously ruled that competent adults experiencing unbearable suffering could legally seek out physician-assisted death.

The deadline for the federal Liberal government to craft such legislation is this June, and an assistant professor in UNBC’s School of Nursing is anxiously waiting to see what it will look like.

“The Carter decision that came down in 2015 did what most court decisions do which is that it decided the case in front of it,” says Catharine Schiller. “So there were a lot of different things in the decision the Supreme Court did not talk about.”

She says that includes no mention about rural access and rural issues in the context of physician-assisted suicide.

“They didn’t talk about the rest of the health care team and how they would be, or could potentially be, involved in physician-assisted suicide situations.”

For example in cases where a doctor was not available and where nurse practitioners lead the health care team in those communities – something she says is quite common.

“In a lot of northern communities it’s the nurse practitioner who leads the team or they have a registered nurse who leads the health team and there may be a physician who comes in once in a while, or who only offers services by a telemedicine kind of system.”

As a result, Schiller says the new law will need to be creative and allow for some flexibility in its implementation.

“For example one option that’s been bandied about is telemedicine and having that option for people in remote communities where a physician or whoever is allowed to approve a physician-assisted suicide and start that process.”

She says that could allow the doctor or health care provider to actually see the patient and “feel out the situation.”

“If we require a person to physically be in the same space as the health care provider that they’re seeking this from, then rural communities are really going to have some problems,” she says.

“Presumably the person who is seeking this out is quite unwell and to require them to travel then to some distant city, I’m not sure that’s fair,” says Schiller.

“But I’m also not so sure that it’s fair to require the health care provider to travel great distances to the individual. So we may need to be quite flexible in some of the solutions and offer some creative solutions.”