Health minister says delayed access to medical assistance in dying 'should not happen'

Manitoba's Health Minister says he doesn't know all the details of a terminally ill Winnipeg man's search for medical assistance in dying, but he's troubled by his first impression of the case.

Cheppudira Gopalkrishna, 88, told CBC News he has no chance of recovering from the illness that has confined him to bed for months, and the Misericordia Health Centre hasn't helped him access the province's medical assistance in dying (MAID) services.

However, the faith-based hospital — which is part of the Winnipeg Regional Health Authority — and the health authority's MAID team offer differing accounts of what transpired and the timeline of Gopalkrishna's request.

The hospital also describes itself on its website as being affiliated with the Roman Catholic Archdiocese of Winnipeg.

"Our heart goes out to the individual, that is No. 1," said Health Minister Kelvin Goertzen in question period on Thursday. "But I have sought more information because as the facts are presented, this is something that should not happen."

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Manitoba introduced its policy on medical assistance in dying in June, the same month the federal government amended the Criminal Code to allow doctors and nurse practitioners to help patients with "grievous and irremediable" illnesses to die.

Since then, Goertzen said the province has generally struck "a good balance" between patients' right to access the service and the right of physicians to abstain from providing it.

Winnipeg's other faith-based hospitals, St. Boniface General Hospital and Concordia Hospital, have already banned the practice as conscientious objectors, but Goertzen said those institutions have also put in place procedures to ensure patients who seek out MAID can access information they need.

"At first blush, that doesn't appear to have been the case here. So we will be seeking more information on that," Goetzen said.

"If there have been — as it appears there have been — breakdowns or problems in this process [then] they need to be corrected, because we will follow the Supreme Court's direction in terms of access to medical assistance and dying."

MAID policies from all hospitals are due to be complete next month, Goertzen added.

Health authority must do better: president

Réal Cloutier, interim president of the WRHA, said based on the facts he's seen, the case demonstrates a need for better communication between the health authority and the Misericordia to meet Gopalkrishna's needs.

"As late as last evening, we had a discussion with the CEO of Misericordia and we said, 'We need to sit down together to figure out how we can improve here,'" Cloutier told reporters at a news conference on Thursday.

"Because it's not only the time in terms of when [the] MAID [team] is contacted, and the time to get access to information, but also the time that elapsed from when the first time that interest in MAID was voiced by the individual."

Allison Fenske, an attorney with the Public Interest Law Centre, said Canada doesn't have a "hierarchy of rights," so the right for institutions and individuals to provide MAID as part of religious freedom can be pitted against a patient's right to access it.

"It all becomes even more complex when you have … a religious institution that's asserting a right to religious freedom but is also accepting public dollars," Fenske said.

"When they're publicly funded, the government also has certain responsibilities in terms of respecting the rights of its citizens in the provision of its services."

Cloutier said faith-based hospitals usually function within the health authority as a piece of the larger health-care system.

"Where sometimes things get difficult are on complicated ethical, policy issues like this," he said.

"But from our perspective, the health-care system is a taxpayer-funded system. We have a duty and a responsibility to co-ordinate and administer care in the region, and in large part we do that every single day."

Premier, NDP leader recall moments of loss

NDP Leader Wab Kinew raised the issue in the Manitoba Legislature during Thursday's question period, recalling his father's death from pancreatic cancer and the moment when his dad said he understood why some patients seek out medical assistance in dying.

"It was in that moment that I began to understand that sometimes, being compassionate means offering an end to suffering for some people in our society," Kinew said.

"I think that's why we have to grapple with the tough issues, respecting the religious freedoms of practitioners but also the charter rights of those who may seek medical assistance in dying. And so I would ask the first minister if he can commit to strong palliative care, strong mental health services and, for those who do request it, access to medical assistance in dying."

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Premier Brian Pallister responded by thanking Kinew for his question, and saying everyone, regardless of party affiliations, shares the pain of losing a loved one. Pallister lost his mother-in-law earlier this year.

The premier added the issue drives home the importance of ongoing health-care changes in Winnipeg.

"We must face the challenges of change. We should do that together."