A heated debate about whether a 10-bed hospice in Delta should offer assisted suicide may come to a climax in February.
Delta Hospice Society, the non-profit behind the Irene Thomas Hospice in Ladner, south of Vancouver, is facing pressure from the Fraser Health Authority to offer Medical Aid in Dying (MAID) to its patients. Assisted suicide has been legal in Canada since 2016.
The non-profit says offering a lethal injection to its patients runs contrary to its constitution, while Fraser Health holds the position that patients have a right to it.
“Fraser Health fully supports a patient’s right to receive medical assistance in dying wherever they may be, including in a hospice setting,” health authority spokesperson Tasleem Juma told Canadian Catholic News. “We understand this is a difficult and emotional issue for some people, but it is important to consider the patient in everything we do.”
Last month, representatives from Fraser Health met with leadership from the Ladner hospice to discuss concerns about the hospice not offering assisted dying to patients under the Fraser Health’s 2016 Medical Assistance in Dying policy.
Juma said that after that meeting, Fraser Health “provided them with formal notice of the concerns and shared our expectations that they comply to permit medical assistance in dying by February 2020.”
What happens to the hospice if it refuses to allow on-site assisted suicide by deadline? Juma did not have information about next steps, but Health Minister Adrian Dix hinted at dramatic penalties at a media briefing last month.
“Should they not want to fulfil their contract with Fraser Health, there may well be consequences for that,” Dix said, as reported by the Delta Optimist newspaper. “Delta Hospice can decide it doesn’t want to continue receiving support from the Fraser Health Authority in its mission. They can choose to do that … But, of course, you can’t have it both ways.”
The Optimist reported the hospice receives about half of its funding from Fraser Health.
The small hospice in Ladner is not alone in its stance on assisted suicide. Both the Canadian Hospice Palliative Care Association and the Canadian Society of Palliative Care Physicians released a joint statement at the end of 2019 saying a hospice is not an appropriate place to end the lives of patients.
“MAID is not part of hospice palliative care; it is not an ‘extension’ of palliative care, nor is it one of the tools in the ‘palliative care basket,’” they wrote.
“Hospice palliative care focuses on improving the quality of life and symptom management … for those living with life-threatening conditions … Hospice palliative care does not seek to hasten death or intentionally end life. In MAID, however, the intention is to address suffering by ending life.”
They also called on federal and provincial governments to prioritize funding and access to hospice care, saying less than 30 per cent of Canadians can access high quality hospice care, though 90 per cent of deaths in Canada would benefit from it. In contrast, they said, MAID is considered a right for all Canadians, though only 1.5 per cent of all deaths in the country result from it.
The Delta Hospice Society also has support from the Euthanasia Prevention Coalition, whose petition in support of the hospice had more than 14,500 signatures by press time, as well as the Catholic Physicians’ Guild, which represents about 50 local health care workers.
“To compromise patients who are dying in a natural way knowing that, next door, staff are providing death, it just gives the wrong message,” said Dr. Jim Lane, president of the Catholic Physicians’ Guild in Vancouver.
He said his organization does not support euthanasia or assisted suicide, but now that the practice is legal, supports conscience rights for doctors and keeping MAID out of hospice settings.
“Palliative care organizations are the ones that have always provided ‘medical aid in dying,’ but it’s always been truly medical aid, not death,” Lane said. “If patients go there thinking that’s what’s going to happen to them, it changes the whole tone.”
Michele Coleman, past president of the Langley Hospice Foundation Board, also supports Delta hospice’s refusal to provide assisted suicide.
“Hospice care supports life until its natural end. It is compassionate care for all the person’s physical, emotional, and spiritual needs, as well as grief support for their families. The two philosophies of MAID and hospice care are completely opposite.”
Delta Hospice Society board president Angelina Ireland was not available to comment.
Former executive director Nancy Macey, who founded the Delta Hospice Society at her kitchen table more than 25 years ago, is personally opposed to assisted suicide.