Nick Procaylo / PNG
The operators of the Delta Hospice Society say they’re victims of “bullying” tactics by Fraser Health and medical assistance in dying (MAiD) activists who want the service provided in all non-denominational, hospice palliative care programs.
“Hospice palliative care is not about hastening death and we object to the bullying currently taking place in B.C.,” said Janice Strukoff, an administrative leader for the charitable, non-profit society that has a contract with the health region to provide 10 palliative care beds for the region. It derives just under half its income from the health authority; the other half comes from private donations.
“Hospice palliative care settings are designed for symptom management, the provision of comfort, and care for a natural death which is neither hastened nor prolonged,” she said, adding that providing MAiD in such settings would stoke fear and anxiety on the part of already vulnerable patients who aren’t necessarily ready to die.
Nancy Macey, founder and executive director of the Delta Hospice Society said MAiD can be a traumatizing experience for staff, patients, and volunteers, and all groups might not want to stay or work there if the principals of palliative care are compromised. Hospices are already grappling with a shortage of health professionals so compelling the society to provide MAiD could exacerbate the problem, she said.
Faith-based health facilities have been controversially exempted from obligatory MAiD provision but there is a more ambiguous situation with non-denominational settings. Health authorities get their funding from the provincial government and the former Liberal government had taken a pragmatic approach to MAiD in non-denominational hospices. According to former health minister Terry Lake: “The policy was if the hospice received more than half of the funding from the health authority, they should provide the service if requested. If they were mostly charity funded, they did not have to, but still had to inform patients when they entered the facility about the policy.”
It is not known how many non-denominational palliative care hospices may be affected but it appears the mindset on MAiD, at least in the Fraser region, changed late last year when, a week before Christmas, board chair Jim Sinclair sent a letter to Strukoff saying the region was proceeding with its final phase of the MAiD implementation process, including palliative care settings.
Sinclair said patients should not have to transfer out of any facility where they’re receiving end of life care if they request MAiD. Later that same day — Dec. 19 — the medical director of the Fraser Health Palliative Care Program, Dr. Neil Hilliard, resigned over the imposition of MAiD, as he took issue with the Fraser Health board decision.
Providing euthanasia or physician-assisted suicide is not in accordance with palliative care (which) “affirms life and regards dying as a normal process …” Hilliard wrote in his resignation letter obtained by Postmedia News. Another letter written to federal health minister Petitpas Taylor last week by Macey pleads for federal intervention that would protect palliative care hospices from being compelled to provide MAiD. She said her Delta hospice wants to remain a euthanasia-free, end of life sanctuary.
“Reasonable access is a requirement under the Canada Health Act and the pressure to provide MAiD everywhere is a bullying tactic of the Dying With Dignity activists,” Macey charges.
“Providers of hospice palliative care are extremely concerned about the negative impact of MAiD and hospice care being provided in the same facility,” she said, adding she fears people will not use such hospices if they think their deaths will be hastened.
Michael Marchbank, CEO of Fraser Health, said in an interview Monday he knows about the objections. But the Fraser region is far from being the only health authority in Canada which wants to see MAiD available in hospice palliative care settings. Without naming regions, he said two B.C. health authorities have already implemented widespread service expectations, including in palliative care hospices, and two others are in the same stage as Fraser — in the process of making sure health region and contract facilities comply.
Vancouver Coastal Health says it “expects” non-denominational facilities will provide on-site MAiD services on demand, whether they are operated by the health authority or are a contract provider. Faith-based health care organizations can “conscientiously object and not participate in the direct provision of medically assisted deaths,” said spokeswoman Carrie Stefanson.
While Strukoff and others from the Delta Hospice have tried, unsuccessfully, to persuade the health region to exempt non-faith based palliative hospices, they feel their protests have fallen on deaf ears. But Marchbank insists the consultation and dialogue process is ongoing. “I have no idea what the endpoint will be but the focus has to be on doing what’s best for patients,” he said.
Macey said she’s puzzled by Marchbank’s comments because the only message she’s heard is an inflexible one: “We have no choice, Fraser Health doesn’t want us to be transferring patients to other facilities.”
Macey will be pleading the case at a public Fraser Health board meeting on Wednesday in Surrey.
Health Issues Reporter