The B.C. government’s workaround to allow medical assistance in dying (MAID) at St. Paul’s Hospital will not prevent the continuing forced transfers of end-of-life patients at other religious-run hospitals and hospices, says a Vancouver palliative-care doctor.
“I’m actually shocked,” said Jyothi Jayaraman, who quit her job at a Vancouver hospice, May’s Place, because it stopped providing MAID once it was taken over by Providence Health. “I thought, ‘Is this the outcome?’ There is no concession. No acknowledgment of patient suffering.”
Health Minister Adrian Dix announced Wednesday his ministry reached a deal with Providence Health to ensure patients at St. Paul’s Hospital have access to MAID in a clinical space next to the Vancouver hospital.
Once the adjacent clinical space — connected to St. Paul’s by a corridor and run by Vancouver Coastal Health — is built by August 2024, it will end the practice of St. Paul’s patients being forced to transfer to another health facility for end-of-life care. It’s a traumatic experience that patients’ loved ones have criticized in response to a policy by Providence Health, a Catholic health organization, that bans medically assisted death for gravely ill patients.
The changes come after Postmedia News first reported about the case of Samantha O’Neill, a 34-year-old woman with terminal cancer who was forced to transfer out of St. Paul’s Hospital to a hospice to receive the end-of-life care she requested.
O’Neill, who was in excruciating pain, was sedated to the point of unconsciousness during the transfer and didn’t regain consciousness before the life-ending medication was administered. That robbed her parents, Jim and Gaye O’Neill, of their final hours with their daughter.
Jayaraman said she didn’t know whether to laugh or cry when she read Dix’s statement calling the solution a “patient-centred approach.”
“It’s a mockery,” she said. “I feel Providence (Health) has doubled down (on their position).”
Jayaraman said the workaround at St. Paul’s Hospital doesn’t address the continuing forced transfers at hospitals and hospices run by Providence Health and other religious health groups that oppose MAID.
Providence Health received $859 million in public funding in 2022-23 to operate nine hospitals, long-term care facilities and hospices including St. Paul’s, Mount Saint Joseph Hospital, Holy Family Hospital, Youville Residence, St. John Hospice, May’s Place and three branches of care homes under St. Vincent’s.
Jayaraman said more than half of hospice beds in Metro Vancouver are run by religious health organizations that receive public funding.
Asked about how patients will receive MAID if they’re in a religious-run health facility other than St. Paul’s Hospital, Dix said “typically hospice care everywhere in B.C. allows medically assisted death.”
Jayaraman said that’s not been her experience, saying St. John Hospice, May’s Place, Salvation Army Rotary Hospice House and St. Michael’s Hospice don’t allow it.
The doctor, who has provided medical assistance in dying since it became legal in Canada in 2016, has witnessed 19 instances where patients were forced to transfer out of religious health-care facilities to receive MAID, 13 of which didn’t involve St. Paul’s Hospital. Eight of the 19 forced transfers have taken place since June when O’Neill’s family went public with her story.
“If you knew the kind of suffering I’m seeing, it’s absurd,” Jayaraman said,
Daphne Gilbert, a University of Ottawa law professor, said Dix’s announcement Wednesday doesn’t change the constitutional court challenge she and other advocates are working on against B.C.’s Master Agreement that allows Providence Health to opt out of providing MAID.
“I think it’s time to take a stand,” Gilbert said. “These are publicly funded institutions with religious traditions, yes, but those traditions can’t overcome the proper approach to health care.”
Gilbert said she was “really, really frustrated” when she heard of Dix’s fix for the problem at St. Paul’s Hospital.
“It’s the very weakest of options,” she said. “Having people go through a tunnel underground to get into the new building, however beautiful the new building might be, it’s still the stigma and the problems of having to be moved.”
Sam O’Neill’s father, Jim O’Neill, sent a letter to Dix on Thursday to express his disappointment with the outcome.
While he thanked Dix for and St. Paul’s Hospital for “finally admitting the present system is wrong”, he said Dix has “the opportunity to assert your leadership and authority to establish easier access to MAID in all faith-based health organizations’ facilities in B.C. and to set the precedent for all provincial health ministers across Canada.”
Heavy on his mind is the number of forced transfers that will take place between now and August 2024 when the new clinic is ready.
“It is outrageous, that despite publicly funded St. Paul’s knowing and acknowledging that the forced transfers to access medical assistance in dying cause unnecessary incremental bodily harm to medically fragile patients, St. Paul’s plans to continue the practice almost every other week for nine months while waiting for a new building.”
Providence Health patients soon to get access to MAID next to St. Paul’s Hospital
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