Thursday, August 5, 2021

Fraser Health Authority (British Columbia) reduces Hospice Palliative Care Benefit and promotes euthanasia

The following article was sent to the Euthanasia Prevention Coalition by a palliative care patient advisor who is concerned about the Fraser Health Authority criteria for palliative care.

The Fraser Health Authority (FHA) is the British Columbia regional authority that defunded the Delta Hospice Society for refusing to participate in (MAiD) euthanasia. This article uncovers the discrepancy between the BC Hospice Palliative Care benefit and the FHA residence admission criteria. 

The FHA appears to consider euthanasia as more important than palliative care. Here is the article.


The Fraser Health Authority (FHA) admitted that there is a discrepancy between information posted on the website regarding the admission criteria to hospice and the approved hospice residence admission. To date a partial list of the eligiblity criteria is posted on the FHA webpage. Although, the FHA CEO was asked by a patient partner when would the webpage reflect the approved eligiblity for hospice residence admission, the CEO refused to provide an answer.

​On May 29, 2021, a patient advisor e-mailed the Professional Practice Consultant of the Fraser Health Authority (FHA) in preparation for the What Matters To You day on June 9. This was the message of the advisor to the consultant:
Would you be able to provide a rationale why Fraser Health reduced the life expectancy admission criteria from 6 months to less than 3 months as eligibility for admission to Fraser Health Authority Hospice Residence?

I am just concerned because patients should have access to the benefits longer than 3 months, but FHA is admitting those with life expectancy of less than 3 months?

I believe timely access (in reference to the BC Palliative Care Benefit Program life expectancy criteria) to palliative care is what matters most to those patients and families who need the service

See files from my notes and the screenshots from the source.

On June 4, 2021, the FHA Professional Practice Consultant replied to the advisor:
Thanks so much for your question. I reached out to the Fraser Health Palliative Care team to ask about the discrepancy and as it turns out they need to update the Fraser Health website to reflect the attached document. As you can see, the admission criteria actually does match the BC Palliative Care Benefit Program.

Thanks for bringing this to their attention; you have such great attention to detail.
The attached document mentioned in the message shows that the eligiblity criteria was approved since December 20, 2019 but the approved criteria was not made available to the public until a partial list was posted in June.

On June 10, 2021, the webpage on Fraser Health Hospice admission appears to be a 404 page or “Page not found”. The patient advisor questioned the Fraser Health CEO and copying the BC Premier and the BC Ministry of Health. The Premier and the Minister of Health and CEO viewed the e-mail but did not reply to the patient advisor.

On June 14, 2021, the patient advisor sent this e-mail message of concern to the Professional Practice Consultant:
Thank you very much for reaching out to the FHA Palliative Care Team to ask about the discrepancy between the BC Palliative Care Benefit and the Hospice

Residence Admission posted on FHA Website. Since December 2019, it was only today that the information on the web was updated. Base the previous e-mail, the Palliative Care Team acknowledges that the web needs to be updated to reflect the document with the approved Hospice Residence Admission Criteria . Although an update was done as of today, it is not yet reflective of what was approved.

I am curious of what is the process of FHA when updating webpages for public information? Who approves the information to be posted? I am concern that partial information posted in comparison to what was approved is not consistent to messaging. Patients and family members need to know what was approved. Both patients and health care providers should have the same information.

In my previous e-mail I have notified the Patient Engagement office through the department's email address that instead of updating the website it appeared to be an page with 404 message on June 10, 2021.

To date the webpage with the hospice residence admission is updated with a partial list of what was approved.
As of August 4, 2021, here is the Fraser Health Authority hospice residence admission criteria:

In an effort that patient advisors should be acknowledged for their effort to improve the quality of the delivery of health care system, the Fraser Health Chief Nursing Executive who also leads the Patient Engagement activities of the Fraser Health Authority terminated the patient advisor from the volunteer patient engagement. The reason provided by the executive is that advisor is a risk to the health authority. The termination happened after sending the e-mail of concern of partial list posted for the public.

