A group of health-care professionals dedicated to improving palliative care is defending hospices in B.C.'s Lower Mainland that don't want to provide medically assisted dying to their patients.
"It needs to be made available, but it doesn't have be made available in every, every facility," Dr. David Henderson, president of the Canadian Society of Palliative Care Physicians, told CTV News.
"I think it needs to be the decision of that hospice."
In a letter to Fraser Health, the Canadian Society of Palliative Care Physicians argued that offering medically assisted dying could undermine the role of hospices as providers of comfort and care for those nearing the end of their lives.
“Both the public and many health care providers have had a longstanding fear of Palliative Care as they feared that it hastened peoples’ deaths… For 40 years we have been trying to educate the public and health care professionals that Palliative Care neither hastens or prolongs the natural process of dying,” the letter read.
“To now start having (medically assisted dying) available on Palliative Units and Hospices can potentially undermine the last 40 years of advocacy.”
The health authority, however, says all facilities in its jurisdiction should eventually provide medically assisted dying, but hasn’t set a timeline or said whether it will mandate the requirement.
Henderson said he isn't aware of any other health authorities in Canada that want all facilities to offer the procedure.
In its policy, neighbouring authority Vancouver Coastal Health says it acknowledges "the conscience rights of colleagues who do not wish to participate in assessment for or provision of medical assistance in dying."
On its website, the B.C. government acknowledges that "not all doctors or nurse practitioners will be willing or able to provide medical assistance in dying," but defers the responsibility to decide where the procedure is available to individual health authorities.
According to the Delta Hospice Society, there simply isn't enough demand to justify the rule, citing that only one person has been transferred out of Irene Thomas Hospice for the procedure since medically assisted dying was legalized 18 months ago.
A total of 28 patients were transferred out of hospice sites for the procedure in the entire Fraser Health region during that time.
"If you go into the history of what hospital palliative care is and the definitions that people use around it, including the World Health Organization, it excludes anything that hastens death," said Delta Hospice Society president Chris Pettypiece.
"I think people have expressed concerns about whether or not…hospice palliative care organization is the right place for such services to be made available."
Faced with concerns from volunteers, donors and staff, the society is now reaching out to the community for feedback before it decides what to do next.
The federal government introduced a Bill C-14 in April 2016 following a landmark Supreme Court ruling the year before that struck down the ban on medically assisted dying. The bill became law in June 2016.
A Health Canada report shows that, as of October, more than 2,000 Canadians had ended their lives with the help of a doctor.
With files from CTV Vancouver's Michele Brunoro