Canadian Society of Palliative Care Physicians: Euthanasia is not consistent with the philosophy, intent or approach of hospice palliative care.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

*Sign the petition: Hospice Organizations Must NOT be Forced to do Euthanasia (Link).

On December 2, I reported that the Delta Hospice Society that operates the Irene Thomas Hospice in Ladner BC, renewed its opposition to euthanasia (MAiD) while supporting excellent care. The Board stated:

MAiD is not compatible with the Delta Hospice Society purposes stated in the society's constitution, and therefore, will not be performed at the Irene Thomas Hospice.

Irene Thomas Hospice

The BC Health Minister, Adrian Dix, responded by declaring that the provincial government will take action if the Delta hospice refuses to kill its patients. Dix suggested that they will stop funding the 10 bed hospice if they refuse to do MAiD.

In its recent Call to Action, the Canadian Hospice Palliative Care Association (CHPCA) and the Canadian Society of Palliative Care Physicians (CSPCP) stated that MAiD (euthanasia) is not part of hospice palliative care.

On Tuesday, the President of the CSPCP, Dr Leonie Herx, sent a letter to Minister Dix supporting the refusal by the Delta Hospice Society to do euthanasia (MAiD) and stating that MAiD is not consistent with the philosophy, intent, or approach of hospice palliative care which supports dying as a natural process and does not hasten death: Herx stated:

The Canadian Society of Palliative Care Physicians is concerned that palliative care centres in Fraser Health, such as some hospices, might be mandated to provide Medical Assistance in Dying (MAiD) on site. While we appreciate the requirement for MAiD to be available, requiring it to be provided in hospices and palliative care units poses risk for potential harm. The risks are outlined in in our submission to the Special Joint Committee: (Link).

The Canadian Hospice Palliative Care Association (CHPCA) and Canadian Society of Palliative Care Physicians (CSPCP) recently released a Joint Statement on Hospice Palliative Care and MAiD which further outlines that MAiD is not consistent with the philosophy, intent, or approach of hospice palliative care which supports dying as a natural process and does not hasten death: (Link).

The Canadian Medical Association (CMA) also recognizes the distinct nature of these practices in the unanimously passed General Council Resolution DM 5-63 which states: The Canadian Medical Association recognizes that the practice of assisted death as defined by the Supreme Court of Canada is distinct from the practice of palliative care.

One of the biggest potential harms is to those who do not choose MAiD (more than 98% of those who die as only about 1.5% choose MAiD). Both the public and many health care providers have had a longstanding fear of Hospice Palliative Care because they were afraid it hastened peoples’ deaths. This has led to late referrals and people choosing to not be referred to palliative care services that could have benefited them. For over 40 years we have been trying to educate the public and health care professionals that Hospice Palliative Care neither hastens nor prolongs the natural process of dying.

The core philosophy of hospice care is to provide a culture of caring that enables persons to live fully until they die a natural death and to minimize the symptoms and fears of the dying process, but never to intentionally hasten death.

Insisting that MAiD be provided in all palliative care centres and hospices has the potential to undermine the last 40 years of education about and advocacy for Hospice Palliative Care and goes against the core, foundational principles of hospice care. It also removes choice for those who want to choose a natural death supported by high quality hospice palliative care without fear their lives will be shortened.

Hospices and PC units should be able to make their own local arrangements for patients who request MAiD that allows patients access to this procedure and also maintains the integrity and availability of Hospice Palliative Care.

We kindly ask for you to consider the risk of harm and to help provide good access to high quality hospice palliative care.

Sign the petition: Hospice Organizations Must NOT be Forced to do Euthanasia (Link).

Terminally ill Ontario man is denied the care that he needs to live.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

I have published previous articles (1) (2) (3) (4) about how denying the care that terminally ill people need and the effort to make euthanasia or assisted suicide (MAiD) more available.

For instance, Ontario doctors who oppose euthanasia have been ordered to do an effective referral for euthanasia. Effective referral is defined as referral for the purpose of the act. This means that a physician who opposes killing must send his patient to a physician who will kill.
 
