The family of a B.C. woman who sought help from MAID to end her life but was ultimately denied say changes need to be made.
Medical Assistance in Dying, or MAID, has been legal in Canada since 2016. However, due to faith-based policies, MAID is not permitted in some hospitals and facilities in B.C.
This year, there have been 17 forced transfers of patients to receive MAID out of facilities run by Providence Health Care in Vancouver, as it is a Catholic health-care provider.
There were an additional two transfers but they were to people’s homes and therefore, not forced.
Providence Health Care wouldn’t make someone available to speak on camera but confirmed the forced transfers included nine from St. Paul’s Hospital, four from Mount Saint Joseph, two from St. John Hospice and four from May’s Place Hospice.
Sam O’Neill, 34, was a patient at St. Paul’s Hospital last year. She had terminal cancer but was denied MAID due to the hospital’s religious affiliation.
In immense pain, Sam had to be sedated while sitting on a commode, wrapped in a blanket inside St. Paul’s so she could be transferred to St. John Hospice, also operated by Providence Health Care, where MAID is allowed.
The difference is that Providence Health Care owns and operates St. Paul’s Hospital, whereas it only operates St. John Hospice.
Sam ended up being sedated multiple times during the transfer and never regained consciousness at St. John Hospice and therefore was not able to provide final consent for MAID prior to the procedure.
Her parents say to provide dignity to dying patients, the hospital policy needs to change.
“It still involves depriving the individual of religious rights,” her mom Gaye O’Neill told Global News. “It involves moving an individual who is in too much pain, unimaginable pain … to be adjusted in a bed let alone being transferred to a gurney and bounced along hallways and elevators and corridors, just so they don’t sin on Providence Health Care’s watch.
“It’s cruel, it’s disrespectful. It’s illegal, because access to MAID is legal in Canada.”
Along with a local palliative care doctor, Gaye and Jim are taking legal action against Providence Health Care and the B.C. government over what happened to their daughter.
“If you want to use the smoke and mirrors of faith then you do a timeshare agreement or a condo-type agreement, just a timeshare, that says for the time it takes to provide MAID, the province owns that bed in that room, period. Under this timeshare agreement,” Jim said.
He added that this would remove the physical harm to medically fragile patients who may be forced to move facilities to access MAID.
“Use a pen and change the policy,” Gaye said.
“Respect people’s rights to religion, stop assuming there is only one way to express our faith – we come from many different angles, we all have different beliefs, we all believe differently. Catholics also have different levels of devotion, respect that.”
Gaye said a hospital room is a patient’s home until they leave and it needs to be a safe place.
Daphne Gilbert is a professor of law at the University of Ottawa and part of the legal team bringing a lawsuit from Sam’s parents against Providence Health Care and the B.C. government.
“I was outraged when I heard Sam’s story and we very quickly reached out to the O’Neill’s to offer whatever support we could offer,” she told Global News.
“In the beginning, we were looking only to offer emotional support. And, you know, we weren’t even talking about litigation. But the more I heard from Gaye and Jim and then I also spoke with Sam’s brother and sister and the more I heard about the details of what happened, I was just so angry. That was my main reaction – anger.”
Gilbert said while there are faith-based hospitals across the country, Sam did not choose to go to St. Paul’s Hospital – she was taken there by ambulance because it was the closest facility to her home.
“We know that a lot of people don’t actually have choices in Canada about where they end up,” she added. “It could be where their specialist is, it could be where there’s bed availability, it could be just proximity. And we also know that the hospitals don’t have any screening criteria whereby they only serve people who ascribe to their values.”
Dr. Jyothi Jayaraman, a MAID practitioner in Vancouver and a clinical assistant professor in palliative care, was working in May’s Place and Cottage Hospice as a palliative care physician when both those facilities were placed under Providence Health.
“I understood from them that MAID would no longer be provided in the hospice,” she said. “The patients under my care would need to be transferred out.”
Jayaraman said she has already experienced many forced transfers with MAID patients and that was not going to be her way forward.
She said a group of about 160 physicians, along with the organization, Dying with Dignity, wrote to Health Minister Adrian Dix to end the practice of forced transfers but they never heard back.
Jayaraman said she did not have any direct dealings with Sam’s case but is grateful to Sam’s parents for coming forward and speaking out.
Sadly, she said, Sam’s forced transfer is not unusual.
“I did four forced transfers last week,” Jayaraman said. “Three of them were from St. Paul’s and one was from Mount St. Joseph.”
She said Sam’s case just highlights the gravity and the severity of what can happen.
Jayaraman said in 2016, when MAID became legal, St. Paul’s Hospital would not even allow assessments of patients for MAID to be done on-site. The patient had to be transferred out of the hospital before an assessment for eligibility could be done.
Health Minister Adrian Dix said a new facility, being built as part of the new St. Paul’s Hospital complex, will alleviate these issues of patients having to be transferred from the hospital in order to access MAID.
But Gilbert said that won’t solve the problem.
“First of all, Providence Health Care operates 18 facilities in British Columbia and this solution of an adjacent building only applies to St. Paul’s, and so there will still be 17 facilities where MAID can’t happen and there is no other option,” she said.
“Secondly, for patients like Sam and others who are in such a medically vulnerable situation, even being moved out of their room to this adjacent facility poses a risk. Sam’s experience of excruciating pain would have been the same whether she was in an ambulance or a stretcher coming down elevators, down several flights to the ground floor to be moved across the corridor into this adjacent building. It would have been the same experience of pain for her.”
Gilbert said there is still a stigmatizing shame attached to being told that what a patient is asking for, which is a legal medical service in Canada, is available only at another hospital, forcing the patient to be moved.
“We live in a multicultural diverse society,” she said.
“It is 2024 and I think it’s time for the church to accept that its role in health care now has to be in line and in accordance with the values of Canadians and not just its own followers.”
For Sam’s parents, the fight for change continues.
“We need to do this,” Gaye said. “We need to do this for Sam. We need to do this for everybody else.”
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