alberta – Lemon Fresh Media

Assisted Dying in Alberta’s Bible Belt

6–9 minutes

Since the decriminalization of Medical Assistance in Dying (MAID) in 2016, there have been 2,281 medically assisted deaths in Alberta, with roughly 30 per cent of the procedures occurring in the province’s rural areas. Exactly none of them have occurred in Covenant Health facilities, Alberta’s Catholic health care provider.

Covenant Health is funded though Alberta Health Services (AHS). They received $760 million in funding in 2021, which accounted for 86 per cent of its total revenue.

However, Covenant Health does not strictly report to the AHS, according to the Cooperation and Services agreement between AHS and Covenant health signed in 2010.

According to the agreement, Covenant Health is “entitled to decline to provide a service which conflicts with its Principles of Faith and Ethics,” and that it is an “independent operator . . . governed by its own boards of directors”. The chairman of the this board is former Alberta Premier Ed Stemach, and they in turn report to the six Catholic Bishops of Alberta.

Covenant health adheres to the values as outlined in the Health Ethics Guide, published by the Catholic Health Alliance of Canada in 2012, and as such refuses to be complicit in matters related to abortions, gender reassignment, in vitro fertilization, contraceptive care, and assisted dying.

Rather, patients who elect to take part in such procedures must instead be moved to another facility, in what is called a “forced transfer”.

“Forced transfers [occurs] when a person who has been assessed and approved for MAID, and if they happen to be in a religious institution that does not allow MAID to be provided in their institution,” said Carl Ulrich, chair of Dying With Dignity Canada’s Edmonton Chapter and former Unitarian-Universalist minister.

“We feel that this is really an unfair imposition to someone who’s on their very last day.”

“I don’t know if everyone’s aware but ambulances are really trucks,” said Ulrich, “They’re not limousines that ride smoothly, and for someone who’s very frail and in pain it can be quite brutal to transfer them.”

From 2016 to 2020, there were a total of 125 patient transfers for MAID in Alberta, with 109 patients being transferred from faith-based facilities as reported by AHS — although that information has since been removed from their website.

Forced transfers have been controversial in relation to MAID laws due to the fundamental nature and condition of those who apply, as a patient must be suffering unbearably from an irreversible illness, a disease, or a disability in order to be deemed eligible for an assisted death.

What this means is that the patients subjected to forced transfers are usually the ones most inconvenienced by it.

In 2022, Scott Harrison of Vancouver shared his story with BC news site The Orca about the forced transfer of his partner, Christina Bates, the morning of her scheduled death. She had been staying at St- Paul’s Hospital, which is operated by Providence Health Care — a Roman Catholic faith-based care provider.

He shared his discontent with the process, writing that “the final hour of Christina’s life was unfairly stressful, and completely avoidable.”

Harrison also expressed his irritation over a public hospital having the ability to “pick and choose” which medical services they would provide.

In 2018, Ian Pope experienced similar inconveniences at the very same hospital, being transferred out of the facility twice in order to be assessed for MAiD. The first transfer resulted in a ruptured catheter bag in-transit, and it wasn’t until his third trip from St-Paul’s hospital that he was administered an assisted death.

Many Albertans will be faced with similar situations.

When questioned about what it would take for Covenant Health to review its policy on providing MAID, communication manager Karen Diaper provided the following statement on behalf of the organization:

“Covenant Health conducts a regular review process of its policies (generally every 3 years) unless changes such as legislation occur that would suggest an earlier review or consideration for revisions is needed.”

264 of all of Alberta’s MAID deaths since 2016 occurred in the province’s area just east of Edmonton — home to five Covenant Health Hospitals.

This corridor encompasses the towns of Bonnyville, Mundare, Vegreville, Camrose, Killam, Sedgewick, Caster — as well as parts of Edmonton.

The Alberta Bible Belt: These are the towns in the area served by Covenant Health hospitals, as well as the distances to the closest AHS hospital.

For many of the people living in these communities, it’s not just about the 30-minute drive out of town that they have spent their whole lives getting accustomed to.

It’s about leaving home.

Lara White is a senior’s outreach nurse with Community Mental Health, in Camrose. She grew up in Camrose, and was born in the original St -Mary’s hospital before it was demolished and rebuilt in 1989.

