“We are being bullied to participate in medical assistance dying”

Alert from a growing number of Canadian physicians

News Release

Physicians’ Alliance Against Euthanasia

Montréal, March 9, 2020 – The Physicians’ Alliance against Euthanasia has received reports that unwilling physicians are being pressured and bullied to participate in Medical Assistance in Dying (MAiD): euphemism for euthanasia and assisted suicide.  Fearing reprisals, physicians have asked that no information that could identify them be disclosed.

The pressure has been intense for many physicians, especially amongst palliative specialists, some leaving even before this latest development. Descriptions were made of toxic practice environments and fear of discipline by medical regulators.

“The anxiety, fear, and sadness surrounding my work bled into my family life, and I ultimately felt that I could not manage practicing palliative care at this stage of my life.”  (Former palliative care physician, March 2020)

In different locations across Canada over the last months to weeks there has been a change in certain hospital MAiD policies. The change seems intended to provoke crisis or confrontation: to force objecting physicians to facilitate MAiD, or to have to refuse — and face contrived allegations of “obstructing access.” 

Reports consistently focus on the MAiD providers refusing to accept full responsibility for the death of the patient and forcing other physicians to share responsibility for the death. If the physician asks to withdraw from care and allow the MAiD provider to take over as before, the MAiD provider resists assuming the natural pattern of care.

The reports we are hearing from distressed physicians describe deliberate disruption of arrangements that were previously working satisfactorily and that had permitted patients to have access to MAiD while still allowing for conscience objectors to not be involved in facilitating the patient’s death. This bullying and betrayal of collegial relationships can poison practice environments and compromise patient care. Such behavior should not be tolerated by health care administrators in Canada.

Canadian physicians having similar stories of bullying are encouraged to contact the by email: info@collectifmedecins.org.

Contact: Charmine Francis,Coordinator
438-938-9410
info@collectifmedecins.org

Resources:

Canadian Medical Protective Association: Most Responsible Physician: A key link in the coordination of care.

Lauren Vogel. Culture of bullying in medicine starts at the top.
Canadian Medical Association Journal (December, 2018

Camille Bains. Systemic change needed to address suicide among physicians in Canada, doctors say. CBC News/Canadian Press (May, 2019)

Gabrielle Horne. Physician, heal thyself: the potential crisis of conscience in Canadian medicine. What if your faith in doctors having conscience was shaken? Globe and Mail (May, 2019)

BC Hospice challenges closure over government’s proeuthanasia policy

Government refuses compromise

Easier and cheaper to kill than to care

News Release

Delta Hospice Society

Vancouver — Delta Hospice officials were shocked and outraged this week by the Fraser Health Authority’s blatant move to cut off all discussions and close the facility because it wants the hospice to provide MAiD (Medical Assistance in Dying) at every facility. The Irene Thomas Hospice is dedicated to allowing patients access to expert symptom management for physical, emotional and spiritual distress. It provides comfort, meaning dignity and hope as one dies a natural death.

Angelina Ireland, President of the Delta Hospice, said the Fraser Health Authority and the British Columbia Minister of Health abruptly cancelled the Hospice’s contract on Tuesday without even acknowledging or responding to the hospice’s offer to a reduced level of government financing of the facility by $750,000 per year in order to meet the 50% funding level for exemption from providing MAiD.

“The actions of the Ministry reveal that the issue of MAiD vs. palliative care is an agenda-driven policy rather than one that ensures access to skilled and compassionate palliative care for eligible patients in distress, and their families,” she said. “And it’s all about dollars. It is easier and cheaper for the government to provide euthanasia rather than continue with palliative care. Basically, they are saying that no palliative care facility in BC has a right to exist unless it also provides euthanasia.”

Faced with the government’s decision and refusal to consider other options such as decreased provincial funding, Ms. Ireland said the hospice will look at all of its legal and other options to continue to exist and serve patients and families in their final days, as they have always done.

The decision is particularly baffling, she said, since access to MAiD for those who request it is available at many locations in the lower mainland, including Delta Hospital right next door to the hospice. That, in her mind, reinforces the view that this is not about patients or families, but rather about a social policy agenda.

BC Hospice challenges closure over government’s proeuthanasia  policy

“MAiD is a separate public health care stream, distinct and apart from palliative care. If the government wants to open MAiD facilities that’s their option, but they must not be allowed to download it onto the backs of private palliative care facilities.”

“Palliative care physicians and nurses believe in the philosophy of specialty palliative care and practice as defined by the World Health Organization (WHO), which maintains that palliative care provides relief from pain and other distressing symptoms and which affirms life and regards death as a normal process. At no point does WHO include euthanasia as an aspect of palliative care!”

Forced closure of the facility ignores the fact that this is a privately owned hospice built on land leased from the government, employs more than fifty people and has contributed significantly to BC’s public health care system.

“This is an invasion of the historic medical discipline of palliative care. The Canadian model is respected around the world. The government and the health authority are running roughshod over that principle and reputation.”

Ms. Ireland expressed hope that “even at this late date” Fraser Health Authority and the BC Ministry of Health will come to the table and discuss the issues, including the financial offer. “Our deepest concern is with those patients and families who have entrusted their final days to us. We want to make sure those days are filled with comfort and peace. That is still our goal.”

