 |
| Angelina Ireland |
Executive Director, Delta Hospice Society
As Britain debates assisted dying, Canada’s experience offers a cautionary story about what can happen when a hospice seeks to preserve its founding philosophy.
When Canada’s medical assistance in dying (MAiD) law came into effect, our hospice refused to provide it. Months later, a health authority official entered our hospice and handed letters to dying patients explaining that the hospice was closing and they would need to move elsewhere for their care. Because Delta Hospice Society declined to provide MAiD, our hospice patients were given six weeks to leave. They could make their own arrangements or be taken to another hospice in the region. We had to lay off all our staff and volunteers, and we were given 30 days to vacate the property.
That moment did not happen in isolation. It was the culmination of a journey that began years earlier, when I was a cancer patient myself. I never imagined cancer would change not only my life but also my understanding of what it means to care for another human being. Cancer took me through surgery, chemotherapy, radiotherapy and years of hormone therapy. Along the way, I found the Delta Hospice Society. The care I received was built on a philosophy that began in Britain with Dame Cicely Saunders. It taught that suffering is more than physical pain. It is emotional, social and spiritual too. That philosophy changed my life. It is one of history’s ironies that the philosophy Britain gave the world was ultimately the philosophy we found ourselves defending in Canada.
Britain is now debating whether to legalize assisted dying. Before crossing that threshold, it should understand what happened to one hospice in Canada that believed its role was never to hasten death.
I later became the President of the Delta Hospice Society around the time medical assistance in dying (“M.A.i.D”) was legalized in Canada. Our hospice was built entirely through private fundraising. Like many Canadian hospices, its day-to-day operations were supported by public funding. We ran a very successful hospice and palliative care program for 10 years serving over 2,000 patients and their families. When MAiD became legal in Canada, there was no provision to “opt out” to protect our medical discipline. Ultimately, we were expected to provide MAiD in our hospice. We refused because we believed MAiD was incompatible with the philosophy of palliative care on which our hospice had been founded.
I received various registered letters from the Vice President of the health authority requiring us to implement MAiD and demanding we comply. I met him over coffee to explain why we resisted, but instead I was cut short and told that our position would not be tolerated and that the decision had been made at a higher level. Soon after, the official letter came, giving us notice that no further operating monies would be paid and our Hospice would cease operating under Delta Hospice Society. With 22 years left, our land lease was cancelled immediately. The buildings returned to the landowner and our charity received no compensation for the millions of dollars it had invested.
After 10 years of MAiD in Canada, my experience has convinced me that when hospice care is no longer permitted to remain distinct from assisted dying, something important is lost. I do not suggest that Britain will necessarily follow Canada’s path in every respect. But my experience shows how profoundly legal and policy changes can reshape the institutions and traditions that care for people at the end of life.
Hospice care was founded on accompanying people through dying rather than intentionally hastening death. Once intentionally ending life becomes part of end-of-life care, we risk losing something unique about the hospice tradition.
I have watched friends die in hospice. I have also watched cancer patients recover to good health – through good healthcare, and great doctors. That experience reinforced for me the importance of treating each person with hope as well as compassion. Hospice taught me that dignity is found not in choosing death, but in never abandoning those who are dying. That is the tradition I learned from Britain. That is the tradition Britain gave the world. It is the tradition I hope Britain chooses to preserve.
When Canada’s medical assistance in dying (MAiD) law came into effect, our hospice refused to provide it. Months later, a health authority official entered our hospice and handed letters to dying patients explaining that the hospice was closing and they would need to move elsewhere for their care. Because Delta Hospice Society declined to provide MAiD, our hospice patients were given six weeks to leave. They could make their own arrangements or be taken to another hospice in the region. We had to lay off all our staff and volunteers, and we were given 30 days to vacate the property.
That moment did not happen in isolation. It was the culmination of a journey that began years earlier, when I was a cancer patient myself. I never imagined cancer would change not only my life but also my understanding of what it means to care for another human being. Cancer took me through surgery, chemotherapy, radiotherapy and years of hormone therapy. Along the way, I found the Delta Hospice Society. The care I received was built on a philosophy that began in Britain with Dame Cicely Saunders. It taught that suffering is more than physical pain. It is emotional, social and spiritual too. That philosophy changed my life. It is one of history’s ironies that the philosophy Britain gave the world was ultimately the philosophy we found ourselves defending in Canada.
Britain is now debating whether to legalize assisted dying. Before crossing that threshold, it should understand what happened to one hospice in Canada that believed its role was never to hasten death.
I later became the President of the Delta Hospice Society around the time medical assistance in dying (“M.A.i.D”) was legalized in Canada. Our hospice was built entirely through private fundraising. Like many Canadian hospices, its day-to-day operations were supported by public funding. We ran a very successful hospice and palliative care program for 10 years serving over 2,000 patients and their families. When MAiD became legal in Canada, there was no provision to “opt out” to protect our medical discipline. Ultimately, we were expected to provide MAiD in our hospice. We refused because we believed MAiD was incompatible with the philosophy of palliative care on which our hospice had been founded.
I received various registered letters from the Vice President of the health authority requiring us to implement MAiD and demanding we comply. I met him over coffee to explain why we resisted, but instead I was cut short and told that our position would not be tolerated and that the decision had been made at a higher level. Soon after, the official letter came, giving us notice that no further operating monies would be paid and our Hospice would cease operating under Delta Hospice Society. With 22 years left, our land lease was cancelled immediately. The buildings returned to the landowner and our charity received no compensation for the millions of dollars it had invested.
After 10 years of MAiD in Canada, my experience has convinced me that when hospice care is no longer permitted to remain distinct from assisted dying, something important is lost. I do not suggest that Britain will necessarily follow Canada’s path in every respect. But my experience shows how profoundly legal and policy changes can reshape the institutions and traditions that care for people at the end of life.
Hospice care was founded on accompanying people through dying rather than intentionally hastening death. Once intentionally ending life becomes part of end-of-life care, we risk losing something unique about the hospice tradition.
I have watched friends die in hospice. I have also watched cancer patients recover to good health – through good healthcare, and great doctors. That experience reinforced for me the importance of treating each person with hope as well as compassion. Hospice taught me that dignity is found not in choosing death, but in never abandoning those who are dying. That is the tradition I learned from Britain. That is the tradition Britain gave the world. It is the tradition I hope Britain chooses to preserve.
No comments:
Post a Comment