“I don’t think that it’s right that the facility has a blanket policy of refusing procedures to people,” said White.

“Our tax dollars are funding it, and we can’t access all the services that we should be able to.”

White spoke of the difficulties involved with a forced transfer, considering the closest non-Covenant Health Hospital is in Daysland – 30km outside of the city.

“If they’re in the palliative care home in St. Mary’s Hospital, and they make the decision that they want to die with dignity, they now have to be transferred to another facility,” said White, “And they might be in a really bad physical state, they might have a lot of pain. The move is a big deal — not only for them, but for their families. “

“If they’re already in palliative care, it’s asinine to me that they now have to be moved to another facility.”

White also mentioned the issue of transportation given the current state of ambulatory care in the province. As a nurse and the mother to a paramedic, she has had a first-hand view of Alberta’s current health care crisis.

“We know how difficult it is to get an ambulance even to an emergency nowadays.”

Finally, White spoke of her bond with the city of Camrose.

“If I had a condition that was really going to negatively affect the quality of my life, I can see myself choosing MAID,” said White, “And I’d like to be able to have the choice of dying in the hospital that I was born in.”

“It would be very sad for me that [I would have] to choose to go elsewhere.”

Brenden Leier, a clinical ethicist for the University of Alberta and Stollery Children’s Hospitals, as well as the Mazankowski Alberta Heart Institute, says the issue is overstated in the political sphere.

“Systematically, the pressure from the public often is often pressure to say, in principle, you shouldn’t have the right to refuse these types of things if these institutions are publicly funded,” said Leier, “That’s more of a political issue that frontline people don’t have the opportunity to work out.”

“My preference is always to empower people at the frontlines to solve their own problems,” said Leier, speaking on healthcare in rural communities.

“They’re the best at it,” said Leier, “And because they have a vested interest, it’s not theoretical or political.”

Drawing from his personal observations, Leier believes that difficult circumstances always work out the best when local staff are “challenged or charged and respected enough to solve their own problems” and that those might simply be “ad hoc solutions on a one-by-one basis”.

“Politically, that might not look good, but practically it’s probably ideal,” said Leier.

A bigger concern, according to Leier, is the access to MAiD in long-term care facilities, in particular the nature of the people occupying them.

“People don’t consider them hospitals, they consider them to be their home where they move in to receive assistance,” said Leier.

“Can your landlord tell you, if you live in an apartment building that you can’t have MAID in your apartment?”

A 2019 Alberta Health Services Performance Report commissioned by the UCP government and prepared by Ernst and Young recommended to “end the current Covenant Health Cooperation and Services Agreement and develop a new agreement that enables more effective system coordination by AHS”.

The report also stated that “AHS should be able to set clear expectations for outcomes to Covenant and have the ability to hold Covenant accountable to achieving those outcomes”.

Centre for Suicide Prevention providing materials, training to Alberta pharmacies

2–3 minutes

The Centre for Suicide Prevention (CSP), a Calgary based organization with a focus in education, is now providing materials and START training to pharmacies in Alberta that request it.

According to the centre, pharmacists and their staff have the potential to play a crucial role in recognizing customers as suicidal, as well as how to approach them and how to assist them.

Akash Asif, the director of external relations for the CSP, spoke about how one of these interactions could look like.

“[It could be] someone is standing in front of the aisle and looking at a bottle of Tylenol, or other drugs there, and they don’t look like themselves — they look a little bit different or there’s some nervousness,” said Asif.

“[We want to] prepare people and equip them with the understanding of skills to be able to go and see and talk to them, let them know that [they’re] there for them.”

One of the CSP’s tools in achieving this goal is START training, an online training course provided by LivingWorks.

The course can be completed in less than two hours and focuses on recognizing when someone is thinking about suicide and connecting them to help and support.

“The first thing is understanding that anyone can be going through suicidal thoughts, or that anyone can consider suicide,” said Asif.

“It’s [about] recognizing the warning signs and mutations; knowing and paying attention to the people around you and understanding that there’s something different about them.”

Asif said these signs can present themselves in a variety of different manners, such as sporadic swings in mood or behaviour.