Recently the Delta BC Hospice Society that are refusing to do euthanasia have been ordered by the Minister of Health to do MAiD or lose their funding.

Sign the petition: Hospice Organizations Must NOT be Forced to do Euthanasia (Link).

Mark Doner

An article by Bill Hodgins for MyKawartha.com reports that Mark Doner, who is living with terminal cancer, was informed that the personal support worker hours that he receives are being cut. Hodgins explains:

Doner is dying of cancer. The 58-year-old Peterborough man says since he was diagnosed in 2017, it has spread from his colon and small intestine to his liver. He’s outlived the time his doctors gave him and he’s not going to get any better.

Doner lives alone in a highrise apartment in Peterborough, and currently gets assistance from personal support workers (PSW) six days out of the week. Every second day, he gets two hours of help. It’s one hour on alternate days. Nurses visit about every three days.

Earlier this month, he says a co-ordinator from the Local Health Integration Network (LHIN) dropped by, asked him some questions, then informed him his personal support worker care hours would be cut to just one hour on the days where he was getting two hours of care.

“I just don’t get it,” says the former resort chef. “I’ve had operations. I’m in pain. I have some good days but even my girls (the PSWs) say I should be asking for more care.”

Do support worker cut-backs lead to elder abuse? Hodgins quotes Jennifer Brown, a long-term care advocate in Ontario.

“How is cutting the weekly hours of personal support workers in Ontario LTC (long-term care) homes combating elder abuse?

“How does sowing anxiety and fear about their own job security among the uncut personal support workers, that results in increased sick days and heavier workloads for those who do come to work, combat elder abuse?”

The article does not suggest that Doner is being pressured to euthanasia. Whether the Ministry of Health wants people, like Doner, to ask for euthanasia or euthanasia is an "accidental" outcome of their policy, the fact is that he is being denied the care that he needs and euthanasia is being pushed.

The Health Minister should know that people, like Doner, who live in their private residence cost the government less money than those living in assisted living or a hospital. If the government does not provide enough home care support he may eventually be forced to move into assisted living which will cost the government a lot more money.

At the same time, the number of seniors waiting for long-term care placements is at a record high.

This is not a conservative vs liberal ideological debate - home care is less expensive and more dignified.

Denying people the home care that they need is dangerous and promotes euthanasia (MAiD).

Forcing Hospices to do Euthanasia in Canada

This article was published by National Review online today.

By Wesley J Smith

Euthanasia is more than just legal in Canada. It has become a government-guaranteed right.

Sign the petition: Hospice Organizations Must NOT be Forced to do Euthanasia (Link).

But how to guarantee that the legally qualified who want to die are made dead? Unless the government establishes killing centers out of Soylent Green, it will have to coerce doctors into doing the killing — as has been done in Ontario. And, it will have to force medical facilities into allowing euthanasia on premises, whether their administators like it or not.

Such an imposition is now taking place in British Columbia, where the Dignity Hospice board of directors are standing tall for the hospice philosophy of caring — but never killing — by refusing to permit euthanasia in the facililty. In response, the BC Health Minister is threatening to restrict funding in the single-payer system, which, ironically, would undercut the facilities ability to care optimally for their patients who don’t want to be killed. From the Globe and Mail story:

A B.C. hospice society that refuses to provide medical assistance in dying at its facility in violation of local rules has been given until Thursday to submit plans for compliance.

Sign the petition: Hospice Organizations Must NOT be Forced to do Euthanasia (Link).

Health Minister Adrian Dix said the Delta Hospice Society, which operates the Irene Thomas Hospice in Ladner, may face penalties if it fails to do so.

“We’ve asked them … to provide their plan to fulfill their contract with the Fraser Health Authority and it is our expectation that they will,” Mr. Dix said on Wednesday. “Should they not want to fulfill their contract with Fraser Health, there may well be consequences of that.”

It it my understanding that there is a Fraser hospital directly across the street from the hospice where patients are euthanized. It would be easy to move hospice patients who want to have that done to the hospital where they could be put down according to their desire. But even if that weren’t true, so long as the hospice advises patients that euthanasia is not permitted on site, why force the issue? Why threaten to bring financial ruin upon a small, heterodox-managed institution?

