Renewed discussion over assisted dying amid dispute at faith-based sites

VANCOUVER — Two incidents in British Columbia have renewed a debate about whether faith-based health institutions that receive public funding should be allowed to opt out of offering medical assistance in dying.

Documents obtained through a freedom-of-information request by the advocacy group Dying With Dignity Canada show that Providence Health Care, a Catholic health care provider, apologized to Vancouver General Hospital for a mismanaged transfer of a frail patient seeking assisted death.

“I want to convey my sincere apology for the issues that arose in the transfer,” wrote David Unger, then-director of ethics services at Providence in an email on May 18, 2017. “This was a foreseeable and preventable issue for which I accept full responsibility as the director of ethics.”

Emails written by Providence staff say the man was at risk of losing his capacity to consent to an assisted death if he was not transferred quickly from St. Paul’s Hospital. The man requested an assisted death on a Saturday, but necessary documentation was not filled out until Wednesday, an email says.

When he arrived at Vancouver General, there was no bed available, and when a bed was found, it was not appropriate, an email says. It took another hour before an appropriate bed was found, it adds.

An apparent miscommunication by St. Paul’s resulted in the delivery method for “a commonly used palliative care medication” not being ready when the patient reached Vancouver General, said Providence spokeswoman Elaine Yong, although she said she could not elaborate due to privacy concerns.

Christopher De Bono, vice-president of mission, ethics, spirituality & indigenous wellness at Providence, said 58 patients have asked to talk about assisted death and 17 have received transfers of care.

Since the incident last spring, the organization has established a new assisted-death policy that provides clear guidelines for arranging a transfer. It has also created a new position called the “medical assistance in dying response lead” who assists staff when a patient makes a request, said De Bono.

Shanaaz Gokool, CEO of Dying With Dignity Canada, said it’s unacceptable in 2018 for institutions to refuse to provide a “basic and essential” health care service.

“It creates a system of forced transfers for some of the most vulnerable people in our country and people who are often very physically compromised,” she said.

Gokool said while she supports the rights of individual doctors to make choices based on conscience, it’s not appropriate for entire institutions to claim they are doing so, when there may be doctors within these facilities who support medically assisted death.

The B.C. Health Ministry said that under an agreement with the Denominational Health Association, faith-based facilities are not required to provide services that are inconsistent with their religious mission. There are no plans to terminate this agreement, it said in a statement.

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