“START is really around paying attention, having [the] conversation, and then connecting that individual to the proper resources.”

Tasha Porttin, pharmacist and store manager of the Jasper Mettra Pharmacy, is one of the first participants of the CSP initiative.

Porttin says she first heard of the START training through the CSP and that most of her staff have completed the training.

“It’s great for people that aren’t necessarily healthcare workers . . . to have kind of a bit of basis around suicide prevention and knowledge on how to start that conversation with individuals”, said Porttin, “and just how to ask questions that maybe we’re not used to asking or maybe not comfortable with asking.”

Porttin also requested suicide prevention materials from the CSP, which now adorn her pharmacy.

The materials provided include assorted signage, pop-out shelf talkers, and take-away cards.

“Some people have expressed that that’s really refreshing to see,” said Porttin, “[and the staff are] really kind of grateful that it is up in the store [because] it just gives people the opportunity to know that this is a safe place.”

“I even had somebody, to be honest they were quite teary eyed, when they were thanking me for putting it up,” said Porttin.

“You could tell that that was a very touching thing for them to see.”

To those experiencing suicidal thoughts, the CSP recommends contacting Calgary’s Distress Centre. The centre has a 24-hour crisis phone line, and also provides counselling to those in need.

Never stuck in a Ruta

2–3 minutes

Golden, BC native Matt Ruta is a ski mountaineer, a skimo racer for Team Canada, a project manager for a woodworking business, and a blogger — and he has been playing in the mountains for most of his life. He says it started with his parents.

“I was very fortunate to grow up with outdoor-sy parents and I grew up hiking and scrambling and backpacking and that kind of thing, [and] they did take us out for a little bit of ski touring,” says Ruta, 26.

“When I was 16 or so, I took an avalanche course on my own.”

As eager a teenaged Ruta was to get out into the backcountry, he was also competing internationally in the sk cross circuit.

“I wasn’t the most talented or the fastest, but I got to travel to some really amazing places and kind of got the elite athlete experience even though I myself wasn’t necessarily elite,” said Ruta.

From 2011 to 2014, Ruta competed in 31 different International Ski Federation (FIS) events, his best result being a fourth-place finish in 2014.

After finishing up his ski cross racing career, Ruta found himself free to explore the mountains proper.

“I would have been probably 17 or so when I first skied something that felt big to me. I think it was either the Kindergarten couloir on Boom Mountain or the Phantom couloir on Mt. Ogden.

“When you’re 17 years old, and you’re exploring the world outside of a racecourse it feels like you’re going to the moon.”

Couloirs are steep, narrow crevasses penetrating mountain faces; both the Kindergarten and the Phantom qualify as complex backcountry terrain. His aspirations would only grow from there.

A graduate of the Thompson Rivers University journalism program, Ruta chose to also chronicle his ski trips on an online blog.

His website boasts trip reports detailing his adventures on impressive peaks with impressive names; the Silverhorn, the Skyladder, the Sickle, the Grand Daddy couloir, the South Twin.

“[My most] memorable line was the Southeast Twins’ tower, which I skied in 2016,” said Ruta.

“That’s the first ski objective I did that really felt like it was more than just pushing myself, it was like something that was pushing what had been skied in the Rockies.”

On the writing side, Ruta says he takes inspirations from people like alpinist Barry Blanchard, a Calgarian who pushed the climbing boundaries in the Canadian Rockies. Blanchard also wrote a well-received biography.

“The Calling [A Life Rocked by Mountains] is such a good book,” said Ruta.

“I love it, it’s just permanently sitting on my coffee table.”

To those looking to emulate him, Ruta suggests taking advantage of resources that weren’t readily available ten years prior; things like weather observations, avalanche forecasts, and trip reports shared online.

He also suggests hiring a guide.

“For a couple hundred bucks you can do a guided day with someone like Kevin Hjertaas, who’s one of the best steep skiers in rockies history and he’s now a guide,” said Ruta.

“He’ll teach you stuff. It’s amazing.”

Avalanche professionals seek to raise awareness among Alberta snowmobilers

2–3 minutes

As more Albertans continue to venture into the province’s avalanche terrain each year, organizations like Avalanche Canada are faced with the increasing task of keeping recreationalists safe – whether they travel on foot, skis, or motor vehicle.

