Man’s final day turns into painful ordeal

Catholic hospital denies plea for assisted death

A Vancouver man’s last day alive became an excruciating ordeal after the Catholic-run hospital caring for him rebuffed his request for a doctor-assisted death, forcing him to transfer to another hospital, his family says.

The combination of the cross-town trip and inadequate pain control left Ian Shearer, 87, in agony through most of his final hours, says daughter Jan Lackie.

“To hear him crying out, screaming … was just horrible,” said Lackie, breaking into tears as she recalled the day in late August. “That’s what keeps me from sleeping at night … I don’t want any other person to go through what he did.”

Ian Shearer’s experience at St. Paul’s Hospital highlights one of the thorniest issues concerning assisted death: the decision of most faith-based — but taxpayerfunded — health-care facilities to play no part in a practice made legal by the Supreme Court of Canada and federal legislation.

Lackie said the suffering her father endured shows why it is important that church-governed facilities, including dozens of hospitals, nursing homes and hospices across Canada, be required to allow assisted deaths within their walls.

“We have nine judges who said ‘Yes’ to medical assistance in dying,” she said. “I don’t understand how the Vatican has so much power, even here in Canada.”

The bill implementing the Supreme Court’s ruling, passed in June, includes no requirement that any institution permit the practice.

Catholic health administrators say the objection to assisted death stems from the organizations’ most basic beliefs, and note there are numerous other, less contentious procedures available at some facilities, not others.

“Life is sacred and the dignity of the person is important,” said Michael Shea, president of the Catholic Health Alliance of Canada. “These organizations neither prolong dying nor hasten death, and that’s a pretty fundamental value for them.”

Shaf Hussain, a spokesman for Providence Health Care, which operates St. Paul’s, said he could not comment on Shearer’s case specifically. But under a policy finalized this summer, he said, the Catholic organization arranges to transfer patients as comfortably as possible when they express a desire for assisted death.

Even the medical assessment required under the law and the signing of consent forms must take place outside Providence properties.

“All feedback we take very seriously,” said Hussain. “We’ll be working with our partners in the health-care system to ensure the patients’ needs do come first … and to minimize the discomfort and pain.”

Shearer, a retired accountant originally from Calgary, suffered from spinal stenosis — a narrowing of the spine that can put pressure on the spinal cord — heart disease, kidney failure and, toward the end, sepsis, said his daughter.

He spent about three weeks at St. Paul’s, the closest hospital to where he lived in Vancouver, said the Calgary woman. The spinal condition was so debilitating, “just to touch him, he would scream.”

Lackie said she was surprised by his request, but supportive, realizing that her father was dying “a slow, painful” death.

It would be days, however, before Shearer was transferred to Vancouver General, and on the designated date — Aug. 29 — the ambulance arrived more than three hours late, said the daughter.

The man’s dose of the pain drug fentanyl had been reduced to ensure he was lucid enough to consent to the assisted death, but as time wore on the pain grew worse, and there was a shortage of the narcotic on his ward, she said.

Already in agony, Shearer cried out desperately with each bump during the fourkilometre ambulance ride, said Lackie.

He eventually received the series of injections ending his life at Vancouver General, a “beautiful,” peaceful death, she said.

Dr. Ellen Wiebe, a B.C. physician who has carried out several assisted deaths, provided the service for Shearer, one of three patients from St. Paul’s she has seen for the same reason.

To get around the hospital’s ban on patients even being assessed there, she said she makes “flower visits”: masquerading as a friend bringing a bouquet.

Assisted-death bans cannot only lead to suffering during the transfer itself, but effectively deny patients the right in areas where there is no alternative to the faith-based institution, said Shanaaz Gokool, head of the group Dying with Dignity.

“This is going to be a real issue, and it’s going to be a real issue across the country.”

The facilities are causing vulnerable patients suffering because of a decision that benefits only the institution, argued Juliet Guichon, a bioethicist at the University of Calgary.

“How can such harm be justified?”