I can say, from four years of experience, that it is much more difficult in rural areas, because there are limited alternatives for patients. In simple terms of travel for sick people, using two ferries just to come to Vancouver Island would be a challenge. They might have just one physician on the small remote island, or a physician who might fly in and fly out every two weeks.
It has caused difficulty in the past to get witnesses. That's why we are eternally grateful for the amendments proposed in Bill C-7. It has been difficult for patients with disabilities and with end of life, even from cancer, to get adequate supports, although the work that has been done for that has always been exemplary and commendable. We always feel that as MAID providers we have added another layer of that into it and actually enhanced the reach of palliative care and disability support, and not just done MAID work.
In terms of concerns, it is harder for patients to get alternatives if they feel that they are being blocked or are not receiving information or access, and that has led to significant delays and stress to families. We've also seen that people who did not know about the alternatives often actually had suicide plans in place, and the moment they learned of all the supports....
We actually have a MAID consultation and those things are brought forward. We play devil's advocate to really make sure those things have been adequately addressed and provided, and the suicide plans disappear. Those people may actually end up having natural deaths and not MAID, because they were kept comfortable and had good care and it enhanced their quality of life. However, those who did have MAID had good access, because we made it work.