October 24th, 2020

Assisted dying hurdles unfair, doctor says

By GILLIAN SLADE on October 10, 2020.

A local physician says the city's only hospice care will not allow a patient to access medical assisted death on site, an that the issue is creating unnecessary for patients who are already facing end-of-life care.--NEWS FILE PHOTO


A local physician is raising concerns about Medicine Hat’s only hospice refusing to allow medical assistance in dying to take place in the facility.

Dr. Lena Derie-Gillespie, local family physician with additional skills in anesthesia who is an assessor and a provider for MAID, says the hospice’s requirement that a patient be moved out to access MAID somewhere else can cause considerable stress for the patient.

Medicine Hat Regional Hospital no longer has a palliative care ward and Carmel Hospice, in St. Joseph’s Home, is operated by Covenant Health.

“As a Catholic health care organization, Covenant Health is committed to uphold the inherent dignity of every human being throughout the entire continuum of life from conception to natural death. Therefore, Covenant Health will not provide nor explicitly refer for MAID given the incompatibility of MAID with the organization’s mission and ethical tradition,” reads an official policy.

Derie-Gillespie says that creates unnecessary barriers.

“When the only local hospice is in a faith-based organization it is a huge obstacle for patients,” she said, arguing that denying MAID on site means Covenant Health is essentially not providing end-of-life care.

Karen Diaper, communications manager for Covenant Health, says that in 2019 there were 186 patients in Carmel Hospice and four received a MAID assessment on site before being transferred out to access it. There have been 125 patients to date in 2020, with two assessing on site and then transferring out to access the service.

Derie-Gillespie says the number of patients opting for MAID is irrelevant.

“I do not see how Covenant can argue they are practising patient-centred care … when in actual practice they are forcing patients in their final days or hours to endure what can be a painful or stressful journey, not to mention the uncertainty of organizing an appropriate alternate location for provision.”

Covenant is funded by the provincial government – just like Alberta Health Services – but Diaper says it is not funded to provide assisted dying.

“MAID, by its nature, is a very complex and specialized service that cannot be performed everywhere,” said Diaper. “As faith-based providers in Alberta, Covenant Health operates under agreements that acknowledge our right to operate according to our own ethics and beliefs.”

Derie-Gillespie says it is “not an issue of personal conscientious objection; this is an issue of a facility directly inhibiting and putting roadblocks in the path of patient care.”

She says the MAID provision team, comprised of a physician or a nurse practitioner, a registered nurse and a paramedic for IV support, is co-ordinated by the AHS MAID service. They attend any appropriate location for patient provision including long-term-care facilities or even the home of a patient.

“We bring our own meds, our own IVs and supplies and own paperwork. We even have our own IV pole,” said Derie-Gillespie, noting a provider bills Alberta Health as they would for any patient service.

The direct assistance of hospice staff is not required and they are not asked to participate. Derie-Gillespie says a patient that qualifies for MAID should not have to negotiate hurdles over the faith of a publicly funded organization.

Carmel Hospice was officially opened in Medicine Hat in 2012 after a local group had lobbied and worked tirelessly for years to see hospice care here. At the time a palliative care option was available at the hospital, but the ward was closed in 2017.

Derie-Gillespie says it’s inappropriate for the city’s only end-of-life care facility to be operated by Catholic views when not all patients have the same beliefs. She says they should be able to have confidence in the hospice providing what is medically best for the patient rather than having to comply with a specific faith.

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13 days ago

I believe in MAID and feel that Covenant Health should lose any funding provided by AHS until such time that they  allow medical assistance in dying to take place in the facility. We finally have laws in Canada that allow MAID and to have a patient denied their rights because Covenant Health is against it because of their religious stand is simply deplorable.

13 days ago

We finally have laws in Canada that allow MAID and to have a patient denied their rights
It’s one thing to allow MAID, it’s another thing to require that you perform it at your site. And no one’s right’s are being denied, arrangements are still made for the process at another facility. I guess my rights are denied if I have to travel to Calgary to have an angiogram performed?
St Joe’s has been doing a fantastic job, but they aren’t about to do a 180 on something so integral to their beliefs. If you want to pull their funding then go for it, that just leaves the other 98% of patients with no end of life care. It’s unlikely you could set up another hospice without enormous additional costs.
So just wait until I’m gone before you shoot yourself in the foot.

10 days ago
Reply to  GrannySmith

The most important issue here is a patient’s right to a dignified and comfortable death. Having to move a terminally ill patient to accommodate that end is neither dignified nor comfortable. Shame on Covenant Health. Given there are no other options available for those in hospice and that this service is legal, access on site should be absolute. Damn your religious beliefs!

8 days ago
Reply to  fd4thought

Not sure how moving a patient in any way denies them a dignified death. But like I said, if it so offensive then pull their funding then and open up a secular hospice. Problem solved.
Don’t try to force them to do something that goes directly against their beliefs. You’re the one’s who changed the rules on them, not the other way around. Less than five years ago euthanasia was illegal and could get you in jail.
I’m not Catholic but I do respect people who believe in something and stand by those beliefs. Damn your moral relativism.

7 days ago
Reply to  GrannySmith

No one is asking a Catholic patient to choose MAID. The patients who ask for this are entitled to it within the facility . It is obviously administered by a non Catholic physician to a non Catholic patient so…. how is it in any way violating their beliefs? Pretty arrogant I think and yes as keeping with my moral relativism perspective, I find asking for unique exceptions based on religious dogma unacceptable . As to moving a frightened and fragile terminal patient to another facility to accommodate a dying wish, I think it beyond cruel.

Last edited 7 days ago by fd4thought
5 days ago
Reply to  fd4thought

“…how is it in any way violating their beliefs?”
I’m not sure if you’re being intentionally obtuse here or sincerely don’t understand the issue with allowing practices that go against your fundamental beliefs to take place in your building. Like it or not, St Joe’s is not a secular institution, and never was. AHS was fully aware of this when they agreed to fund hospice care there. If this is no longer acceptable, then like I said, pull the funding and build your own instead of ranting about ‘religious dogma’.
Also, I think you know that to meet legislation, MAID is never a last minute request – it is a fairly involved process that requires significant planning, and this would usually give any successful applicant plenty of time to be comfortably moved to another facility from St Joe’s.
I truly wonder what the agenda is here.