Because of the message that Delta sends that euthanasia is morally wrong and an improper way to treat terminally ill patients. That is what burns. Hence, the authoritarian response of the government.

This is both a civil rights issue and a matter of basic compassion. Think about the patient in the next bed who values life and knows that his neighbor is being killed by a doctor. That would be both terrifying and morale destroying because of the cruel message communicated that his life — like that of the neighbor — is no longer deemed worth protecting.

The ongoing assault on medical conscience in Canada demonstrates how the culture of death brooks no dissent. The same thing will happen here if we let the wolf in the door. Those with eyes to see, let them see.

Hastening death isn't what hospice is about.

This article was published by OneNewsNow on December 16, 2019

Euthanasia proponents in Canada are targeting a hospice program in what is no doubt hoped to be the start of a domino effect.

Sign the petition: Hospice Organizations Must NOT be Forced to do Euthanasia (Link).

Delta Hospice in British Columbia refuses to kill its patients, as it recognizes a hospice facility is meant to make its patients as comfortable as possible until their natural death. But Frazier Health, the authority that receives funding through the provincial government, has decided that all organizations it sends money to, including Delta, will euthanize patients.

"The board of the Delta Hospice has maintained a position saying that they oppose euthanasia," relays Alex Schadenberg of the Euthanasia Prevention Coalition. "On top of it, they maintain the position that euthanasia's not compatible with hospice care. Further … part of their articles of incorporation say that they do not hasten death."

Alex Schadenberg

But Frazier Health is warning Delta that maintaining that policy will end their funding, thus shutting down the hospice facility.

"If the Delta Hospice is forced to do euthanasia, then the other hospice organizations that are also holding out … will be in a situation where they will also likely be forced to do euthanasia," Schadenberg warns.

In Delta's case, there is a hospital across the street that does euthanize patients, so the question is why Delta Hospice is being compelled to offer services that are already available nearby.

• BC Health Minister says he will force the Delta Hospice to kill (Link).

BC Health Minister says he will force the Delta Hospice to kill.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Sign the petition: Hospice Organizations Must NOT be Forced to do Euthanasia (Link).

The BC Health Minister, Adrian Dix, declared yesterday that the BC government will take action if the Delta hospice refuses to kill its patients.

Adrian Dix has suggested that they will stop funding the 10 bed Delta Hospice if it refuses to kill.

On December 2, I reported that the Board of the Delta BC Hospice Society that operates the Irene Thomas Hospice in Ladner BC, renewed its position opposing euthanasia (MAiD) while supporting excellent care. The Board stated:

MAiD is not compatible with the Delta Hospice Society purposes stated in the society's constitution, and therefore, will not be performed at the Irene Thomas Hospice.

In its recent Call to Action, the Canadian Hospice Palliative Care Association and the Canadian Society of Palliative Care Physicians stated that MAiD (euthanasia) is not part of hospice palliative care. They stated:

MAiD is not part of hospice palliative care; it is not an “extension” of palliative care nor is it one of the tools “in the palliative care basket”. National and international hospice palliative care organizations are unified in the position that MAiD is not part of the practice of hospice palliative care. 

...Hospice palliative care sees dying as a normal part of life and helps people to live and die well. Hospice palliative care does not seek to hasten death or intentionally end life. 

The Delta Optimist newpaper reported, on December 7, that Fraser Health informed the Delta Hospice that their position is at odds with the policy of Fraser Health. A spokesperson for Fraser Health told the Delta Optimist that:

The region noted it fully supports a patient’s right to receive medical assistance in dying wherever they may be, including in a hospice setting.

The position of the Delta Hospice is not new. In February 2018, the Delta Hospice was ordered by Fraser Health to provide euthanasia. The Delta Hospice did not comply with the Fraser Health edict.

If the Delta Hospice closes, the residents of Delta will lose the 10 bed hospice that is known for providing excellent end-of-life care.

If the Delta Hospice is forced to do euthanasia, then all Canadian Hospice groups will be forced to do euthanasia.

