Critics of St. Boniface ban on medically assisted deaths 'disingenuous': ER doctor

The debate over a policy at St. BonifaceGeneral Hospital, one of only two locations in Winnipeg that offers palliative care, to ban assisted deaths appears to be far from over.

One emergency room doctor and medical ethicist argues it's "a little bit disingenuous" for people who have benefited for years from faith-based care to now criticize the hospital for its decision.

But a former chair of the St. Bonifaceboard argues it's important that the hospital put the needs of the patient before the values of the institution.

Murray Kilfoyleresigned in protest after a June 12 vote thatreversed an earlier amendment allowing assisted deaths in special cases. He said he thought of what he would want for hisown mother if she were in palliative care at St. Boniface and wanted a medically assisted death, but would have to transfer to a hospital where it's allowed.

"Ithurts me," he said.

"It hurts me that a process is being imposed on them that they don't want, that they haven't requested, and that process is likely to cause them stress, burden, pain that is not compassionate health care,"Kilfoylesaid Wednesday.

"The intent of the amendment was to say, in rare circumstances, if the medical team feels that a patient can't be transferred that the act would take place at the hospital."

The amendment was only overturned after the Catholic Health Corp., the organization which governs the hospital,added members to the hospital's board before a revote.

Patients at St. Boniface Hospital are now allowed to be assessed by the Winnipeg Regional Health Authority's medical assistance in dying, or MAID, team, but if they qualify for the procedure, they must be transferred somewhereelse to receive it.

"Personally, I believe it's impossible for the medical practitioners to prevent that from being harmful, painful, upsetting, burdensome to the patient," said Kilfoyle. "I'm convinced of that."

He believes even moving a patient from one room to another puts stress on them, if they are sick and in pain.

That view is shared byDr.Marcus Blouw, a former member of the St. Bonifaceboard, who told CBC Tuesday he believes St. Bonifaceis violating charter rights with its new policy.

'Tremendous value' of religious organizations

Dr. Merril Pauls, a Winnipeg emergency room doctor and medical ethicist, argued what's missing from the ongoing debateis an appreciation for the great contributions the Catholic Church has made to St. BonifaceHospital.

"The conversations fail to recognize the tremendous value that religious organizations in general, and the Catholic Health Corporation with regards to St. Boniface, add to health care," Pauls said.

Records show the hospital brought in $15 million from "other income" last year, which includes donations from followers of the Catholic faith. For a point ofcomparison, thehospitalreceived $352 million from the Winnipeg Regional Health Authority.

Paulssaid his personal experience working at the hospital and seeing the care his relativesreceived there has shown it to be a compassionate place that treats patients with dignity values rooted in Catholic traditions, he said.

"I think it's ironic, or a little bit disingenuous, that people will have benefited from that health care regardless of their religious affiliation for years and years [and]now suddenly become very upset."

Transfers common practice: ER doctor

Pauls, who describes himself as a member of a Christian church but not a Catholic, said patients are wrong to think they are entitled to medically assisted death at St. Boniface.

"I don't think it's true that people have a legal or ethical right to receive any specific intervention or care at any specific place," he said.

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Transferring patients from one hospital to another is a common practice in Winnipeg and patients who require medicalassistance in dying are not unlikepatients who, for example, require a special scope or test not available at their admitting hospital, Pauls said.

"There are other options, whether they are things like terminal sedation that can actually address concerns about somebody being too unstable or too ill to move," he said.

Kilfoyle, while not a doctor, thinks differently. Oneor two patients suffering in transit is one or two too many, saidKilfoyle,andthose in their final moments who wish to end their suffering should be treated as an exception, and treated where they wish to die, he said.

He added the patients who are beingtransferred for the MAID service are some of the sickest and most vulnerable and are unlike other patients who might have to travel to another facility for a test or procedure.

Andit's a decision based on religion not the absence of a service or piece of equipment that's forcing the patient to travel to another hospital toend their life the way they've chosen, he said.

Documents from St. Boniface say at least one patient has already died after being transferred from that hospitalto the Health Sciences Center to receive a medically assisted death.

"We should be in the business of not harming patients and being compassionate with them. If we unnecessarily harm one patient, then that's not a good thing," said Kilfoyle.

"I'm not the only one that feels that way."