Although the advisor was unfairly removed and banned from all volunteer activities within the health authority, the patient advisor hopes that the Fraser Health will be transparent to the public and post to their website the full list of the eligibility for hospice residence admission and provide the meaning of Medical Orders of Scope of Treatment (MOST) M1 or M2 to the public.
· M1 means Supportive care, symptom management & comfort measures. Allow natural death.
Transfer to higher level of care only if patient's comfort needs not met in current location.
· M2 means Medical treatments available within location of care. Current Location:
Transfer to higher level of care only if patient's comfort needs not met in current location

People who have less than six months to live should be given the dignity to live the last moments of their life with their families and should be given the right to access the hospice beds when they are eligible to be admitted and not to delay the admission to the last 3 months of their life. M1 should have been the protection of those in the hospice to be allowed natural death. And M2 should have been considered that medical treatments in the hospice is intended for palliation and those wishing for MaiD, transfer is allowed as the formal transfer could be facilitated within 30 days after a medical practitioner or nurse practitioner completes the form for the reason of transfers such as facility do not allow provision of MaiD in the facility or any reasons that requires an effective transfer.

The question now is do Fraser Health go through the process of public engagement, legal and ethical review for all their corporate policy to ensure no discrepancy with any legislations?

Note: The name of the patient advisor is withheld because of an active complaint with the BC Ombudsperson regarding unfair removal of patient advisors in Fraser Health Authority following the concern about discrepancy between the BC Palliative Care Benefit and the FHA Hospice Residence Admission.


Tershia said...

Those responsible for this evil decision will not escape the wrath of God.

carole pellizzari said...

WHAT HAVE WE BECOME???????????????

Nancy said...

Fraser Health should go through the process of public engagement, legal and ethical review for all their corporate policy to ensure no discrepancy with any legislations. Who else should we tell this to, other than our MP? And, where is the petition to sign? Thank you, Alex!

Khang said...

What's a shame, we've worked all our lives to pay taxes and in our last moment of our lives, we don't have hospice to leave this world in peace! What the government has done to us???

Anonymous said...

Who is responsible and accountable for the public information posted on the Fraser Health Website? Why would the CEO take action on this matter to ensure responsible posting of correct information.

Norman said...

How would the CEO and the Chief Nursing Executive ignore the discrepancies? They are healthcare professionals but they are not taking actions.

Perleechiele said...

Looking forward for Victoria and Jacqueline to post the document that was approved on the Hospice Admission Eligibility criteria on the web. Uploading the approval shouldn't be the problem. As medical doctor and nurse, both Victoria and Jacqueline should fulfill their responsibility and accountability to the public to be truthful of what was approved by the Palliative Care Team of Fraser Health.
For patients denied of access to hospice beds because of late admissions, should contact the Patient Care Quality Office
Fraser Health
11762 Laity St, 4th floor
Maple Ridge, BC V2X 5A3

Tel: 1-877-880-8823
Fax: 604-463-1888

Marian said...

Praying for a change of heart and a gift of wisdom that key decision makers to be truthful and respect human life. Praying that medical practitioners and nurse practitioners who fulfills their oath to do no harm (not to administer lethal dose) to the patients under their care. Keeping the faith, good over evil.

tracy bn said...

That is the link to date, it is still not showing the full list.

Is this the problem-solving skills of the Fraser Health executives? The problem was a discrepancy, the solution they provided was updating with a partial list. What is the reason the CEO and Chief Nursing Executive are not taking action to post the document approved by the Palliative Care Team?

The public needs honest leaders. Honesty is the best policy. Can the Vancouver Coastal Health Authority administer health care in Greater Vancouver? The leadership of VCHA is far better. They have honest and caring leaders. The province does not need to pay two CEOs for the Greater Vancouver area.

Rina said...

What is happened to the executive leadership of Fraser Health?

Adrianne said...

When did 3 became a reflection of 6???

Mitchell said...

From Eastern Canada, we support the vision of Delta Hospice Society for a euthanasia-free hospice.

Thank you Angelina and DHS Board for protecting the real delivery of Palliative care and educating the community that MAiD is never a part of a Palliative Care.