Sign the petition: Hospice Organizations Must NOT be Forced to do Euthanasia (Link).

Delta Hospice Must Not Be Forced to do Euthanasia.

Alex Schadenberg

Executive Director, Euthanasia Prevention Coalition

Sign the petition: Hospice Organizations Must NOT be Forced to do Euthanasia (Link).

In February 2018 the Board

of the Delta BC Hospice was given an Edict from Fraser Health to provide euthanasia (MAiD).

At that time, the Board of the Delta Hospice decided not to do euthanasia and continued its good work.
 

Recently, the Board of the Delta Hospice re-stated its opposition to euthanasia. The new board passed a resolution stating:

MAiD is not compatible with the Delta Hospice Society purposes stated in the society's constitution, and therefore, will not be performed at the Irene Thomas Hospice.

A spokesperson for Fraser Health told the Delta Optimist that:

it fully supports a patient’s right to receive medical assistance in dying wherever they may be, including in a hospice setting.

The order by Fraser Health is contrary to the stated purpose of the Delta Hospice Society constitution.

Sign the petition: Hospice Organizations Must NOT be forced to do Euthanasia (Link).

If funding for the 10 bed hospice is stopped people in the community requiring care at the end of life, will lose the excellent care provided by the Delta Hospice.

By forcing the Delta Hospice to provide euthanasia, Fraser Health is also redefining the meaning of hospice/palliative care.

In its recent Call to Action, the Canadian Hospice Palliative Care Association and the Canadian Society of Palliative Care Physicians stated that MAiD (euthanasia) is not a part of hospice palliative care. They stated:

MAiD is not part of hospice palliative care; it is not an “extension” of palliative care nor is it one of the tools “in the palliative care basket”. National and international hospice palliative care organizations are unified in the position that MAiD is not part of the practice of hospice palliative care. 

...Hospice palliative care sees dying as a normal part of life and helps people to live and die well. Hospice palliative care does not seek to hasten death or intentionally end life. 

If the Delta Hospice is forced to provide euthanasia then all Hospice Palliative Care organizations within Canada can be forced to provide euthanasia.

Hospice/Palliative Care is not MAiD. The Delta Hospice must not be forced to provide MAiD.

Fraser Health is overstepping its role as a health authority in forcing and bullying the Delta Hospice to provide MAiD.

Sign the petition: Hospice Organizations Must NOT be forced to do Euthanasia (Link).

Delta Hospice ordered by Fraser Health to do euthanasia.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Delta Hospice

On December 2, I reported that the Board of the Delta BC Hospice Society that operates the Irene Thomas Hospice in Ladner BC, renewed its position opposing euthanasia (MAiD) while supporting excellent care. The Board stated that:

MAiD is not compatible with the Delta Hospice Society purposes stated in the society's constitution, and therefore, will not be performed at the Irene Thomas Hospice.

Fraser Health, the government agency that allocates health funding in that region reacted to the Delta Hospice Society by ordering them to provide MAiD (euthanasia).

Sign the petition: Hospice Organizations Must NOT be forced to do Euthanasia (Link).

The Delta Optimist newpaper reported, on December 7, that Fraser Health informed the Delta Hospice that their position is at odds with the policy of Fraser Health.

A spokesperson for Fraser Health told the Delta Optimist that:

The region noted it fully supports a patient’s right to receive medical assistance in dying wherever they may be, including in a hospice setting.

The Delta Optimist also reported that the lobby group, Dying With Dignity, also believes that the Delta Hospice should be forced to do euthanasia:

Alex Muir with the Vancouver chapter of Dying with Dignity Canada called the new board’s vote to repeal MAiD disappointing, adding his group believes Delta Hospice should be forced to abide by Fraser Health policy that MAiD be provided in all non-faith-based facilities under its jurisdiction.

Muir then added that Dying With Dignity considers palliative care and MAiD to be essential options on a spectrum of care.

Delta Hospice President, Angelina Ireland

The position of the Delta Hospice is not new. In February 2018, the Delta Hospice was ordered by Fraser Health to provide euthanasia. The Delta Hospice did not comply with the edict from Fraser Health at that time.