While there were no Alberta snowmobile fatalities in avalanche terrain in 2021, snowmobilers and snow bikers did account for six of the twelve fatalities nationwide; and since 2012, 42 of Canada’s 104 avalanche fatalities have occurred on snowmobiles. Snowmobilers are generally at more risk due to their ability to travel long distances over varying avalanche terrain, as well as the fact that snowmobiles deliver approximately five times more energy to a snowpack than a skier.

“We meet with [snowmobilers] to find out what’s going on in the snowmobile industry,” said Alex Cooper, a communications associate for Avalanche Canada, “[and to find out] where we can apply our efforts to make sure that we’re reaching out and getting snowmobilers trained.”

Avalanche Canada utilizes several programs to target snowmobilers specifically, and according to their 2021 annual report, “make significant efforts to make and maintain connections throughout Western Canada, with a specific emphasis on reaching riders in Alberta and Saskatchewan.”

Avalanche Canada launched a dedicated snowmobile outreach program in 2011 and introduced a snowmobile mentorship program in 2020. They also collaborate with groups such as the Alberta Snowmobile Association (ASA) to provide information and training guidelines.

Courses are provided by Avalanche Canada and similar organizations throughout the winter season, with the most popular program being the Avalanche Skills Training (AST1) course. Out of the 15,029 students enrolled in courses in 2020-2021, only eight per cent were snowmobilers.

Shane Lavery, 31, has recently taken up the sport of backcountry snowmobiling after nearly ten years of ski touring.

“The safety protocols in general when it comes to snowmobilers, at least in my limited experience so far … it seems to be a lot more lax,” says Lavery.

On the differences between ski touring and snowmobiling, Lavery says it comes down to increased exposure and magnitude.

“[The] sheer amount of exposure versus a ski tourer or a snowshoer [means] you can get to ten times the amount of terrain in a fraction of the time,” said Lavery, “I think the propensity to actually cause larger events is definitely there when it comes to sledding in comparison to skiing or split-boarding.”

While avalanche awareness amongst snowmobilers remains a concern, awareness amongst all general practitioners has risen steadily throughout the years. One tool to measure this growth is the increase in Mountain Information Network (MIN) postings. MINs are a way to share avalanche observations and trip reports to both recreationists and professionals.

Since its inception in 2014, more than 13,000 reports have been uploaded to the database. Out of the 5,561 submitted MINs during the 2020-21 season, 476 were in Alberta — a 205 per cent increase from the previous year. For comparison, B.C. users logged 3,445 reports in the same time span, which was a 125 per cent increase from the previous year.

Is CWD putting Alberta’s game farms at risk?

3–4 minutes

As Chronic Wasting Disease (CWD) spreads through Alberta, one conservationist organization has announced the time is nigh for the province’s game farms.

CWD is a prion disease similar to bovine spongiform encephalopathy (BSE, or mad cow disease), except that it affects cervids rather than cattle. Like BSE and all other prion diseases, CWD has a 100 per cent fatality rate.

While the disease is being researched extensively, its potential impact is uncertain. What is certain, according to a map published in May by the United States Geological Survey (USGS), is that CWD is present in Alberta’s game farms.

In response to this USGS map, the Alberta Wilderness Association (AWA) penned an open letter to the provincial government requesting game farms be shuttered immediately, citing the fact that they help facilitate the spread of diseases like CWD into native wildlife populations.

Carolyn Campbell, a conservation specialist for the AWA, says the organization has been besieging the province to outlaw game farms since the practice was introduced in the 1980’s.

“CWD [is] in captive facilities in Alberta, as well as in Saskatchewan [and] that really tells us a lot that this is a continued problem” says Campbell, “the chain of new infections and of supporting new infections, needs to be broken by eliminating game farms.”

According to Campbell, wild animals are curious when it comes to game farms and will often come for a closer look.

“Body fluids that are on the ground can be eaten or even spread in the soil,” said Campbell, “and so the wildlife is vulnerable to that transmission.”

While a major worry is susceptible wildlife, there is also concern of human infection through the consumption of infected meat.

