In fact, it has heated up all over again in British Columbia, where the Fraser Health Authority — which delivers health care to 1.8 million people in southern B.C. — plans on moving ahead to force hospices to provide assisted suicide, popularly termed medical assistance in dying (MAiD).
Various health care workers and volunteers are fighting the move that some see as “bullying” tactics to increase the pressure to end the lives of their patients.
“I’m speaking on behalf of the sick and most vulnerable who cannot advocate for themselves,” said Nancy Macey, the executive director of Delta Hospice Society.
Macey, who created the non-profit on her kitchen table 25 years ago, was horrified to find out before Christmas of the Fraser Health Authority’s plans. Now she and many others are raising the issue with local politicians, the media, the Fraser Health Authority and with anyone willing to listen.
“Hospice palliative care, as defined by the World Health Organization, does not hasten or prolong death,” Macey wrote in a letter to B.C. Health Minister Petitpas Taylor and seven local politicians.
Assisted suicide, Macey said, runs contrary to these principles. She wants to see hospices have the ability to opt-out of providing assisted suicide on site, and instead transfer patients who want the lethal injection to their homes or other facilities.
“What we’re concerned about is if you introduce euthanasia into (hospice care), it’s going to put up barriers to access.”
She is worried the consequences of forcing assisted suicide into hospices, especially those that don’t want to participate, will only make matters worse for the majority of the dying.
“Those who choose to have MAiD represent one per cent of the population,” she said. “The euthanasia people have choice anywhere they want it. Where does the choice come for the people who don’t want to be in an environment with euthanasia?”
Hospice supporters say imposing assisted suicide would exacerbate the already difficult problem of providing quality palliative care to all Canadians: only about 30 per cent can currently access it. They say the majority of terminally ill patients who won’t seek assisted suicide might fear entering a hospice.
“If people are afraid to access it, there is going to be more suffering,” said Macey. “There is going to be people ending up in emergency departments, there will be caregiver burnout and people will die in emergency care and hospitals, all the stuff we’ve been working on for 25 years to avoid.”
The Delta Hospice Society operates under contract with Fraser Health and is not required to provide assisted suicide under current policies. The Langley Hospice, however, is affected.
“To mix MAiD with hospice care makes absolutely no sense,” said Kiernan Hillan, a volunteer at the Langley Hospice for four years.
“It’s contrary to the whole direction the hospice should be going in. It’s not a place of killing. It’s a place where you live your last moments. You’re not going there to decide that you’re going to die. You’re going there to live your last moments to the fullest possible.”
Hillan is passionate about caring for the dying and feels it’s important to be there as one of the few male volunteers and employees.
However, he’s worried he will be forced out.
“We love people, we care for people, we listen to them, we make coffee for them, we get a blanket, and we help them when they eat. But now comes a point where we’re supposed to support them when they make a decision to end their life? No, that doesn’t make sense,” he said. “If I’m sitting there as a volunteer and someone in the next room would be having MAiD, I don’t know if I could be in that facility.”
He’s not the only one worried that existing hospice staffing issues will get worse. Already, high-profile medical professionals like Dr. Neil Hilliard, the executive director of the Fraser Health Palliative Care Program, have resigned over the issue. Vancouver family physician Dr. Williard Johnston has publicly called on Fraser Health to “back down” and stop “bullying” hospices.