B.C. doctor predicts ban on assisted death in faith-based institutions will go to court

Dr. Jonathan Reggler says he's certain a ban on assisted death in faith-based institutions in B.C. will eventually wind up in court. 

Reggler is an assessor and provider of medical assistance in dying (MAiD) on Vancouver Island. 

He says patients in many faith-based hospitals and residential care homes have to be transferred to a different facility to have an assisted death.

In B.C., the Denominational Health Association (DHA) includes 44 faith-based facilities.

Although many of these institutions do not allow medically assisted deaths on their premises, most do support the assessment and transfer of patients.

However, according to Reggler, this process can be extremely arduous for both the patients and the family. 

Reggler had a patient in a faith-based hospital who wanted an assisted death, and says he begged the CEO to allow him to carry it out at the facility.

Died on the day of transfer

"The family looked into trying to get a court order," Reggler said. "But the patient's condition was so poor that the legal process would have taken too long."

Reggler says the patient was transferred out of the hospital, but their condition rapidly deteriorated. 

"They died on the day of the transfer," Reggler said.

"The receiving doctor in Nanaimo had to essentially give the patient something called palliative sedation, which was not what the patient wanted."

Reggler adds the transfers can be extremely painful for the patient, because they can't be given too much medication over fears they will lose their mental capability to consent to MAiD. 

"I've seen patients arriving in their home in great pain, because we have to be careful with the amount of medication they give a person to enable a transfer."

Christopher De Bono is the vice-president of mission at Providence Health Care, a Catholic organization and a member of the DHA. 

De Bono says Providence Health Care does not allow assisted death in its facilities like St. Paul's Hospital in Vancouver, but it has developed a MAiD Response Lead to facilitate transfers. 

"We've actually had 12 transfers of care for persons that were interested in pursing medical assistance in dying in other locations," De Bono said. 

"And out of those, we have very few that are eventful."

Providence Health did apologize last year for problems that occurred during the treatment of a patient who was transferred for MAiD. 

No bed available

According to documents received through Freedom of Information by Dying with Dignity, there was a delay in the signing of the MAiD documents while the patient was at risk of losing the mental capability to consent. 

In addition, when the patient arrived at Vancouver General Hospital there was no appropriate bed available.

Although Reggler's own patient could not wait to go through the courts, he is certain there will be a legal constitutional challenge. 

"It will come from someone who is either stable and suffering in an acute care hospital or a person who is living in a residential care home," Reggler said. 

"I believe they will decide, 'I am not going to move. I should not have to put up with the suffering. I should not have to leave my home.'"

Reggler adds he is extremely confident the courts will come down in favour of the individual and not the institution. 

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According to figures shared by the B.C. Ministry of Health, from June 2016 to November 2017, 61 patients were transferred from facilities that do not provide access to MAiD in order to receive the service.

In a statement, the Ministry of Health also confirmed there are no plans to terminate the agreement with the DHA.

To hear more, click on the audio link below:

A Good Goodbye is a radio and digital series exploring medically assisted death in B.C. Tune into your local CBC Radio One morning show Jan. 29–Feb. 1.