Palliative care doctor calls for broader change as province discusses allowing MAiD at St. Paul’s Hospital

Dr. Jyothi Jayaraman has been a palliative care physician in Vancouver for more than 20 years. And when medical assistance in dying was approved in Canada in 2016, she became a MAiD practitioner.

“One of the criteria for eligibility is intolerable suffering. So when a patient says I’m ready to die, what they’re saying is I cannot suffer anymore,” said Jayaraman.

But she says the policy at St. Paul’s Hospital to transfer palliative care patients who’ve been approved for MAiD to other facilities in the final hours of their lives causes even more suffering.

“I have borne witness to many, many of these transfers, as have my colleagues,” said Jayamaran, who is one of more than 160 local health-care professionals who wrote to the premier this spring asking him to stop the forced transfer of MAiD patents from facilities run by faith-based organizations like Providence Health Care, which oversees St. Paul’s.

“We really heard nothing back. So it seemed as if our lived experience of witnessing forced transfers had no meaning at that point,” she said.

Then Sam O’Neill’s story came to light.

The 34-year-old terminal cancer patient had to be sedated for her transfer from St Paul’s to a hospice to undergo MAiD in April, and she didn’t wake up to say goodbye to her loved ones.

“Sam’s situation captured I think the country,” said Jayaraman. “There is talk now in the country about: How is this happening? Most people can’t believe it’s happening. Let me tell you that I have seen enough.”

And it appears the provincial government has also seen enough. Health Minister Adrian Dix is now in discussions with Catholic-run Providence Health Care about setting aside its religious objections and allowing MAiD to happen at St. Paul’s using outside practitioners.

“We are talking to them, and I expect this issue to be resolved,” said Dix. “We are starting with St. Paul’s because circumstances in acute care are often different. When you’re going to acute care, you’re not choosing at all. So this is the place to address things, and that’s what we are working with Providence on.”

Dr. Jayaraman argues pushing for change at St. Paul’s isn’t enough. “This is not a time for half-measures. This is not a time to say, St Paul’s will allow it, and it’s only because it’s an acute care facility.”

She says long-term care and palliative care patients often have no choice about where they end up. And if the facility is faith-based, they’re also forced to move to undergo MAiD.

“In long-term care (patients) have moved there sometimes five to six years ago, that is their home. They pay rent, it’s recognized as their home. Why should they be moved out of their home?” she said.

Jayaraman is advocating for an end to all forced MAiD transfers from publicly-funded health- care facilities, a fight she says has become a calling.

“I think this is something that needs to be stopped, and I’m prepared to do whatever I can,” she said.