The practice of medicine is an inescapably moral enterprise precisely because physicians are always seeking to do some kind of good and avoid some kind of evil for their patients. However, the moral aspect of practice as it relates to the conduct and moral responsibility of a physician is usually implicit, not explicit. It is normally eclipsed by the needs of the patient and exigencies of practice. But it is never absent; every decision concerning treatment is a moral decision, whether or not the physician specifically adverts to that fact.
This point is frequently overlooked when a physician, for reasons of conscience, declines to participate in or provide a service or procedure that is routinely provided by his colleagues. They may be disturbed because they assume that, in making a moral decision about treatment, he has done something unusual, even improper. Seeing nothing wrong with the procedure, they see no moral judgement involved in providing it. In their view, the objector has brought morality into a situation where it doesn’t belong, and, worse, it is his morality. . . [Full Text]
Alert from a growing number of Canadian physicians
Physicians’ Alliance Against Euthanasia
Montréal, March 9, 2020 – The Physicians’ Alliance against Euthanasia has received reports that unwilling physicians are being pressured and bullied to participate in Medical Assistance in Dying (MAiD): euphemism for euthanasia and assisted suicide. Fearing reprisals, physicians have asked that no information that could identify them be disclosed.
The pressure has been intense for many physicians, especially amongst palliative specialists, some leaving even before this latest development. Descriptions were made of toxic practice environments and fear of discipline by medical regulators.
“The anxiety, fear, and sadness surrounding my work bled into my family life, and I ultimately felt that I could not manage practicing palliative care at this stage of my life.” (Former palliative care physician, March 2020)
In different locations across Canada over the last months to weeks there has been a change in certain hospital MAiD policies. The change seems intended to provoke crisis or confrontation: to force objecting physicians to facilitate MAiD, or to have to refuse — and face contrived allegations of “obstructing access.”
Reports consistently focus on the MAiD providers refusing to accept full responsibility for the death of the patient and forcing other physicians to share responsibility for the death. If the physician asks to withdraw from care and allow the MAiD provider to take over as before, the MAiD provider resists assuming the natural pattern of care.
The reports we are hearing from distressed physicians describe deliberate disruption of arrangements that were previously working satisfactorily and that had permitted patients to have access to MAiD while still allowing for conscience objectors to not be involved in facilitating the patient’s death. This bullying and betrayal of collegial relationships can poison practice environments and compromise patient care. Such behavior should not be tolerated by health care administrators in Canada.
Vancouver — Delta Hospice officials were shocked and outraged this week by the Fraser Health Authority’s blatant move to cut off all discussions and close the facility because it wants the hospice to provide MAiD (Medical Assistance in Dying) at every facility. The Irene Thomas Hospice is dedicated to allowing patients access to expert symptom management for physical, emotional and spiritual distress. It provides comfort, meaning dignity and hope as one dies a natural death.
Angelina Ireland, President of the Delta Hospice, said the Fraser Health Authority and the British Columbia Minister of Health abruptly cancelled the Hospice’s contract on Tuesday without even acknowledging or responding to the hospice’s offer to a reduced level of government financing of the facility by $750,000 per year in order to meet the 50% funding level for exemption from providing MAiD.
“The actions of the Ministry reveal that the issue of MAiD vs. palliative care is an agenda-driven policy rather than one that ensures access to skilled and compassionate palliative care for eligible patients in distress, and their families,” she said. “And it’s all about dollars. It is easier and cheaper for the government to provide euthanasia rather than continue with palliative care. Basically, they are saying that no palliative care facility in BC has a right to exist unless it also provides euthanasia.”
Faced with the government’s decision and refusal to consider other options such as decreased provincial funding, Ms. Ireland said the hospice will look at all of its legal and other options to continue to exist and serve patients and families in their final days, as they have always done.
The decision is particularly baffling, she said, since access to MAiD for those who request it is available at many locations in the lower mainland, including Delta Hospital right next door to the hospice. That, in her mind, reinforces the view that this is not about patients or families, but rather about a social policy agenda.
“MAiD is a separate public health care stream, distinct and apart from palliative care. If the government wants to open MAiD facilities that’s their option, but they must not be allowed to download it onto the backs of private palliative care facilities.”
“Palliative care physicians and nurses believe in the philosophy of specialty palliative care and practice as defined by the World Health Organization (WHO), which maintains that palliative care provides relief from pain and other distressing symptoms and which affirms life and regards death as a normal process. At no point does WHO include euthanasia as an aspect of palliative care!”
Forced closure of the facility ignores the fact that this is a privately owned hospice built on land leased from the government, employs more than fifty people and has contributed significantly to BC’s public health care system.
“This is an invasion of the historic medical discipline of palliative care. The Canadian model is respected around the world. The government and the health authority are running roughshod over that principle and reputation.”
Ms. Ireland expressed hope that “even at this late date” Fraser Health Authority and the BC Ministry of Health will come to the table and discuss the issues, including the financial offer. “Our deepest concern is with those patients and families who have entrusted their final days to us. We want to make sure those days are filled with comfort and peace. That is still our goal.”
The Ministry and the Authority have both publicly stated they plan to take control of the premises currently occupied by the Hospice. The Delta Hospice Society built the Irene Thomas Hospice without taxpayer funds, at the cost of approximately $9,000,000. The Society has operated the Irene Thomas Hospice for 10 years, providing more than 700,000 hours of volunteer labour and $30 million to the public health care system. For the government to step in and seize this private property is “a scandalous appropriation of private assets,” said Ireland.
On Saturday April 4, a Rally for Delta Hospice will be held in front of the Legislative Buildings at noon. Speakers include Dr. Margaret Cottle (palliative care physician) and Dr. Will Johnston (family physician and obstetrician) along with MP Tamara Jansen and Alex Schadenberg of the Euthanasia Prevention Coalition.
-30- For further information, contact: Angelina Ireland. President Delta Hospice firstname.lastname@example.org
I just can’t understand why as learned as you are, you tenaciously use the verb KILL to refer to MAD. You cannot ignore that this verb requires a non-consenting victim. It makes of you a malicious pro-lifer who does not mind lying. MAD must be requested ! Camus wrote: «To misname things amount to adding to the world’s misery»…in La Pléiade, Oeuvres complètes p. 908.
This message was left for the Project Administrator by a member of the Clinicians’ Advisory Council of Dying With Dignity (DWD) Canada after he/she had downloaded several papers from the Administrator’s Academia web page.
The downloaded papers do not challenge the legalization of euthanasia and assisted suicide (EAS). The substantive morality of the procedures and their legalization is outside the scope of Project advocacy. The papers simply defend practitioners unwilling to be parties to killing their patients by providing or facilitating EAS services.
Unfortunately, the DWD Clinical Advisor was exasperated by the description of euthanasia and assisted suicide as “killing.” This, he/she exclaims, is a malicious lie that adds to the world’s misery.
Such a cri de cœur calls for a thoughtful discussion of the question it raises.
Does providing euthanasia and assisted suicide entail killing — or does it not? [Full text]
It looks like the leadership of the Delta Hospice Society has decided to forgo substantial funding from the Fraser Health Authority by refusing to provide Medical Assistance in Dying (MAiD).
An article this week in The BC Catholic featured an interview with DHS board president Angelina Ireland who was quoted as saying the society rather lose funding, saying MAiD is completely incompatible with palliative hospice care. . . [Full text]