Covenant Health Refusing Patients the Right to Die

Honourable Sarah Hoffman
Deputy Premier, Minister of Health
Members of Executive Council
Executive Council
423 Legislature Building
10800 - 97 Avenue
Edmonton, AB T5K 2B6

Dear Minister Hoffman,

Please accept my gratitude for the work that you and all of your staff do to deliver effective public health care in Alberta. I have had the privilege of personally receiving exceptional care in Alberta Health facilities throughout my life. I have also had many dear friends receive similarly exceptional care in Alberta Health and Covenant Health facilities.

I am writing today regarding Medical Assistance in Dying. One cannot spend time in a health care facility, or in society without facing the reality of death and considering the issue of Medical Assistance in Dying (MAID). I recently read a very powerful article on this issue, which I have provided an except and link to below. I strongly encourage you to take the time to read the article, it had me in tears as this issue is so profoundly personal. I have dealt with chronic, terminal illness and would not be alive if not for the miracle of organ donation and transplant. I have also faced, as we all do, the illness and death of many people I love. As you know, and have eloquently stated in the Legislature, MAID is fundamentally about human rights, as confirmed by the Supreme Court of Canada. As you prepare to receive the report from the Medical Assistance in Dying Regulatory Review Committee I would like to commend you on acting to provide access to this human right, with one notable and very problematic exception.

The exception that I am deeply concerned about, and beg you to reconsider, is allowing Covenant Health to refuse access to Medical Assistance in Dying for patients in its publicly run and publicly funded health care facilities. I agree with individual health care providers having the right to refuse to perform the ethically complex Medical Assistance in Dying procedure, but organizations do not have rights, humans do, and organizations cannot systematically withhold access to an individual’s human rights. Individuals who refuse to perform this procedure have a moral and legal duty to provide meaningful and timely access to professionals that will provide it. I believe that Covenant Health Policy No. VII-B-440, “Responding to Requests for Medical Assistance in Dying”, directly contravenes your Order respecting Medical Assistance in Dying Standards of Practice, and prevents access to a fundamental and legally confirmed human right for patients in publicly funded Covenant Health facilities.

As the attached article so clearly demonstrates, requiring the discharge or transfer of patients who are sick enough to qualify for Medical Assistance in Dying is simply not practical and amounts to a refusal of an individual’s right to this service:

“Two days before he was scheduled to die, John Shields roused in his hospice bed with an unusual idea. He wanted to organize an Irish wake for himself. It would be old-fashioned with music and booze, except for one notable detail — he would be present. The party should take up a big section of Swiss Chalet, a family-style chain restaurant on the road out of town. Mr. Shields wanted his last supper to be one he so often enjoyed on Friday nights when he was a young Catholic priest — rotisserie chicken legs with gravy. Then, his family would take him home and he would die there in the morning, preferably in the garden....

His newly developed plan for how he would spend his last moments, though, worried his wife, Robin June Hood. Her husband had not left his bed once since he arrived at the hospice on a stretcher, 17 days earlier. His 78-year-old body had thinned; his voice dimmed. He lasted only 15 minutes in conversation before his eyes fluttered closed. Just leaving the room would exhaust him. She knew he could not make it to the restaurant, and there was no way she could tend to his needs at home, even for one night — especially his last.

Happily, Dr. Green had become adept at brokering delicate family discussions over the past year... Many were too sick to devise elaborate rituals, but others had chosen the location, attendees, readings and music as if planning a wedding. Dr. Green called them something she picked up at a conference on euthanasia in the Netherlands: “choreographed deaths.”

She arrived at Mr. Shields’s hospice room that day to finalize the plans. The couple held hands as she helped them stitch a compromise. On March 23, the last night of Mr. Shields’s life, they would host a party in the hospice solarium with Swiss Chalet takeout for all. The next morning, he would die in his hospice room. Then, his wife and stepdaughter would take his body home and lay it out in his beloved garden for two days. The plan, Mr. Shields said that afternoon, was “absolutely terrific.”

I find the Covenant Health Policy on MAID morally and ethically reprehensible, and believe it to be illegal. I have had multiple close personal friends and family members placed in Covenant Health facilities (including the Edmonton General Hospital across the street from my home) purely because of a lack of capacity elsewhere. Most of these people were not Roman Catholic and would have preferred to receive care, and often finish their life in a facility not run by Covenant Health.

