It took Edna Kruger nearly a year in a hospital bed to succumb to the cancer she had been battling for five years.
Although she benefitted from excellent palliative care and was treated by a compassionate staff, Bradley Peters couldn’t help but feel that the system was failing his grandmother.
“In my mind it was a process that didn’t reflect her life values or her life experiences,” said the co-ordinator of the Edmonton chapter of Dying with Dignity, a group that advocates for better end-of-life care.
This was in 2009. Now, with the Supreme Court ruling that allows for physician-assisted suicide under certain conditions, the playing field is different.
Or is it?
Recently, while attending the 26th Annual Palliative Education and Research Days conference in Edmonton, Peters was shocked to learn that Covenant Health, a faith-based health care service provider, would not make this service available to its patients.
“This was surprising to me because Covenant Health is a publicly-funded institution and it essentially has, in some sense, a monopoly on palliative care institutions in Edmonton.”
Covenant Health operates 41 of the 70 palliative care beds in the Edmonton region, as well as 1,500 of the region’s long-term care beds.
Kruger was being cared for in a Covenant Health facility, as was Peters’ grandfather, not by choice, but because that’s where a bed was available.
Both could have benefitted from different end-of-life options, said Peters, who questions how that would be achieved under an institutionalized ban on physician-assisted suicide.
Would the patient be asked to move to a different institution? He said it would be unfair to ask someone living in pain to seek out another institution. Would the patient, knowing they would like the option of assisted dying, have to wait to access a facility that offers the service?
“When you arrive at the hospital it’s not like a restaurant. There isn’t a menu of services that they provide, where you can say ‘Oh, well maybe we’ll try the one down the street.’ I think it’s hugely concerning,” said Peters.
Peters said Dying with Dignity recognizes that assisted dying is all about choice for both the patient and the doctor. “Physicians should absolutely be able to say ‘I’m not OK with this, this is not a service that I provide,’” he said.
But doctors also have the responsibility to explore all viable options, make referrals if they do not offer a service and not abandon their patients.
He is worried that this will act as a barrier to access, which is why he is lobbying for the service within all publicly funded institutions. Covenant Health receives over 80 per cent of its funding from Alberta Health Services.
That could mean granting temporary privileges to family doctors to perform the procedure within a Covenant Health facility.
“I’m not sure how it’s going to look, but they need to come up with something,” said Peters.
Covenant Health did not directly respond to how it planned to address the new legislation.
In an emailed statement, Dr. Gordon Self, vice-president of Mission, Ethics and Spirituality, said that Covenant would continue to provide the same quality, palliative end-of-life care as it always has. This means neither hastening, nor prolonging death.
“We are confident we will find a way to respond respectfully and compassionately to requests for physician-assisted death that does not abandon the person in our care nor compromise the values of care providers or our organization,” said Self.