The message of Angelina speaks the truth:

Zeint said...

Why admit in the last three months (may only have few days to live after wdmission to hospice) and not as early as the life expectancy of 6 months or less (greater chance to be discharged because condition improved, quality of life improved). Fraser health should not deny earlier admission f0r those with LIFE EXPECTANCY OF SIX (6) MONTHS.

Krista said...

I do not know if Dr. Victoria Lee CEO of Fraser Health Authority could still utter this part of her oath "If I do not violate this oath, may I enjoy LIFE and art, respected while I LIVE and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help."

Christien said...

As of August 18, 2021, the Fraser Health still have this eligibility criteria posted on their website and this is the information available to the public:

"For admission to hospice, a person must:

have care needs that cannot be supported in a community or long-term care settings.
have a life expectancy of weeks to months.
agree to Medical Orders for Scope of Treatment (MOST) M1 or M2"

It is really a shame to the executive leadership team of Fraser Health that no one or even the Palliative Care Executive Lead is taking an action to correct the information on the web even though they have promised to update the webpage. What is happening to the leaders of this health authority?

Mitch said...

On this video, Jacqueline Per of Fraser Health was mentioning about dialogue. Was there a dialogue done between Fraser Health and patient partners?

How truthful is she with her words, does she walk her talk?

Sharon said...

Supposedly Fraser Health will educate physicians as they promise:

"education for physicians on the newly implemented most (medical orders for scope of
treatment) program, focusing on the importance of providing diagnostic and prognostic
information for patients and families, and supporting and encouraging advance care planning
conversations throughout the patient’s care journey"

But, Fraser Health failed to provide this educational opportunity to physicians.Where did the budget for education of physician go?

Annie said...

Was defunding a solution to improved access to hospice beds?

It is shameful that the FHA leadership is going southward. The public pays for the salary of executives expecting to serve the vulnerable. But now the vulnerable are at risk and no safer place to die.

Meriam said...

As I was reviewing the original FHA posting, it mentioned agrees to the philosophy of hospice care. The philosophy of hospice care does not include MAiD, why would Fraser Health mandate the provision of MAiD in hospices? The mandate is not a provincial mandate, the FHA Board Chair is not true to what he is saying to the public. The province has an opt-out provision of the MAiD Policy. Contracted organizations can opt-out.

Who is responsible for defunding a hospice that adheres to the philosophy of hospice care?

Hospice is not a killing place.

Toby said...

At the end of the day, it is about living with integrity.

Wisdom is important. Lying will never put someone at peace. It is explicitly mentioned 6 months or less for the life expectancy admission criteria, it is the choice of the leaders to lie to the public.

That is very risky when the health authority have dishonest leaders.

Pray for the CEO and Chief Nursing Executive for wisdom to diacern the truth.

Alex Schadenberg said...

The issue of defunding the Delta Hospice Society for refusing to participate in (MAiD) euthanasia was based on the BC Minister of Health. Fraser Health is not innocent but they were fulfilling the demands of the Provincial Health Ministry.

Onorina said...

As posted on the Fraser Health News Release page "The termination follows the DHS board's refusal to comply with the provincial medical assistance in dying (MAiD) policy."

Too sad that Fraser Health made a decision without consulting the licensing body. The licensing body that issued a palliative care service to the Society should have the authority to determine if MAiD policy applies to the Society or should be it be the Provincial Palliative Policy? When does a MAiD policy apply to a contracted organization that OPT-OUT?
The MAiD Policy have this provision, a contracted organization can opt-out. They have the right not to provide MAiD in the facility. Was this overlooked by Fraser Health?

Ayesah said...

This is very shameful that nobody from the leaderds had the courage to speak up about ethical breaches They are might be thinking of more immediate rewards such as staying on a good footing with the powerful.Too sad. A reflection that nurses in Fraser Health are afraid to speak up with the leaderdhip style of the chief nursing executive that seens to make actions that is defined as "discriminatory action" terminating after a concern is raised.
Very shameful.