Please require Covenant Health to provide its patients access to this human right in the publicly funded health care facilities where they are placed. If Covenant Health will not do so, they should no longer be allowed to operate publicly funded health care facilities and these facilities should immediately be transferred back to Alberta Health Services. The phase out of Covenant Health would likely make sense from a cost efficiency perspective as well, but that is secondary to this issue of human rights.

Please provide a written response confirming that you have read my letter, and outlining your planned course of action on this critical human rights issue. Thank you again for all you, and your staff do for the people of our province. I count my blessings with every day of “donated time” that our health care system has given me as I watch my kids grow and revel in all the wonders of this world.

Respectfully Yours,

Justin Wheler

Cc: Honourable Rachel Notley, Premier of Alberta; Honourable Brandy Payne, Associate Minister of Health; Mr. David Shepherd, MLA for Edmonton-Centre; Patrick Dumelie, President and CEO Covenant Health.

References:

1. “At His Own Wake, Celebrating Life and the Gift of Death” By Catherine Porter. The New York Times, MAY 25, 2017 (https://nyti.ms/2rXBF0m).

2. O.C. 142/2016, Order respecting Medical Assistance in Dying Standards of Practice (http://www.qp.alberta.ca/documents/orders/Orders_in_Council/2016/616/2016_142.html).

3. Covenant Health Policy No. VII-B-440: Responding to Requests for Medical Assistance in Dying (https://www.covenanthealth.ca/media/122358/responding-to-requests-for-medical-assistance-in-dying-policy-vii-b-440-may-24-2016.pdf ).

Excerpts from Covenant Health Policy No. VII-B-440: Responding to Requests for Medical Assistance in Dying

Policy Statement: “The organization’s ethical and moral opposition to medical assistance in dying and the organization’s unequivocal position to not provide or explicitly refer for same needs to be recognized, respected and honoured by all persons served by, or working within Covenant Health including, but not limited to: funders, regulatory bodies, advocacy groups and the larger community.”

Principles: “...Covenant Health and its personnel are prohibited from participating in any actions of commission or omission that are directly intended to cause death...”

“Covenant Health recognizes and abides by all legislative requirements and regulatory standards governing access to medical assistance in dying elsewhere, while reciprocally, fully expecting others to respect Covenant Health’s institutional integrity as a [Roman] Catholic care organization and the conscience rights of its personnel to not provide or directly refer explicitly for same”

Procedure: “When, after discussion with the attending physician the patient still clearly expresses a desire for medical assistance in dying, alternative arrangements will be explored with clear communication that such practice is not provided in Covenant Health facilities.”

“If the person who desires medical assistance in dying chooses to stay in a Covenant Health facility, the patient/resident is informed that Covenant Health’s employees and volunteers do not provide or assist the person to fulfill this desire while the patient/resident is participating in Covenant Health services.”

Democracy in action... or inaction?

Well, its a big day for attempting a better world. A couple weeks ago I contacted the members of Canada's Senate to ask them to remove non budgetary items from the Budget Implementation Act (Bill C-10), specifically some disturbing changes to the Navigable Waters Protection Act (NWPA) that were highlighted by the Sierra Club: http://org2.democracyinaction.org/o/5654/t/3791/campaign.jsp?campaign_KEY=1092

I received some decent replies, but ultimately the Senate proved to be only slightly more effective than the House of Commons in making our 'democracy' work. There was some decent discussion, but a motion to split the bill into its budgetary and non budgetary parts was voted down: http://www.albertasenator.ca/hullabaloos/

I have not interacted much with Senators but based on the replies some of them are pretty worried about the path we are going down too. And since they know a lot more than me, that makes me even more concerned.

