The medically assisted death of a British Columbia man with a history of depression has led to advocates calling for stronger safeguards for vulnerable patients -- and better clarity in the law.

Alan Nichols, who showed no signs of facing an imminent demise, was given a medically assisted death in July despite pleas from his loved ones, family members told CTV News on Tuesday.

Nichols’ family said he was taken to the hospital in mid-June and ended up receiving a medically assisted death in late July. They told CTV News they were only given four days’ notice and that they’d been blindsided.

“We want answers. Why did they allow Alan to die? Why did they give him permission?” Nichols’ sister-in-law, Trish, told CTV News.

They were told two doctors confirmed Nichols was competent to apply for an assisted death. But the family says he was mentally ill and unable to give informed consent.

Chilliwack General Hospital -- where Nichols died -- declined to comment.

“You've got to involve the family, you've got to obtain all the information on the patient,” Nichols’ brother Gary said.


'SIGNIFICANT RISK'

Nichols’ story doesn't surprise some advocates at Canadian Association for Community Living (CACL), which represents the intellectually disabled.

The group’s executive vice president, Krista Carr, has increasingly heard stories of staff at hospitals offering medically assisted deaths to at-risk people simply getting routine medical care.

Carr told CTV News people with autism or intellectual disabilities have been told “they may want to consider ending their lives, as opposed to living with a disability.”

She said some parents are even being told, “We can ensure your child doesn't wake up from this surgery.”

“I think it's absolutely terrifying. And it’s definitely terrifying for the individuals who have an intellectual disability and families that we support right across this country,” Carr said.

CACL is demanding clearer guidelines and rules for medically assisted deaths because they believe their ambiguity poses a risk to people with intellectual disabilities. She warned that a “tremendous amount of people at significant risk here.”

Her group is also lobbying the federal attorney general to appeal Quebec Superior Court's Sept. 11’s decision that will make it even easier for patients to get a medically assisted death.

“We are supposed to be supporting people to live. Our health-care system is supposed to be a wellness system. It’s supposed to be a system that helps people get better,” Carr said. “Now, it’s the opposite of this.”

She feels there’s been a “devaluing of disabilities,” adding that this has led to medically assisted deaths becoming a “tool that’s available for you to then end your life … at a time of weakness or at time of extreme vulnerability.”


BETTER DISCUSSION NEEDED

In an email to CTV News, mental health advocate Mark Henick said more pressure needs to be on medical staff.

“It is the responsibility of both the patient and their doctor to determine if the desire to die is more related to the primary condition, or to the thought distortions that are a trademark feature of most mental illnesses,” he said, adding this is particularly true when some chronic health conditions can “destroy the quality of our mental health.”

He said that “if the mental illness is [a primary factor], the desire to die might be coming about as the result of a thought distortion which blocks the person from seeing any hope.”

But Henick stressed that a “mental illness on its own does not rob someone of their decision making capacity and, when it does, doesn’t always affect decision making in all aspects of the person’s life.”

And because of this, he said there needs to be better, clearer discussions between doctors, patients and their families.


NICHOLS' STORY REACHES CAMPAIGN TRAIL

Nichols’ story has led federal party leaders on the campaign trail to weigh in.

When asked about the case, Liberal Leader Justin Trudeau said “we will, of course, continue to work to make sure we're getting that balance right in the coming years.”

Conservative Leader Andrew Scheer said he felt more oversight was needed.

“One of the main concerns I had with this piece of legislation was ensuring there are adequate safeguards to protect those who may not have the ability to give consent to death to request these types of services,” he told reporters in Jonquiere, Que.

Critics are also raising concern over why British Columbia -- where Nichols died -- has nearly double the rate of medically assisted deaths per 100,000 citizens than the rest of Canada.