Dr. Sabine Gilch, of the University of Calgary’s Prion Disease Research department, has been conducting experiments on CWD using tissue matter attained from infected macaque monkeys.

By injecting this material cerebrally into rats, Dr. Gilch and company discovered that there was a chance of infectivity in the animals that could trigger a clinical prion disease. Based on the results of this study, which Dr. Gilch described as “a little bit controversial”, she believes human transmission possible.

Dr. Gilch says CWD can be a problem on game farms due to the difficulty of its identification as well at its lasting properties- it has a long incubation period and can survive in soil for many years. However, she does not believe outlawing game farms to be the solution.

“I don’t think it would help now if we close all deer farms”, says Dr. Gilch, “CWD is here, it’s in the wild animals, and at the moment there is no means to stop the spread.”

Dr. Keith Lehman, Alberta’s Chief Veterinarian, felt similarly.

“I don’t see that closing game farms is going to do anything to help stop or slow the spread of disease within the province,” said Dr. Lehman. He did add that, at this time, all policy options were being kept open- including the potential to close game farms.

Both Dr. Gilch and Dr. Lehman described the CWD situation as complex, making clear that more research is necessary- and research needs funding.

The Alberta Prion Research Institute (APRI) announced in early June that it is making up to $1 million in funding available over the next two years to those researching CWD. Ron Clarkson, Director of APRI, spoke of the potential hardships that are associated with CWD.

“Once it’s in a farm, and once it’s in the soil, [game farmers] pretty much have no option other than to shut the farm down,” said Clarkson, “It’ll have a significant economic impact to hunting, as well as to Aboriginal communities that rely on animals for food. [CWD] is going to have a significant impact on their lifestyle.”

Alberta caribou face uncertain future

3–5 minutes

Minister of Environment and Parks Jason Nixon issued a statement this week concerning ongoing caribou conservation efforts in Alberta. The statement was a direct response to an Environment and Climate Change Canada (ECCC) report, with Nixon saying he was “pleased to see the federal government’s acknowledgement of Alberta’s strong caribou recovery plan and actions to date.”

Alberta entered an agreement with the Canadian government in October of 2020, when the Agreement for the Conservation and Recovery of the Woodland Caribou in Alberta (ACRWCA) was signed with ambitions to support the conservation and recovery of both southern mountain caribou and boreal caribou in the province.

Conservation Specialist Carolyn Campbell of the Alberta Wilderness Association (AWA) was part of the movement petitioning the Albertan government for more stringent restrictions. “[The] Alberta government passed an Alberta woodland caribou policy [and] the Cabinet approved it in 2011. [The policy] said maintaining caribou habitat, would be the immediate priority. And so [I] will say AWA really tried to be very regular after oil and gas lease leases were auctioned off every few weeks, in calling them out on all the acreage that was being auctioned off in Caribou range. And then when they started on the range plan . . . we immediately praised them for it.”

“In 2012- 2013 [AWA] were trying to be very, very consistent and calling out the government that it was violating its own intention for caribou to recover and to survive and recover because it was continually leasing large tracts of caribou range. There was a lot, tragically, that was leased in the A La Pêche [region] between about 2010 and 2013 until they stopped. So that in itself was a missed opportunity where they didn’t follow their own stated intentions,” said Campbell.

One facet of the ACRWCA is the creation of 11 sub-regional range plans, which includes the A La Pêche and Little Smoky territories as one sub-region. The report has a timeline in place for 2023 to “finalize subregional plans that consider all land uses, including footprint, recreational and access management plans, for [A La Pêche]”.

Gillian Chow-Fraser of the Canadian Parks and Wilderness society (CPAWS) went into detail as to what conservationists’ groups expect as to what these range plans entail.

“[It is] guidance from the federal government on what they’re supposed to include and this coming from the recovery strategy for woodland caribou that basically said it’s up to the provinces and the territories to develop these range plans, and they forecast out [up] to 100 years forecast of what that area is going to look like every decade for 100 years.

Over that 100 years, the government has to show how they’re going to achieve the federal recovery objectives, which are 65%, undisturbed habitat in each caribou range, and then, that kind of how you get the naturally self-sustaining population numbers.”

