Peter Godor became the first nurse practitioner in Alberta to provide medical assistance in dying.
“The experience has been beyond positive,” says Peter. “I get a great deal of satisfaction from developing connections with patients and their families, and helping patients end their lives in a dignified manner.”
Peter’s work at the Royal Alexandra Hospital intensive care unit as a nurse practitioner has prepared him well for involvement in medical assistance in dying.
“In the ICU, we provide end-of-life care frequently,” says Peter. “We often deal with life and death. We’re familiar with discussing goals of care and end of life topics. Many of our patients are in a state where we’ve moved from aggressive care to focusing on palliation (relieving pain and other symptoms rather than focusing on curative measures).”
The ICU isn’t where Peter provides medical assistance in dying, as patients are seldom candidates, but his work there has inspired him.
Peter says in critical care, he frequently sees patients suffer because of circumstances that are beyond their control, and beyond the control of their family. Medical assistance in dying can give that control back to patients to some degree. It means they get to choose to prevent further suffering and ensure they pass with their loved ones nearby, in a state of calm, while they’re still able to make decisions for themselves.
For families, having a loved one choose medical assistance in dying can mean less turmoil related to decision-making and less stress related to the patient’s pain and suffering. It can mean sharing the moment of passing in a peaceful manner.
“To me, dying with dignity means having autonomy over your own body and health care as opposed to settling for what’s available,” says Peter about the service, which wasn’t available in Canada until recently. “Dignity is having your choice when it matters the most.”
Since January, Peter has supported a dozen clients through their medical assistance in dying decisions.
“Each has been special to some degree,” says Peter. “I was part of the process that ended the intractable suffering of a patient, and I helped a family go through this.”
Patients are as young as 20, though most are over 50.
“Providing medical assistance in dying is not for everyone,” says Peter. “You take on a significant responsibility. At the end of the day, you are ending someone’s life. Not everyone is comfortable with that.”
Peter says many people are unfamiliar with the process and are often concerned about ensuring only appropriate patients are candidates.
“But after clarifying the process, I usually don’t have to defend my role,” Peter says. “People appreciate the diligence of the process; people understand the restrictive criteria for patients to be candidates.”
He took steps to ensure he was well-prepared: “I went through didactic training, did a lot of reading, met with a CARNA practice consultant and reviewed the specifics of the job to ensure my training and experiences were adequate for embarking on this task,” recalls Peter. “I consulted with Alberta Health Services’ medical legal team and the Canadian Nurses Protective Society to ensure I’m legally protected. I did shadow shifts and accompanied physicians so they could mentor me into the role…”
Now that he’s a provider, here’s how the process works:
When legislation was passed authorizing nurse practitioners to provide medical assistance in dying, Peter wanted to ensure his profession was represented.
“I wanted to be part of the process. NPs are an important part of the health-care delivery system and we should be engaged in all aspects of health care,” says Peter.
He encourages others to participate in the discussions. Peter says, “We need people who are interested and invested in health care to think about medical assistance in dying, talk about it and make their opinions known to health-care decision-makers, because this is an evolving, new service for the public.”