Alarm­ing gap in as­sisted dy­ing in Antigo­nish

The Casket - - Page Two -

ca­pac­ity (and there­fore el­i­gi­bil­ity for MAID).

Un­for­tu­nately, it is just a mat­ter of time un­til such a hor­ror story hap­pens here, too.

No Nova Sco­tia Health Author­ity or Depart­ment of Health and Wel­fare pol­icy pre­vents St.

Martha’s from re­fus­ing to al­low as­sess­ment or pro­vi­sion of MAID within its walls. Just the op­po­site, in fact.

The only of­fi­cial state­ment of­fered by the NSHA on this is­sue con­tains two ar­gu­ments for al­low­ing St. Martha’s to force pa­tients to be trans­ferred out for MAID: “There is prece­dent within our pub­lic health-care sys­tems, whereby faith-based health or­ga­ni­za­tions pro­vide com­pli­men­tary (sic) ser­vices to those ac­ces­si­ble through other ser­vice providers.

Not ev­ery ser­vice is avail­able at ev­ery pub­lic fa­cil­ity. In the in­ter­est of qual­ity, safety, ef­fi­ciency and ef­fi­cacy, our health sys­tem does not of­fer many ser­vices (car­diac surg­eries, births, hip re­place­ments to name a few) in all fa­cil­i­ties across the sys­tem.”

“A Mis­sion As­sur­ance Agree­ment was de­vel­oped in 1996 as the own­er­ship of St. Martha's Re­gional Hospi­tal was trans­ferred from the Sis­ters of St. Martha to the province of Nova Sco­tia. The Mis­sion As­sur­ance Agree­ment was made to en­sure that the Terms of Agree­ment doc­u­ments, phi­los­o­phy, mis­sion and val­ues of St. Martha's Re­gional Hospi­tal would re­main the same and the hospi­tal would keep its faith based iden­tity.”

Of course, there is a prece­dent in our health-care sys­tem in the sense that not ev­ery ser­vice is avail­able at ev­ery pub­lic fa­cil­ity.

How­ever, there is no is­sue of “qual­ity, safety, ef­fi­ciency and ef­fi­cacy” jus­ti­fy­ing non-pro­vi­sion of MAID in any in­sti­tu­tion in Nova Sco­tia; providers are will­ing to go to the in­sti­tu­tions and they can bring the equip­ment and sup­plies that they need with them. Qual­ity, safety, ef­fi­ciency, and ef­fi­cacy can be le­git­i­mate jus­ti­fi­ca­tions for not of­fer­ing some ser­vices, but they are not served by forced trans­fers for MAID. This pur­ported jus­ti­fi­ca­tion is based on an in­valid anal­ogy to spe­cial­ized care.

The ar­gu­ment based on the 1996 agree­ment is also in­valid.

The agree­ment signed between the Sis­ters of Saint Martha, Eastern Re­gional Health Board, St.

Martha’s Re­gional Hospi­tal and the Crown (as rep­re­sented by the Nova Sco­tia min­is­ter of health) would not sur­vive a chal­lenge un­der well-es­tab­lished prin­ci­ples of con­tract law and is there­fore not avail­able as a jus­ti­fi­ca­tion for the NSHA or DHW in seek­ing to de­fend a pol­icy al­low­ing forced trans­fers.

Fi­nally, the cur­rent ap­proach al­low­ing forced trans­fers vi­o­lates the Cana­dian Char­ter of Rights and Free­doms and the Nova Sco­tia Hu­man Rights Act.

For­tu­nately, there are at least three so­lu­tions. First, the Sis­ters Antigo­nish could agree to a com­pro­mise pol­icy that would per­mit St. Martha’s to refuse to al­low as­sess­ment or pro­vi­sion of MAID within its walls (by non-ob­ject­ing providers from out­side the hospi­tal), but only if the pa­tient can be trans­ferred to an­other lo­ca­tion with­out un­due harm or de­lay as de­ter­mined by the Nova Sco­tia MAID pro­gram.

Sec­ond, if the Sis­ters will not agree to this com­pro­mise, the Nova Sco­tia govern­ment could leg­is­late it. In­sti­tu­tions that re­ceive provin­cial fund­ing would then be re­quired to al­low the as­sess­ment and pro­vi­sion of MAID on their premises when the pa­tient can­not be trans­ferred to an­other lo­ca­tion with­out un­due harm or de­lay.

Third, al­ter­na­tively, the NSHA could sim­ply not re­new the 1996 agree­ment. Go­ing this route, the NSHA could cease to be bound by it as early as Sept. 28, 2019. Then MAID as­sess­ment and pro­vi­sion would be avail­able with­out com­pro­mise within what would pre­sum­ably be a re­named sec­u­lar hospi­tal.

If none of these so­lu­tions are adopted, Nova Sco­tia may soon have its own Doreen, Bob, Ger­ald, or Ian. Or Nova Sco­tia pa­tients who are, by def­i­ni­tion, ex­pe­ri­enc­ing en­dur­ing and in­tol­er­a­ble suf­fer­ing will have to use pre­cious time and en­ergy at the end of their lives to go to court to ar­gue for their rights to be re­spected.

For two and a half years, the NSHA and the health depart­ment have taken an ex­treme po­si­tion that puts in­sti­tu­tional re­li­gious free­dom far ahead of the suf­fer­ing of vul­ner­a­ble pa­tients. Time’s up.

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