Opinion: It's time to end forced transfers of dying Albertans

Opinion: It's time to end forced transfers of dying Albertans



This article originally appeared in the Edmonton Journal on December 27, 2018.

Dying Albertans deserve quality care and heavy doses of compassion in their final days of life. They generally receive it, due in no small part to the dedication of frontline health-care workers and the heroic sacrifices of family caregivers.

It is clear, however, that Alberta is falling short when it comes to the treatment of desperately suffering residents who request medical assistance in dying (MAID) in some of the province’s publicly funded hospitals, hospices and long-term care homes.

Recent news reports have featured harrowing stories of patients being transferred out of palliative care to be assessed for or to receive MAID. In general, these are patients who, under different circumstances, would be moved only as a last resort. Yet, these gruelling transfers persist because tax-funded health institutions are refusing to allow Albertans to access MAID on-site.

This is unacceptable. Forcing suffering people out of a facility in their time of greatest vulnerability is inhumane and it violates their rights in a number of ways. First and foremost, forced transfers for MAID impose additional pain and stress upon people who are already suffering intolerably. Second, this practice can threaten a person’s ability to access MAID at all. Because people who qualify for MAID are extremely frail, they can lose capacity while waiting for a transfer to be arranged, thus rendering them ineligible for access under federal law.

It bears emphasizing that access to MAID is a right. In its 2015 ruling in Carter v. Canada, the Supreme Court recognized assistance in dying as a constitutionally protected right for Canadians who satisfy certain key eligibility criteria.

Moreover, because MAID is an insured medical service under the province’s public health-care plan, Albertans have a right to equitable access to this important treatment option in accordance with the Canada Health Act and the Canadian Charter of Rights and Freedoms.

While the right to MAID is rooted in fact, claims that public health-care facilities have a right to ban the provision of MAID are not. Organizations that oppose MAID, such as Alberta’s Covenant Health, are correct in asserting that staff members who have moral or religious objections to MAID should not be forced to provide it. Individual clinicians have that right. Bricks-and-mortar institutions — ones that receive substantial public funding and that have a mandate to provide public healthcare to the communities they serve — do not, regardless of whether they have a religious identity.

Public outcry over forced transfers has led Covenant Health to relax its MAID policies slightly. Patients who request MAID in Covenant facilities are now allowed to sign their application forms without leaving the premises, and visiting doctors and nurse practitioners may now enter Covenant sites to conduct the eligibility assessments that are required by law.

These are small steps in the right direction, but they come after far too much foot-dragging on the part of Covenant Health and the provincial government. Both have known for more than two years about the agony and indignity that forced transfers foist upon vulnerable patients, yet neither chose to act until grieving families started speaking out in public about the injustices they endured.

Despite the changes to Covenant’s policy, suffering Albertans will still be forced to move, sometimes to a facility many kilometres outside their home community, to realize their right to a peaceful death. This raises a poignant but necessary question: how many more bereaved families will have to bare their pain in the media, or go to court, for the province to treat people who request MAID with the compassion and respect they deserve?

We urge our provincial leaders not to wait to be shamed into doing what is right. Instead, they must put an immediate stop to forced transfers for MAID because it is the right thing to do.

Sandra Azocar is the executive director of Friends of Medicare. Shanaaz Gokool is the CEO of Dying With Dignity Canada.