While more than 118 people have received a doctor-assisted death since the procedure became legal in Canada, that number likely represents only one tenth of those who made "serious requests" for medical help in dying.

That ratio is drawn from the experiences of Dr. Gary Rodin, who help to draft the procedures and protocols for how hospitals in Toronto's University Health Network agree to grant patients a medically assisted death.

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"To give you a rough guide, we could say that for 10 serious requests that would come forward, only actually about one of them would proceed towards this intervention," Rodin told CBC News.

Rodin explained that patients can be denied a medically assisted death for any number of reasons. A person's condition may not be advanced enough to determine if the patient's death is reasonably foreseeable, or a patient may apply for the procedure when they are only 24 to 48 hours away from dying.

In order for a medical institution to grant an assisted-dying request, a process has to unfold that includes a period of reflection, ruling out those in the final day or two of their lives, he said.

CBC News reported Friday that in Ontario, British Columbia, Alberta and Saskatchewan alone there were 118 medically assisted deaths since the procedure became law June 17.

The Yukon, New Brunswick, Nova Scotia and Quebec could not, or would not, provide data, while the remaining provinces and territories said there were no instances to report at present.

Fighting to die

Some, including NDP MP Murray Rankin, the party's justice critic, have argued that the law passed by Parliament is too restrictive and more people in Canada should have access to the procedure.

"The government thinks everything is fine now? It's not fine," Rankin said. "People are suffering, and it's the government that has caused this to occur by not allowing people... to avail themselves of this service. That's a disturbing fact."

In one high-profile case in Quebec, a woman with multiple sclerosis referred to as Hélène L. — who did not qualify to receive the procedure — starved herself to death just before her 70th birthday.

Quebec's College of Physicians says it believes there will be more cases like this and is working on a plan to help doctors with patients who are starving themselves to death after having been denied a medically assisted death.

Court challenge

Julia Lamb, 25, of Chilliwack B.C., who has spinal muscular atrophy, has joined a legal challenge against the law launched by the British Columbia Civil Liberties Association.

The lawsuit is challenging the provision in the assisted dying legislation that restricts a medically assisted death only to those who are suffering from a terminal illness and whose death is reasonably foreseeable.

"If my suffering becomes intolerable, I would like to be able to make a final choice about how much suffering to endure," Lamb said.

A spokesperson for Health Minister Jane Philpott said in a statement that the federal government understands the difficult choices families are being forced to make.

"In developing federal legislation, our government considered a wide range of opinions and circumstances, and needed to ensure it struck the appropriate balance in providing access to medical assistance in dying, while ensuring protection for our most vulnerable," the statement said. "Now enacted, and after passing with bi-partisan support, we firmly believe that Bill C-14 does strike this balance."