A doctor affiliated with a Catholic hospital in Comox says the institution’s policy barring doctors from providing medical assistance in dying is the “cruellest” directive he has encountered in three decades.
On Tuesday, Dr. Jonathan Reggler resigned from the St. Joseph’s General Hospital ethics committee over the facility’s “blanket prohibition” on doctor-assisted death.
That means sick, frail, and vulnerable people seeking medical assistance in dying either choose to stay at St. Joseph’s and are denied their request, or they are sent home or transferred to another facility, Reggler said.
St. Joseph’s, a 241-bed facility, is the only hospital in the Comox Valley, which has a population of about 65,000.
Campbell River Hospital is about 45 minutes north by vehicle and Nanaimo 90 minutes south.
Jane Murphy, the hospital’s president and chief executive officer, accepted the resignation on behalf of the board of directors.
Murphy confirmed that the hospital does not provide “physician-assisted suicide and euthanasia,” but said it will respond to any patient requests with “respect, support, compassion and kindness, and will do so without discrimination or coercion.”
St. Joseph’s says it has a moral tradition of compassionate care that neither prolongs dying nor hastens death.
Reggler, a family doctor with privileges at the hospital since 2003, said forcing patients who choose doctor-assisted death to go home or travel in possible extreme discomfort is a violation of terminally ill patients’ rights under the Charter of Rights and Freedoms.
“This is the cruellest hospital policy that I have ever encountered in over 30 years of medical practice,” Reggler said in his resignation letter. “St. Joseph’s motto ‘care with compassion’ rings hollow now.”
A Supreme Court of Canada decision in February 2015 struck down a ban on assisted dying.
In June of this year, it became legal. Bill C-14 allows assisted dying for consenting adults “in an advanced stage of irreversible decline” from a serious and “incurable” disease, illness or disability and for whom natural death is “reasonably foreseeable.”
Reggler said he has facilitated medically assisted deaths in a hospice outside of the Comox Valley area, and in a patient’s home.
The physician said he fully supports the rights of medical professionals to decline to assist in a death for reasons of conscience.
“However, it is completely unacceptable for a bricks-and-mortar, publicly funded health-care institution to claim a right to conscientious objection while denying dying patients in its care a rightful treatment option,” he said.
Murphy said the B.C. health sector allows for individuals and faith-based hospitals to conscientiously object: “B.C. has effective processes for transferring patients to other hospitals for numerous medical needs, and minimizing patient discomfort and pain is always the highest priority.”
St. Joseph’s is working with Island Health to determine the best processes, she said.
The law is new for Canadian health-care systems and St. Joseph’s is committed to learning from each case and working with patients and families, she said.
Reggler said he hoped the hospital board would have the “courage” to say no to the Roman Catholic Church, which he said is guiding the hospital’s policy.
In the meantime, Reggler said he will advise patients seeking medical assistance in dying about their options — which could include obtaining a court order requiring Reggler to carry out a medically assisted death at St. Joseph’s.
For that, “they will need to get legal advice and I’d be more than happy to help them to find it,” Reggler said.
Last week, Dying With Dignity Canada called on Premier Christy Clark — as well as the premiers of Ontario and Alberta — to remove barriers to access to medically assisted deaths. B.C. has a smattering of publicly funded hospitals, hospices and long-term care homes that forbid medically assisted dying on site.
St. Joseph’s is the only such faith-based facility on Vancouver Island, Island Health said.
Shanaaz Gokool, CEO of Dying With Dignity Canada, said patients should have equal end-of-life care options across Canada: “They should not have to endure the hardship or the indignity of having to leave their hospital, and perhaps even their community, to exercise what is their right to a peaceful death.”
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