The Ministry and the Authority have both publicly stated they plan to take control of the premises currently occupied by the Hospice. The Delta Hospice Society built the Irene Thomas Hospice without taxpayer funds, at the cost of approximately $9,000,000. The Society has operated the Irene Thomas Hospice for 10 years, providing more than 700,000 hours of volunteer labour and $30 million to the public health care system. For the government to step in and seize this private property is “a scandalous appropriation of private assets,” said Ireland.

On Saturday April 4, a Rally for Delta Hospice will be held in front of the
Legislative Buildings at noon. Speakers include Dr. Margaret Cottle (palliative care physician) and Dr. Will Johnston (family physician and obstetrician) along with MP Tamara Jansen and Alex Schadenberg of the Euthanasia Prevention Coalition.

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For further information, contact:
Angelina Ireland. President Delta Hospice
irelandangelina@gmail.com

Delta Hospice would rather lose funding

Delta Optimist

Sandar Gyarmati

It looks like the leadership of the Delta Hospice Society has decided to forgo substantial funding from the Fraser Health Authority by refusing to provide Medical Assistance in Dying (MAiD).

An article this week in The BC Catholic featured an interview with DHS board president Angelina Ireland who was quoted as saying the society rather lose funding, saying MAiD is completely incompatible with palliative hospice care. . . [Full text]

Alberta’s doctors say they worry about the effects of a conscience rights bill

The Globe and Mail

Christina Frangou

Dr. Jillian Demontigny keeps a rainbow bracelet wrapped around the stethoscope that she drapes across her neck. It’s her signal to any LGBTQ patient who arrives at her clinic: you are welcome here.

Dr. Demontigny is one of 13 physicians working at the Taber Clinic, a family medicine clinic in a southern Alberta town of 8,500 people. Over her 14 years in Taber, she has expanded her practice to offer extra supports for patients looking for the kind of health care that can be hard to access in this rural, conservative region, where anti-abortion billboards are posted along the highway. . . [Full text]

Canadian hospice struggles against state demand to allow euthanasia

Hospice begs permission to refuse $750,000 in state funding

Euthanasia and assisted suicide available in state hospital next door

News Release

Delta Hospice Society

Vancouver area hospice is asking the government to reconsider their proposal to give up $750,000 a year in funding so that it not be required to violate its mandate of care and compassion for patients by providing Medical Assistance in Dying (MAiD) at its facility.

The health authority’s demand is unnecessary, the hospice contends, noting that the MAiD option is widely available at many other facilities, including one next door.

Canadian hospice struggles against state demand to allow euthanasia

By forfeiting the government funding, the hospice would be under the 50% threshold set by the government and therefore exempt from providing MAiD.

Angelina Ireland, President of the Delta Hospice Society, said that the Society’s Charter specifically mandates it to provide compassionate care and support for persons in the last stages of living, so that they may live as fully and comfortably as possible.

“Helping and supporting patients to live fully and comfortably in their last days and giving support to them and their families is what our patients and families come to us for and expect and it is certainly what our staff are dedicated to providing. Taking steps to end a patient’s life is not providing care and support so that ‘they may live fully.’”

Fraser Health Authority ordered the Delta Hospice Society late last year to provide Medical Assistance in Dying (MAiD) claiming that failure to do so would be a breach of the Society’s agreement with the authority.

Ireland said in order to comply with the Authority’s instruction it would have to violate its legal commitments under the province’s Societies’ Act which requires them to follow their Charter. Further, DHS is not in breach of the Agreement. There is nothing in the Agreement which requires DHS to provide MAiD or allow it to be provided on its premises. The FHA is attempting to amend the Agreement by making a unilateral decision to impose an obligation, which in itself would be a contravention of the Agreement. The Fraser Health Authority’s new directive puts the Hospice Society in a difficult position of either honouring their Charter and legal obligations or acceding to what she called “an agenda-driven demand which ignores ourprimary function and pays no heed to the needs or wants of those patients and families we are caring for.”

The Delta Hospice Society has tried to work with the health authority, explaining the dilemma the order places upon them, outlining their function to assist patients live fully in their final days before natural death, and offering options to help settle the dispute but the Fraser Health Authority has refused to budge.

On January 15, 2020, Delta Hospice Society wrote the Fraser Health Authority to ask that they reconsider the proposal to give up the $750,000 a year in funding so that they may benefit from the exemption set out in a Ministry of Health policy.

Ireland said that giving up the funding would cause the Society to focus exclusively on their Hospice operations. The other services the Society provides to the community would be put on the back burner until alternative funding partnerships can be established. The Society is committed to continuing to provide the quality care it has provided since its founding in 1991, and protecting the Society’s mandate and organizational integrity.

Ireland noted further that there are many locations where MAiD is already available to those wishing to avail themselves of that option, including a facility next door.

“Nobody wanting such a service would be prevented access. The issue is not accessibility. It seems to be a purely agenda-driven demand that runs rough shod over both Delta Hospice Society’s desire to live up to its legal requirements under our Charter, as well as ignoring the reality that we are dealing with patients and families in a very vulnerable and delicate position.”

“Our goal,” she added, “is to fulfill our mission. And that is to help patients and their loved ones live quietly, comfortably, and as fully as possible in their final days of life.”

She reiterated the hospice’s desire to negotiate an equitable arrangement with the Fraser Health Authority to maintain Delta Hospice’s role of serving its patients well.

Contact: Angelina Ireland 778-512-8088; irelandangelina@gmail.com