Image credit: Scales family Sally Scales, who ended her life under the new Medical Assistance in Dying (MAiD) law, holds a photo of herself as a nurse in earlier years.

A personal look at assisted dying

Well-known Salmon Arm resident uses new legislation to end life

“Hello. This is Sally Scales. S-c-a-l-e-s. I’m in Salmon Arm and I am preparing to die tomorrow,” said the message on the voice mail.

The message was left overnight Monday, July 3 at the Salmon Arm Observer office.

Sally was one of the more than 400 British Columbians to use the Medical Assistance in Dying (MAiD) service since it became legal in Canada in June of 2016.

In her voice message, Sally said she was being blocked from using MAiD by her landlord because some tenants at Arbor Lodge seniors’ residence did not want it to happen there.

Her son Peter Scales telephoned the newspaper July 4 to explain his mother had been moved to Bastion Place care facility where the assisted dying would go ahead.

She died at 11:30 that morning, as scheduled.

Peter says his mother had been in favour of medical assistance in dying since 1993 when Canadian Sue Rodriguez, who was suffering from ALS – amyotrophic lateral sclerosis, or Lou Gehrig’s disease, took her legal battle for assisted suicide to the Supreme Court of Canada. Although she lost her case in a 5-4 decision, she took her own life in 1994 with the help of an anonymous physician.

Peter says his mom remembered when Rodriguez asked, ‘Whose body is this?’ “She said it’s my own body and I hope the law can change in time for me.”

He recalls that later Sally read an article by an oncologist who said he hoped to die at 75. As former owner of the Lakeshore News, Sally then wrote a column stating she’d like to die at 85. Peter says people around town, including some from her church, told her quietly of similar wishes.

“She knew she wasn’t alone in wanting to die at her own time and of her own choosing.”

Sally underwent open heart surgery 11 years ago, receiving a new valve and a quadruple bypass. At that time, “she said again and again that she was never going through that again.”

Peter said Sally watched both her brothers die and her mother die of heart attacks.

“She knew how the story was going to end.”

The new valve Sally got worked well for about 10 years, but then it wore out “through no fault of the medical profession.”

Although she was offered another valve, she refused.

“She was done. She was 79. She didn’t make it to her 85th.”

Her heart was operating at a maximum 20 per cent efficiency, so she was short of breath, ‘puffing’ and anxious a lot, Peter says.

“It would scare her as maybe this was the time she was going to die.”

As is required under the MAiD process, Sally filled out the application. She was assessed by a Salmon Arm doctor on June 23, says Peter. Then on June 28, a Revelstoke doctor assessed her in her room at Arbor Lodge. Later they agreed on a date of 11 a.m. July 4 to carry out MAiD in her room.

Peter says Sally was anxious about the paperwork.

“There was less than she probably imagined, but it’s certainly paperwork that needs to be done correctly. I think the whole MAiD community, the MAiD providers, are being appropriately extra careful. They don’t want to be seen as killing people, but rather ending suffering.”

Did Sally ever have second thoughts?

“No, that wasn’t her style. She didn’t have second thoughts about anything,” he smiles.

Peter says her family was supportive of her decision.

The only glitch was being informed on July 3 that she wouldn’t be permitted to die at Arbor Lodge, he says.

“She was so happy she could die in her home – which was Arbor – surrounded by her things.”

Peter sees the lodge’s decision as hurtful.

“It seemed like when we wanted to deal with just our mom and our grief, we had this needless logistical detail that seemed really cruel.”

A note to Sally from operations manager Christina Lutz stated, in part: “Respectfully, I do have to take into consideration the general feeling this sets about the house and the opinions of the other residents who live under this roof. Therefore, we will not allow this event to happen here and respectfully request that you find an alternate site.”

Peter says his family scrambled on a long weekend to change locations and Bastion Place was very helpful in accommodating them.

Lutz reiterated in a telephone interview that some residents didn’t like the plan.

“Sally was saying what was happening and the other people who lived here were not comfortable with it.”

Lutz said the lodge was happy to have Sally as a resident for nearly a year.

“She brought spice and laughter and good feelings to our home and we wish the family well.”

Sally’s three children – Peter, Richard and Linda, and three of her five grandchildren were present during her final hours.

He says a nurse and physician attended, the nurse inserting an intravenous (IV) line.

“She arrived and made sure that Sally was comfy and well-positioned on the bed. She stayed with Sally until the doctor was ready,” Peter says.

Peter and his niece then watched the doctor prepare the syringes, labelling them to have them in the right order.

When it was time to administer the drugs, Peter and his niece left the doctor and Sally alone in the room.

“My mom was an old nurse; she said only professionals…, the rest of you be somewhere else.”

He said Sally’s family was allowed to go in after 12 minutes.

Peter describes MAiD as compassionate and efficient.

“I am so glad it was available. I think we were all glad… We had watched mom suffer for far too long.”

He said Sally thanked all the staff, but also asked them their life stories.

“She was true to form, right to the last minute.”

Peter is a historian by occupation and one of his greatest personal interests is religion and beliefs.

“I think it’s a measure of a compassionate society,” he says of assisted dying. “It’s a tough moral quandary for each person and for society. Is it more compassionate to extend life or to end suffering? In Sally’s case she saw it as ending suffering, not ending life.”

Peter says he’s grateful his family could prepare for Sally’s death and spend time with her, knowing what was coming. On the practical side, he says it allows families to put papers in order, to learn important details such as where the will is located.

Interior Health provides statistics for B.C.

From the start of MAiD in June 2016 to May 31 this year, the BC Coroner’s Service has recorded 66 MAiD deaths in Interior Health and 435 in B.C. IH states it cannot provide numbers of individual communities because of small numbers and privacy concerns.

IH also states there is no designated location where MAiD can occur. To date in IH, it’s been provided in individual homes, in hospitals, in residential care facilities and in hospice locations.

“There may be times, given this is still a relatively new service in IH and in B.C., where there are challenges in accommodating MAiD in a specific location…,” wrote an IH spokesperson in an email. “In those cases, we would work with patients and families to find the best possible alternate location.”

Trailblazing was not new to Sally Scales. Peter recounts a favourite memory of his mom’s nursing career.

When she came to Salmon Arm from St. Paul’s Hospital in Vancouver, he says, she discovered that all the nurses were wearing skirts and starched caps, rather than the more practical pants the St. Paul’s nurses were wearing.

Peter says the administrator shouted at her. He referred to the nurses as “his girls” and said he liked them in the uniforms.

“That gave my mom her first crusade in Salmon Arm,” Peter says. “She hated being called a girl, especially by a hospital administrator. I think she might have taken it from a doctor.”

In speaking publicly about medically assisted dying, Peter hopes his mother’s story will help reduce the stigma about death and MAiD.

“They’re separate but interwoven. A lot of people have trouble talking, not necessarily about MAiD, but about death. It’s part of life and it’s inevitable.”

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