How will palliative care fare in Canada?

A member for Canadian Physicians for Life says requiring provision of assisted suicide by Catholic hospitals and by hospices will have disastrous results for palliative care throughout the country.

Karol Boschung, a second year medical student at University of British Columbia, wrote an opinion piece in the Edmonton Journal Nov. 15 expressing concern for the effects of forcing out Catholic healthcare providers.

“Bullying Catholic health-care providers into compliance will not result in expanded access to medical care for all Canadians. If forced to perform procedures which compromise its morals, the Catholic Church may be pressed into withdrawing from the administration of organizations like Covenant Health,” she said.

Covenant Health is one of the major health care administers for Alberta, she said, noting the Catholic health service provides over one-third of palliative-care beds for this province.

According to Covenant Health’s figures in 2008, the organization had more than 8,800 staff across 11 sites. The report states that the budget for 2008 was $514 million, which helped served more than 2,300 beds.

“What might happen to these beds if the government found itself on the hook for purchasing these facilities?” she asked.

“Indeed, attempting to push the Catholic Church out of the administration of Covenant Health would reduce, not improve, access to palliative care and other essential services.”

Boschung spoke on the recent media attention around Doreen Nowicki, who had ALS and committed physician-assisted suicide in 2017. On Covenant Health property, Nowicki had been denied access to the exams to determine the patient’s eligibility for assisted suicide

While sympathizing with the struggle of ALS, Boschung said assisted suicide is not an intrinsic human right as argued by the ethicist Arthur Schafer, who supported Nowicki in a story last month by the CBC.

“We are talking about a fundamental human right, not a privilege to be bestowed at the discretion of a Catholic or religious bureaucrat,” Schafer told the CBC, noting that Covenant’s position was morally inexcusable.

Boschung said that since assisted suicide was decriminalized by the Supreme Court of Canada’s Carter v Canada decision in 2015, assisted suicide “has gone from a criminal offence to a broadly-accepted practice — even a ‘fundamental human right,’ even though legally it is nothing of the sort.”

She added that pressure to provide assisted suicide has affected not only Catholic organizations.

“For example, the Delta Hospice Society, a secular hospice in B.C., was embroiled in controversy earlier this year when the local health authority attempted to bully them into making physician-assisted suicide available on their premises, despite strenuous objections by hospice founders and operators.”

“The operators correctly maintained that PAS was incompatible with the philosophy of hospice palliative care, and that to force them to provide this service was incompatible with the mission of the hospice itself,” Boschung wrote.

Boschung said enforcing PAS is a shorted-sighted solution – a move which will reduce palliative care to ensure the availability of assisted suicide.

“If we really care about the sick and dying, the last thing we need is an approach that leads to a reduction in the availability and diversity of end-of-life care,” she said.

“To push for such an outcome would be a triumph of ideology over practicality.”