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This article was published 27/6/2017 (1192 days ago), so information in it may no longer be current.
Should a health-care institution that accepts millions of dollars in public funding be allowed to obstruct Canadians’ right to a gentle death?
The Catholic Health Corporation of Manitoba (CHCM) would have you believe the answer is yes. After all, this is the organization that restacked the board at St. Boniface Hospital to quash a policy that would have allowed medical assistance in dying (MAID) on-site in "rare circumstances only." So confident was CHCM CEO Daniel Lussier in his employer’s stance that, when asked by a Free Press reporter to confirm the allegations, he gave the following statement: "We control St. Boniface Hospital, for starters, which means we also control the appointments of the board."
Lussier’s cool response is gobsmacking in light of the chain of events that led St. Boniface Hospital’s board to try to soften the hospital’s policies on assisted dying. Documents obtained by Dying With Dignity Canada and shared with the Free Press reveal how the ban on assisted dying subjected patients to gruelling transfers, traumatized families and upset hospital staff who were charged with enforcing the hospital’s rules. Not only do these records highlight the harms of St. Boniface Hospital’s ban on assisted dying, but they also raise questions about the appropriateness of allowing the religious views of a public health-care institution to trump the interests, rights and choices of the community members it serves.
A March 1 memo sent to all St. Boniface Hospital medical staff outlined the problems associated with forcing patients who request MAID to be transferred off-site in order to undergo eligibility assessments or receive life-ending treatment.
"There have been instances when lack of information, unclear processes and inevitable delays in communication with the (Winnipeg Regional Health Authority’s) MAID team and the receiving facility have resulted in a rushed transfer, increased patient suffering during transfer, distress for patients, and moral distress for staff and physicians at SBH and at the receiving facility," wrote Dr. Marcus Blouw, the hospital’s outgoing president of medical staff. "Many caregivers relate the sense of having abandoned the patient."
Blouw’s letter also suggests that the hospital’s policies have ultimately led patients to be denied the choice of MAID, which is a constitutional right according to the Supreme Court of Canada. On one occasion, a patient’s condition deteriorated while being driven to another facility for a MAID assessment.
"The staff at the receiving facility," Blouw wrote, "were not prepared or equipped to manage the patient’s symptoms." The person died hours later, in a state of distress, before getting the chance to exercise their right to final relief.
This is an abysmal standard of care, especially for an institution that prides itself on having established Canada’s first hospital-based palliative care program. Dying Canadians should never have to choose between receiving high-quality palliative care and having their right to MAID available to them. Thus, the CHMC’s insistence on requiring some of Manitoba’s most vulnerable, physically compromised patients to go one way or the other communicates the following message: that the CHMC has allowed its rigid adherence to its Catholic traditions to undermine its stated commitment to "loving care."
For its part, the CHMC contends that St. Boniface Hospital has a right to freedom of religion and, as a result, shouldn’t be required to provide treatments that don’t align with its values. That belief appears to be sincere, but it doesn’t square with reality. As University of Ottawa law professor Daphne Gilbert explained in a 2016 opinion column for the Globe and Mail, the constitutional right to freedom of religion extends to a public institution only if "it was primarily constituted for religious purposes."
The primary purpose of St. Boniface Hospital — whose expenditures for provincially insured services topped $350 million in the 2015-16 fiscal year — is to provide health care to Manitobans, rendering the CHMC’s claim dubious at best.
Perhaps ironically, the CHMC’s decision to ban MAID at its facilities may actually violate the rights of doctors and nurse practitioners who feel compelled to include MAID as part of their practice.
Indeed, according to an internal memo sent on April 15, Blouw had been in contact with at least 30 medical staff who "expressed the view that MAID... must be available to all Canadians, in any institution that receives public funding, regardless of that institution’s historical or religious affiliations." Could preventing these staff from participating in MAID in fact infringe upon their right to conscience?
We at Dying With Dignity Canada are grateful to the anonymous sources who brought the St. Boniface Hospital fiasco to our attention, and we thank Dr. Blouw for defending his memos in the press. By speaking out, these courageous individuals have shone a light on the injustice of allowing hospitals’ dogma to come before patients’ rights.
We hope their actions will inspire other health-care providers to do the same.
Shanaaz Gokool is the CEO of Dying With Dignity Canada.
Updated on Tuesday, June 27, 2017 at 6:56 AM CDT: Adds photo
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