The redeemer is this:
Hello,Thank you for your email regarding Bill C-10, the Budget Implementation Act. I seconded a motion to split the non-stimulus provisions out of Bill C-10 and urged the Senate to adopt it today. Although many Senators were sympathetic, our motion failed. However, and this will be important for laying the ground work for future changes, the Senate did agree to refer non-stimulus subject matters to various committees for further study.
The Navigable Waters Protection Act goes to the Energy, Environment and Natural Resources Committee.
The Investment Canada Act and the Competition Act go to the Banking, Trade and Commerce Committee.
The Public Sector Equitable Compensation Act goes to the Human Rights Committee.
All other non-stimulus items go to the National Finance Committee.
I sincerely hope that you will contact the relevant committee and make arrangements to register your concerns. As a Canadian citizen, you have the right to be heard and it is important for the future of our country that you make this effort. Here is the link to the Senate Committees page which will give you contact information for the committee clerk and the names of Senators who are members of each committee.
Thank you for all your efforts and inspiration to date. Best regards, Elaine McCoy

So my attempts at a better world are to do just that. I am going to contact every senator on the relevent committees and see if I can register my concerns. So there may be more than one entry today but here is number 1, if anyone knows how to make this more effective please tell me:

Concerns with Bill C-10 relevant to your committee

mailto:eenr-eern@sen.parl.gc.ca,adamsw@sen.parl.gc.ca, anguswd@sen.parl.gc.ca, gautht@sen.parl.gc.ca, merchp@sen.parl.gc.ca, milnel@sen.parl.gc.ca, mitchg@sen.parl.gc.ca, russem@sen.parl.gc.ca, sibnic@sen.parl.gc.ca, spivam@sen.parl.gc.ca, stgerg@sen.parl.gc.ca, lebrem@sen.parl.gc.ca, comeag@sen.parl.gc.ca, cowanj@sen.parl.gc.ca, tardic@sen.parl.gc.ca

Dear members of the Standing Senate Committee on Energy, the Environment and Natural Resources,

I have never registered a concern with a Senate Committee before so I am unsure of whether this is the right way to do so. If it is not, please advise me on how I can go about doing this.

My name is Justin Wheler and I am a young Canadian Environmental Engineer with a reasonable level of knowledge and a high level of interest in Environmental Assessments and approvals and how development impacts society and the environment. The concern I have that pertains to your committee is with Part 7 from Bill C-10. Part 7 makes substantial amendments to the Navigable Waters Protection Act (NWPA) that are unrelated to budgetary matters, and were rushed through without adequate stakeholder consultation.

I love the outdoors, especially canoeing and am concerned that this change removes an important step in assessing whether or not projects involving waterways represent a net gain to society. The EIA process is vital to ensuring that all relevant information is brought forth by all affected parties for this type of decision. I am not comfortable removing this responsibility to the discretion of the minister. Passing this type of amendment to a completely unrelated matter under the cover of economic stimulus is completely inappropriate,irresponsible, and undemocratic. This is not the way our Canada should function.

I have many friends and family who have been directly affected by the current economic situation - whether it be through loss of retirement and rainy day savings, loss of jobs, or inability to find work upon graduating from university with a high debt load and little hope. It is a tough time for our economy, and our people. I am personally on a contract position right now that ends in July and I am a little worried about my prospects for finding fulfilling and engaging work after that date. But please, please do not let this tough time be an excuse for unrelated and irresponsible changes to the other parts of Canada that we hold dear.

When we protect public access to waterways in Canada, we are also protecting the natural environment of those waterways. I understand that it is important to initiate infrastructure projects to stimulate the economy, but we should not use that as an opportunity to dismantle safeguards put in place to protect Canada’s environment. In fact, these hasty changes to the NWPA will have serious repercussions for the recreational navigation, ecotourism, fishing, and hunting sectors of our economy, none of whom were consulted about these amendments. Our navigable waterways and the activities conducted on them are a core part of our Canadian Heritage. They provide value to our country in so many ways that are not accounted for in economic balance sheets, but are core to our economy and the well being of our communities nonetheless. The public right of navigation pre-dates Confederation, and it needs to be part of our future.

Including non-budgetary items in Bill C-10 has and will continue to slow down the process of passing the budget. Please separate non-budgetary items, such as the amendments to the NWPA included in Part 7 to allow for these important, long term issues to be dealt with separately in greater depth and expedite the process of passing the budget.

Please separate the proposed amendments to the Navigable Waters Protection Act from C-10, the Budget Implementation Act, so we can get on with the budget. It’s the best way forward for the environment, the economy, and democracy. I have been following some of the Senate discussion on this matter and dared hope that the discussions in your chambers were more attuned to the needs and rights of Canadians.

Please seriously consider the long term impact of your deliberations on this matter. We, the youth of this country, do not want to pay for this urgent economic crisis long into the future with the loss of our rights and our environmental integrity.

I will anxiously await the results of your deliberations on this matter.

Sincerely,

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