By GILLIAN SLADE on October 10, 2020.
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.