When the agreement was originally signed, Minister Nixon expounded on the need for balance between conservation and industry, one of the listed ACRWCA short term targets is to “enable resumption of subsurface mineral sales in woodland caribou local population ranges”.

In September 2016 petroleum, natural gas, oil sands, coal and metallic industrial mineral rights were all restricted in critical caribou habitats awaiting new operating practices. However, forestry continued uninhibited. This has affected the winter range of the A La Pêche, being one of a few southern caribou herds to still follow migratory patterns.

“Now the summer range of the A La Pêche is in pretty good shape [but] the winter range is kind of like . . . if you’re concerned about say safety, [for] kids, it’s not just kind of where they live for, for like part of the day but if it’s very, very dangerous for them to get to school, that doesn’t really help. So, the caribou really need to be able to migrate between safe summer range, which [it] largely is for the A La Pêche — and safe winter range which is not at all safe for them. And that’s where the wolf cull comes in, regrettably,” said Carolyn Campbell.

A main concern for caribou conservation is predation, notably from wolves. Infrastructure such as forestry roads that come along with large scale operations creates a highway for wolves leading into caribou habitat. According to Carolyn, the area is “actually not remote at all, it’s been very heavily disturbed”, and the herd is currently being “propped up now unfortunately by the very dire measure of [really intensive] wolf kill”.

Wolf culls in Little Smoky-A La Pêche have been ongoing since 2005.

Alberta government considers small nuclear reactors

2–3 minutes

In his new book, How to Avoid a Climate Disaster, Bill Gates brings the issue of nuclear power into focus, specifically highlighting the benefits of new technology such as small modular reactors (SMRs). Alberta Premier Jason Kenney notably joined a memorandum of understanding this past summer, pledging to help advance the development and deployment of this very same technology.

Dr. Duane Bratt, a political science professor at Mount Royal University and author of Canada, The Provinces, and the Global Nuclear Revival, said SMRs could be quite vital in the future.

“. . .Oil sands companies are interested in the discussion around SMRs because of their size, because of their potential reality of displacing natural gas, which would drop emissions in the oil sands, as well as the possibility of cogeneration of heat. So, we’re still years away from the commercialization, but we are on the pathway, both in in Alberta and in the rest of the country”.

Dr. Bratt also expanded on the concept of energy security. The idea behind energy security is to be less reliant on imports, as well as to combat volatility in the production process. In Dr. Bratt’s example he points to the fact that uranium, the primary fuel component of a standard nuclear reactor, is not the biggest expense. That honour would go to construction and operation. In contrast, if the cost of natural gas was to rise then there would be a steep increase in cost of production.

“If you look at a place like Ukraine, which was reliant on imports of Russian natural gas, and Russia shut off the flow of natural gas, it really damaged the Ukrainian economy because they didn’t have energy security”.

Dr. Gordon Edwards, co-founder of the Canadian Coalition for Nuclear Responsibility (CCNR), brought up a much different example.

“When [the Fukushima Daiichi nuclear disaster] happened, all of the electricity generation in Japan was stopped because the grid went down, right? But the only supply that still worked were the windmills. The offshore windmills which were floating in the ocean with buoys and so on- they were still working. So, in fact, wind power was working when the nuclear plants couldn’t”, said Dr. Edwards.

This potential unreliability is one of many concerns raised by the CCNR. The most prominent ones include fear of weapon proliferation, prohibitive costs, as well as too long of a timeline to properly combat climate change- if they are helping to combat climate change at all.

“Saying these reactors are clean is sort of like saying that Trump won the election- you know it’s just absolutely false, because in fact every nuclear reactor- including the small ones, produce the most dangerous industrial waste that has ever been produced by any industry in human history”, said Dr. Edwards. He puts far more faith in renewable energy such as solar or wind.

“. . . Renewables have been growing faster than any other form of energy worldwide for the last 10 years 15 years, and they’re without the kind of subsidization and government support that nuclear has had.”

The memorandum of understanding signed by Alberta states a commitment to “positively influence the federal government to provide a clear unambiguous statement that nuclear energy is a clean tech and is required as part of the climate change solution”.