Hospice volunteers push back against assisted suicide pressure

SURREY—Assisted suicide was legalized just over a year ago, but the debate is far from over.

Various health care workers and volunteers are continuing to fight the practice in the face of increasing pressure to end the lives of their patients.

“I’m speaking on behalf of the sick and most vulnerable who cannot advocate for themselves,” Nancy Macey, the executive director of Delta Hospice Society, told The B.C. Catholic Feb. 6.

Macey, who created the non-profit on her kitchen table 25 years ago, was horrified to find out the Fraser Health Authority was moving ahead on plans to force hospices to provide assisted suicide, popularly termed medical assistance in dying (MAiD).

That was before Christmas, and now she and many others are raising the issue with local politicians, the media, the Fraser Health Authority, and with anyone willing to listen.

“Hospice palliative care, as defined by the World Health Organization, does not hasten or prolong death,” Macey wrote in a letter to Health Minister Petitpas Taylor and seven local politicians Feb. 1.

Assisted suicide, Macey said, runs contrary to these principles. She wants to see hospices have the ability to opt-out of providing assisted suicide on site, and instead transfer patients who want the lethal injection to their homes or other facilities.

“What we’re concerned about is if you introduce euthanasia into (hospice care), it’s going to put up barriers to access.” She’s worried the consequences of forcing assisted suicide into hospices, especially those that don’t want to participate, will only make matters worse for the majority of the dying.

“Those who choose to have MAiD represent one per cent of the population,” she said. “The euthanasia people have choice anywhere they want it. Where does the choice come for the people who don’t want to be in an environment with euthanasia?”

Hospice supporters say imposing assisted suicide would exacerbate the already difficult problem of providing quality palliative care to all Canadians: only about 30 per cent can currently access it.

They say the majority of terminally ill patients who won't seek assisted suicide might fear entering a hospice. 

“If people are afraid to access it, there is going to be more suffering,” said Macey. “There is going to be people ending up in emergency departments, there will be caregiver burnout, and people will die in emergency care and hospitals, all the stuff we’ve been working on for 25 years to avoid.”

The Delta Hospice Society operates under contract with Fraser Health and is not required to provide assisted suicide under current policies. The Langley Hospice, however, is affected.

“To mix MAiD with hospice care makes absolutely no sense,” said Kiernan Hillan, a volunteer at the Langley Hospice for four years.

“It’s contrary to the whole direction the hospice should be going in. It’s not a place of killing. It’s a place where you live your last moments. You’re not going there to decide that you’re going to die. You’re going there to live your last moments to the fullest possible.”

Hillan is passionate about caring for the dying and feels it’s important to be there as one of the few male volunteers and employees. However, he’s worried that if assisted suicide is forced in, he will be forced out.

“We love people, we care for people, we listen to them, we make coffee for them, we get a blanket, and we help them when they eat. But now comes a point where we’re supposed to support them when they make a decision to end their life? No, that doesn’t make sense,” he said. “If I’m sitting there as a volunteer and someone in the next room would be having MAiD, I don’t know if I could be in that facility.”

He’s not the only one worried that existing hospice staffing issues will get worse. Already, high-profile medical professionals like Doctor Neil Hilliard, the executive director of the Fraser Health Palliative Care Program, are resigning over the issue. And Vancouver family physician Dr. Williard Johnston penned a column calling on Fraser Health to “back down” and stop “bullying” hospices.

“It’s a very dangerous place to go,” said long-time Langley Hospice supporter Michele Coleman. She said hospices also stand to lose substantial donations.

“We have a number of people who are very much against MAiD who will withdraw their funding and support,” said Coleman, who solicited funds for the hospice while on the foundation’s board of directors for 16 years.

Those funds contribute to beds, staffing, and grieving programs. “They do a fantastic children’s camp for children who have lost parents, grandparents, or siblings,” offer various types of counselling, and host vigils at the bedsides of people who would otherwise die alone.

“All of this type of thing is at jeopardy” if the hospice loses donors who don’t support MAiD.

Retired family doctor Karen Mason also volunteers at Langley Hospice. She has recognized suicide contagion as a real issue in her practice and worries about the impact it could have in hospice settings.

“If a kid commits suicide in a high school, they bring a counsellor in to talk to the other ones because they know the chance of more suicide is higher. I spent my whole career sending people to psychiatric units because they were suicidal and needed help,” she said.

In hospice care, “people feel the pressure because they don’t want to be a burden for their families” and could be more vulnerable to suicide contagion.

“It’s been a long, long journey to convince society as a whole that palliative care isn’t something you need to be afraid of. If you put MAiD in palliative care, people are going to be afraid again.”

At a public board meeting Feb. 7, Fraser Health board chair Jim Sinclair told Macey and other concerned hospice workers the health authority is open to continued talks about the issue. He did not indicate whether the policy would be changed.