Vancouver archbishop critiques euthanasia provision in hospice care

Vancouver, Canada, Feb 26, 2018 / 12:27 pm

Palliative care and hospice units are known for their life-affirming service to individuals who are facing the end of their lives, accompanying patients with dignity, comfort and meaning until their death.

However, the medical authority Fraser Health in Vancouver, the largest city of British Columbia, has opted to impose a physician assisted suicide provision in their palliative and hospice units, sparking criticism from the local bishop and the director of the facility's palliative care program.

"The government needs to immediately halt any efforts to force access to assisted suicide in facilities where caregivers – whether family, friends, or health-care workers or volunteers – selflessly attend to the sick and suffering," said Archbishop J. Michael Miller of Vancouver in a Feb. 22 statement.

"As a community, we must also ask ourselves where and why we are failing to provide for and accompany those who are dealing with lengthy illnesses or approaching death… we need to reach out to the suffering in our midst," Archbishop Miller continued.

The Fraser Health Board recently decided to voluntarily offer "medically assisted death" (MAiD) in their hospice and palliative care units. While health officials are required to make MAiD accessible, the provision has not been federally required in hospice facilities.

In fact, the majority of hospices (29 out of 31) in Quebec, another Canadian province, have chosen to not provide physician assisted suicide in their units, according to Dr. Neil Hilliard, the medical director of the palliative care program at Fraser Health.

Nevertheless, Fraser Health has elected to make physician assisted suicide an option for hospice patients.

Hilliard vocalized his concern over the recent shift and moved to resign as the program's director with the new provision.

"Providing euthanasia or physician assisted suicide is not in accordance with palliative care as defined by the World Health Organization which in part states: palliative care: 'affirms life and regards dying as a normal process' and 'intends neither to hasten or postpone death,'" Hilliard said in a Dec. 19 letter.

"Accordingly, it is not possible for me either to agree with the Fraser Health Board decision or to continue in my role as the program medical director…consequently, I have submitted my resignation…" he continued.

Although resigning from his current position, Hilliard will continue to work with patients who "choose life in the face of death."

Hilliard went on to quote the founder of hospice care, Dame Cicely Saunders, who said that euthanasia "surely cannot and should not be introduced as a logical part or extension of palliative care."

He also pointed to the words of Balfour Mount, a champion of palliative care in Canada, who said that euthanasia has "no relationship" with his patients, where the "goal is quality of life."

Fraser Health's new physician assisted suicide provision points to an overarching concern, said Archbishop Miller, noting the growing sentiment that the sick and lonely are "burdensome" to society.

"In nearly every case we can provide adequate pain management to comfort patients," Miller said.

"But what about the lonely, the abandoned, and those who see themselves as a burden to others or society? How do we address their needs and assure them that their life has meaning?" he continued.

The Vancouver archbishop additionally said that the Church needs to provide more support for the dying, noting that "all of us, not only those who are caregivers, are called to act on Jesus' teaching," of carrying each other's burdens.

Miller also expressed gratitude for the caregivers who tend to those near the end of their lives in hospice and palliative care, saying their work has inestimable value.

"These men and women are an example for all of us – government and public alike – as we seek ever better ways to accompany the suffering, not to wash our hands of them with a lethal injection."