Recently the Canadian Hospice Palliative Care Association (CHPCA) and the Canadian Society of Palliative Care Physicians released a joint statement upholding that hospice palliative care is not compatible with MAiD (euthanasia). They stated:

Healthcare articles and the general media continue to conflate and thus misrepresent these two fundamentally different practices. MAiD is not part of hospice palliative care; it is not an “extension” of palliative care nor is it one of the tools “in the palliative care basket”. National and international hospice palliative care organizations are unified in the position that MAiD is not part of the practice of hospice palliative care.

Hospice palliative care and MAiD substantially differ in multiple areas including in philosophy, intention and approach. Hospice palliative care focuses on improving quality of life and symptom management through holistic person-centered care for those living with life threatening conditions. Hospice palliative care sees dying as a normal part of life and helps people to live and die well. Hospice palliative care does not seek to hasten death or intentionally end life.

If the Delta Hospice is forced to do euthanasia, then all Canadian Hospice groups can be forced to do euthanasia.

Sign the petition: Hospice Organizations Must NOT be forced to do Euthanasia (Link).

British Columbia (BC) Health Authority orders hospice to do euthanasia.

Alex Schadenberg

Executive Director, Euthanasia Prevention Coalition

Sign the Petition: Killing Conscience Rights in BC Hospitals and Hospices.

 The recent edict by the Fraser Health Authority in British Columbia ordering (non-religious) healthcare facilities to participate in euthanasia (MAiD) including hospices is an infringement on the conscience rights of the medical staff. I believe that:

Institutional conscience rights are about the rights of the workers within an institution to not participate in acts that they consider wrong.

Delta Hospice

The edict by Fraser Health directly effects institutions such as the Delta Hospice that is opposed to participating in euthanasia. Janice Strukoff, an administrative leader with the Delta hospice stated:

“Hospice palliative care is not about hastening death and we object to the bullying currently taking place in B.C.,”

Nancy Macey, the founder and executive director of the Delta hospice stated:

MAiD can be a traumatizing experience for staff, patients, and volunteers, and all groups might not want to stay or work there if the principals of palliative care are compromised. Hospices are already grappling with a shortage of health professionals so compelling the society to provide MAiD could exacerbate the problem.

Dr Neil Hilliard

In response to the order by the health authority, Delta hospice rejected the order and Dr Neil Hilliard, the medical director of the Fraser Health Palliative Care stated in his resignation letter:

Providing euthanasia or physician-assisted suicide is not in accordance with palliative care (which) “affirms life and regards dying as a normal process …”

Last weekend a meeting in Langley BC concerning the forcing of euthanasia upon medical facilities against the staff decision to not participate in MAiD. 

Sign the Petition: Killing Conscience Rights in BC Hospitals and Hospices.


The meeting attracted 300 people and featured federal MP Mark Warawa and provincial MLA Mary Polak, along with representatives from the Fraser Health Authority. At the meeting Warawa commented that the battle to protect conscience rights: "is not over. It's just begun." Warawa also stated:

“That (permitting MAiD) will destroy palliative care as it has developed,”

Mary Polak

Mary Polak was forthright in her comments by stating:

“To say that you are going to place medical assistance in dying — or let’s call it what it is, killing people. Sorry, but that is what it is — (and decide that) you’re going to put that into a hospice palliative circumstance, is to completely contradict what palliative care is to begin with,”

The decision of the Fraser Health Authority also affects plans to build a new hospice in Langley. Kathy Derksen, the executive director of the Langley hospice stated:

When MAiD was first law, Fraser Health consulted with stakeholders and agreed it would not be imposed on hospice and palliative care facilities.

Healthcare workers conscience rights have become a national issue in Canada. Recently, an Ontario Court decided that doctors who oppose euthanasia must participate by doing an "effective referral" for euthanasia.

Dr Will Johnston eloquently explained the pressures that are faced by medical professionals in his article: The alarming trend of forcing hospitals and hospices into doing assisted suicide.