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Palliative care doctor slams Providence Health’s forced transfers of MAID patients

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Dr. Jyothi Jayaraman is calling on Health Minister Adrian Dix to pass legislation to prevent religious health organizations from opting out of providing MAID

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A palliative-care doctor says she quit her job at a Vancouver hospice after it was taken over by a Catholic health organization, Providence Health, which bans medically assisted death for seriously ill patients.

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Dr. Jyothi Jayaraman, who has provided medical assistance in dying since it became legal in Canada in 2016, said she’s witnessed 12 occasions in which patients were forced to transfer out of Providence-run facilities to receive MAID. Everyone has put the patient and their families through suffering in their final hours, he said.

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“Every single forced transfer is unbearable,” she said.

She is calling on Health Minister Adrian Dix to pass legislation to prevent religious health organizations from opting out of providing MAID.

Pressure has been growing for Dix to force Providence Health to change its policy following Postmedia News’ reporting of the case of Sam O’Neill. The 34-year-old Vancouver woman with terminal cancer was forced to transfer from St. Paul’s Hospital to another health facility to receive the medically assisted death she requested, an ordeal her family said robbed her of dignity.

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Since Postmedia first reported on O’Neill’s case, several other families have come forward to share their traumatic experiences with loved ones’ forced transfers at the end of life.

Jayaraman, who had been providing end-of-life care at May’s Place on Powell Street since January 2020, quit in February of this year after she was notified Providence Health would be taking over operations and banning MAID in the hospice. May’s Place is owned by a Vancouver non-profit, The Bloom Group.

Providence Health does not allow MAID in its facilities because it clashes with Catholic teaching that opposes any action that terminates human life. Jayaraman, who has been a palliative care doctor since 2001, said more than half of hospice beds in Metro Vancouver are run by religious health organizations that oppose MAID.

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Jayaraman raised his objections to the new MAID policy at May’s Place with senior leaders at Vancouver Coastal Health which provides funding to Providence Health.

“When I knew nothing I said would make a difference, the only option I had was to quit,” she said. “My whole job is to relieve suffering. I could not accept patients under my care being transferred.”

Jayaraman worked with Dying with Dignity Canada to gather the signatures of 161 health professionals on a letter to Premier David Eby and Dix calling for the end of forced transfers of MAID patients from religious-run health facilities. The health professionals have not received a response.

Postmedia requested an interview with Dix on Monday, but he was not made available. Providence Health did not provide a statement before the deadline.

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After May’s Place was taken over by Providence Health on May 28, an arrangement was made for Vancouver Coastal Health to offer MAID in a room in the same building as the hospice. For Jayaraman, that workaround is unacceptable and still requires patients to transfer from one location to another.

This workaround is also in place at St. John Hospice, which is where O’Neill was transferred to have her medically assisted death. Her family said the room seemed like a former storage closet. The hallway was too narrow so the gurney had to be awkwardly pivoted in the room a fraction at a time, they said, adding to the family’s grief before O’Neill’s death.

Sam.
Handout photo of Sam O’Neill, who died days before his 35th birthday, in hospital with his dog, Jack, and a friend’s dog, Bella. Photo by Gaye O’Neill /Handouts

O’Neill, who was in excruciating pain due to her advanced cancer, had to be sedated to the point of unconsciousness during the transfer and did not regain consciousness before the life-ending medication was administered. Her parents, Jim and Gaye O’Neill, said this robbed them of their final hours with their daughter.

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“Even this (designated) room to me is absurd,” Jayaraman said. Two weeks ago, Jayaraman accompanied a woman in her 80s suffering from advanced stage breast cancer as she was wheeled down a narrow corridor into the VCH-operated room to receive MAID.

Daphne Gilbert, a University of Ottawa law professor who is working on a legal challenge to BC’s master agreement that allows Providence Health to opt out of providing MAID, said providing a designated room for MAID operated by another health agency isn’t good enough.

It doesn’t address the larger issue that hospitals are being allowed to determine “on a values ​​basis what treatment people get in their facilities,” said Gilbert, who is vice-chairwoman of the board of Dying with Dignity Canada, which advocates fair access to MAID.

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Nine of the forced transfers Jayaraman has witnessed were from St. Paul’s Hospital, one from Mount Saint Joseph Hospital, two from St. John Hospice and one from the Salvation Army Rotary Hospice in Richmond, which is not a Providence-run facility.

Providence Health operates hospitals, long-term care facilities and hospice in Metro Vancouver including St. Paul’s Hospital, Mount Saint Joseph Hospital, Holy Family Hospital, Youville Residence, St. John Hospice and three branches of care homes under St. Vincent’s.

In the most recent fiscal year, it received $859 million in public funds.

Providence Health said that since medically assisted dying became legal in Canada in 2016, 402 of its patients have made formal requests for MAID and 131 have followed through with a transfer to other facilities.

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Quebec is the only province that does not allow religious health organizations to deny MAID requests thanks to legislation passed in Quebec in 2014, two years before the right to medically assisted dying was enshrined in Canadian law.

Dying with Dignity Canada’s CEO, Helen Long, has said individual health care workers have the right to conscientious objection and should not be forced to do something that conflicts with their beliefs but MAID practitioners should be allowed to provide care in any taxpayer-funded facility.

Jayaraman said he’s talked to many nurses and doctors in Providence-run facilities who fundamentally believe in providing MAID to patients who are suffering but are hamstrung by a policy coming from the top down.

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“I know for a fact that even they (health care staff) are outraged at what they have to do,” she said of the forced transfers. “To me, that’s the worst of it. Because we talk about conscientious objection, but these people are being prevented from doing what their conscience dictates which is to remain as supportive (to the patient) as possible.”

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