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When MAiD Matters More Than ChoiceWhen MAiD Matters More Than Choice

When MAiD Matters More Than Choice

A small palliative care facility in Vancouver has been told it must drop its refusal to provide MAiD for qualifying patients in its care, despite being a private organization.

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When MAiD Matters More Than Choice January 27, 2020  |  By Peter Stockland
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Over the past three decades, a small palliative care hospice in suburban Vancouver has raised millions of dollars and provided about hundreds of thousands of volunteer hours to benefit British Columbia’s health system.

Now, the Delta Hospice Society must drop its refusal to provide Medical Aid in Dying (MAiD) for qualifying patients in its care. Or else.

In a bid to stave off whatever “or else” might mean, the Hospice Society board contacted its overseer, the Fraser Health Authority, offering to give back $750,000 in public money it receives. Returning the funds would place it beneath a particular threshold so it can operate without being obliged to medically kill the sick and dying. 

Unfortunately, notes board president Angelina Ireland, we live in a time when MAiD means more than money.

“When I spoke to the CEO of Fraser Health and one of the VPs there, they told me ‘no, we don’t care.’ They just wanted to get me off the phone. They weren’t even interested in talking to us,” Ireland told Convivium. “They’re coming in with a hammer, and it’s boom – or else.”

Unable to have a conversation, the board retained Ottawa lawyer Albertos Polizogopoulos to represent them. He sent the Health Authority a formal letter offering to remit the amount in exchange for the private hospice being able to abide by its own constitution and past practice in declining MAiD requests. 

The Fraser Health Authority has been quoted in media reports as saying that it fully supports the “right” to receive medical aid in dying wherever that might be, including in hospices. It has also said publicly that it has “received an unusually high volume of reports indicating that the Hospice’s current position on MAiD is adversely affecting the well-being of staff and physicians working at the Hospice.”

But the response so far from the Health Authority to Delta hospice’s offer of giving money back? Crickets.

“We’re still waiting to hear their response to our proposal,” said Ireland. “This is supposed to be a two-way street. The Delta Hospice Society is a private organization. We do not belong to the government. This is not a government institution. We have subsidized the government by raising $30 million for health care, not to mention providing 750,000 volunteer labour hours to the system. But they are telling us they’re in control and it’s ‘do what we say or we will crush you.’”

She admits the 10-bed hospice might be mere weeks from being crushed unless it agrees to comply and permit MAiD on its premises. While the Society owns the building and has a 35-year lease on the land, the Fraser Health Authority decides which patients are admitted for palliative hospice care. 

“We don’t have the control to bring (patients) in on our own. They could move (the patients) we have. They could stop sending them. We’re here, prepared to give the services and care we’ve provided for the last 10 years in this facility. But if Fraser Health decides they don’t want to give us any more patients, that would pretty much be the end of us.”

For Ireland, and others she knows, there’s a particularly personal pain in that prospect. As a cancer patient, she used the services of the hospice and was so taken by its care and approach that she joined the board as a volunteer.

“I’ve been cancer free for five years. When I got better, I said I want to give back to this organization because they were so helpful to me and my friends who went there too. Some of my friends didn’t make it. Some of them passed away in the hospice. So, it holds a special place in my heart. There is a personal struggle here now.”

Her hope now is that attention to the struggle will prompt in serious political pressure from across Canada on the B.C. government. She wants Canadians to demand that a small hospice be permitted to keep its doors open so patients who don’t want MAiD, and don’t want to be in an environment where it’s offered, can get end of life care according to their choice. 

Ireland makes clear that the board’s resistance is not about the assisted dying issue in general. In fact, the hospice is located less than a five-minute walk from a hospital where MAiD is made available to all who qualify. Nor is the Delta Hospice’s refusal to euthanize or allow assisted suicide based on religious objections. 

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If it were a faith-based palliative centre, it could legally continue refusing MAiD. The resulting paradox is that because the Delta Hospice is not faith-based, it doesn’t appear able to rely on Charter protections for freedom of religion, which might provide strong grounds for a legal challenge to the Fraser Health Authority’s order.  

At the moment, it seems the strongest legal case might be for breach of contract.

“Our contract was started in 2010. There was no mention of euthanasia at that point. It was not part of the landscape. It was not part of the deal. We don’t want it to be, and we’re not accepting that it now is,” she says. “We reject it as far as the kind of services we provide, and part of the philosophy of hospice palliative care. We do not hasten death.”

But even a legal fight over contract terms would be protracted…and expensive. Such energy and financial outlay would, she insists, be far better spent on care for those facing the last days of their lives. Ireland warns that all Canadians should sit up and pay attention to the implications of that not just for health care, but also for democratic freedoms.

“We’re at a place where there is no room for dissent, for what looks like defiance of authority. We’ve been called fanatics and horrible people because we believe that if you want the kind of end of life care we provide, you should be allowed to go where it’s offered. There are many people in this country that want hospice palliative care. They don’t want to be euthanized or be in a facility where people are being killed next to them. They want a sanctuary. Freedom means they should be allowed to have it.”

But the health-care overseer obviously means business – or else. If it’s allowed to prevail, a small sanctuary in suburban Vancouver, and much, much more, could be facing the end of life as we know it. 

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