Assisted suicide policies under fire

Two Canadian palliative care hospice centres thousands of kilometres apart are standing firm against pressure to start providing medically-induced deaths at their facilities.

That stance will see the Delta Hospice Society in Delta, B.C., have its government funding pulled by 2021, while the Nipissing Serenity Hospice serving a large area surrounding North Bay, Ont., is facing public pressure to reverse its refusal to offer assisted dying on its premises.

Delta Hospice Society president Angelina Ireland is “shocked and outraged” the B.C. government will pull all funding from the 10-bed facility that provides palliative care for seriously ill patients and support groups for families in South Delta. Earlier this year, the Fraser Health Authority and Health Minister Adrian Dix said the hospice would face unspecified consequences if it did not start allowing legal assisted suicides on site by Feb. 3.

Ireland responded that the hospice would rather give up $750,000 of its government funding (and put the hospice below the 50-per-cent funding threshold set by government) than deliberately end the lives of its patients, and offered to do so. The offer was met with silence, until Feb. 25, when Dix announced the government was terminating the contract with Delta Hospice.

“Putting the patient first is what matters most,” said Dix. “No organization can influence this decision or impose it. I respect anyone’s right to disagree and no one has ever required hospice staff to deliver medical assistance in dying, but they must allow eligible residents who want the service to access it.”

He said he made the decision “reluctantly” and after making “every effort to support the board to come into compliance.”

Ireland doesn’t see it that way. In a Feb. 26 statement she said the government cancelled the contract with Delta Hospice “abruptly” and “without even acknowledging or responding” to the hospice’s attempts to negotiate.

“The actions of the ministry reveal that the issue of MAiD (medical assistance in dying) vs. palliative care is an agenda-driven policy rather than one that ensures access to skilled and compassionate palliative care.”

Delta Hospice has been serving the public since 1991. When assisted suicide became legal in 2016, it was made available at the Delta Hospital across the street, which shows accessibility is not the issue, says Ireland.

“If the government wants to open MAiD facilities, that’s their option, but they must not be allowed to download it onto the backs of private palliative care facilities.”

In North Bay, the board of directors of the 10-bed Nipissing Serenity Hospice is mindful that medical deaths are new to Canada. It also recognizes the legal right to access an assisted death. But the board carefully considered expert information on the matter before it opened in January and chose to apply the standards set by the Canadian Hospice Palliative Care Association and the Canadian Society of Palliative Care Physicians in not offering assisted dying, said Vivian Papaiz.

“We need to focus on giving good palliative care, not just about ending life,” said Papaiz, vice-chair of the board and also chair of Hospice Palliative Care Ontario.

In a joint statement, the palliative care association and the physicians’ society said, “Hospice palliative care does not seek to hasten death or intentionally end life,” while recognizing death as a normal part of life and that palliative care is to help people live and die well.

Papaiz said it has been transparent on the matter and respectful to both sides of the argument, yet a vocal minority, including a group of local doctors and a private citizen who launched an online petition which garnered more than 6,000 signatures (many from outside the area, even beyond Canada, said Papaiz), has spread misinformation that the board’s decision was influenced by donors or religious considerations.

She said that’s not the case at all and that the board in October 2016 passed a resolution saying it would not accept donations with any strings attached. She said Nipissing Serenity Hospice has lost donations from both sides of the debate for sticking to its guns on donations.

Though religious considerations will not be taken into account, that hasn’t kept the Diocese of Sault Ste. Marie, in which North Bay is located, from expressing its support for the hospice’s stance. In a statement to The Catholic Register, Sault Ste. Marie Bishop Marcel Damphousse said a “significant part of the fundraising campaign to build Nipissing Serenity Hospice was based on the understanding” it wouldn’t offer assisted dying, so “in all integrity, the board was under the obligation to respect the intent with which donations were made.”

To date, there has been no government pressure like the Delta hospice has faced — Nipissing Serenity Hospice and others in Ontario rely on the government for 50-60 per cent of its operating costs, mostly to pay for medical teams — and Papaiz commends the Ontario government for its palliative care support. But she’s concerned that a vocal minority could hamper access to palliative care.

“My concern is that in our community, maybe these doctors who now realize they can’t have MAiD in a hospice are not allowing people who genuinely need palliative care to come,” she said.

For those seeking an assisted death, Nipissing Serenity Hospice will help the patient access it, but won’t perform it on its premises, said Papaiz.