TORONTO -- About 200 Canadians have received help killing themselves since legislation authorizing medically assisted suicide came into force in June, new figures obtained by The Canadian Press show, but those numbers do not paint the whole picture.
To date, 87 people have taken advantage of the law in Ontario, while the total in British Columbia is 66, the provinces' coroner's offices reported Thursday. Alberta has tracked at least 23 deaths, Manitoba has had 12, while Saskatchewan has had fewer than five cases. Figures from elsewhere were not immediately available.
But if an outline is beginning to emerge of demand across Canada for help in dying, a dearth of even basic information still exists.
For example, there are little data on how many people have requested help but have been refused, the medical conditions prompting such requests, those who have made requests but changed their minds, and the number of people who have died before the request could be granted.
Even statistics on gender, age and where the deaths have occurred are elusive.
Shanaaz Gokool, CEO of Dying with Dignity Canada, said it's impossible to discern clearly what's happening across the country, or how the legislation is being applied.
"It's very difficult to assess what is going on," Gokool said. "No one's doing this in a very systematic way. The numbers don't tell us enough."
In Manitoba, more than 60 people have requested assisted death, a spokeswoman for the Winnipeg Regional Health Authority said. Most were turned down, although it was not clear why. The latest Alberta figures show 23 people have been refused for reasons including a mental-health diagnosis or death "not reasonably foreseeable."
Kerry Williamson, with Alberta Health Services, said the most cited health conditions were cancer, multiple sclerosis, and amyotrophic lateral sclerosis, with the average age being 67.
In June, the federal government brought in a law allowing assisted suicide for those suffering from an incurable condition and for those facing a "reasonably foreseeable" natural death, a definition critics have argued is open to too much interpretation.
Andrew MacKendrick, a spokesman for Health Minister Jane Philpott, said Thursday the legislation does call for a national monitoring system -- but it only has to be in place by next June.
"That gives the minister of health a period of time to set that system up so we can actively monitor it and understand it better," MacKendrick said.
One key issue, Gokool said, is how publicly funded faith-based hospitals opposed to assisted suicide are dealing with the issue. In some cases, she said, it appears the hospitals are delaying approval until the person has already died or transferring them elsewhere.
Alberta Health Services, which has so far been the most forthcoming with information, said two patients had been transferred from Covenant Health, the country's largest Catholic health-care provider, to another facility for medical assistance in dying.
The Catholic Bishops of Alberta and the Northwest Territories produced a set of guidelines late last month directing priests to refuse funerals for some people who choose assisted suicide. The bishops called physician-assisted death a grave sin, saying it contradicted the teachings of the Catholic Church.
In Ontario at least, the official cause of death is clearly noted on death certificates.
"We are classifying them as suicides with reference to the underlying disease process," said Cheryl Mahyr, a spokeswoman for Ontario's chief coroner.
To date, Mahyr said, no autopsies have been required and no difficulties have arisen with regard to the death investigations.
The Royal College of Physicians and Surgeons of Canada acknowledged the various views among doctors on helping patients die but said it was too early to comment on how the system was working. Quebec's physician body said it had no relevant data.
Last week, Alberta Health Services reported that demand for assisted death had been higher than expected, but the body that regulates Ontario's doctors said it was difficult to know how demand has aligned with expectations.
"This is a new service for patients," Kathryn Clarke said. "The picture will come into focus over time concerning uptake."
Ontario Health Minister Eric Hoskins said Thursday the system was "working well" but added that the province planned legislation to complement the federal law, with part of it related to reporting.
Health Canada said it was working with provinces and territories to identify what data would be collected and how before developing reporting regulations.
