Editor: Regarding recent news stories about hospice care and medically assisted death, I am a family physician who worked for several years in palliative and hospice care in Fraser Health.
While good hospice care can be very beneficial, and I would like to see it offered to everyone with a terminal illness, not all suffering can be alleviated with medication or other forms of treatment.
My belief is that the choice of a medically assisted death should be up to the individual patient, although proper screening and advice is of course necessary.
That said, I sympathize greatly with hospice staff who have devoted their careers to providing care that “neither hastens nor postpones death,” and who may or may not have their own religious beliefs that conflict with providing euthanasia, as they are forced up against changing public mores, laws, and institutional pressures.
In some ways this is not unlike termination of a pregnancy, a legal service that not very practitioner wishes to provide, but still triggers an obligation to refer the patient elsewhere.
However, there is an important difference here, in that the act of transferring a patient from hospice to another institution may fly in the face of the principles of hospice care by worsening the very symptoms that they have been admitted to ease, such as severe pain.
Another mandate of hospice is to provide a home-like environment where patients may spend their final days, and being transferred adds the stress and, often, disorientation, of moving to a strange locale.
Plus, as anyone involved in a health care profession knows, patient transfers do not always go smoothly, and there may be timing and jurisdictional issues that can lead to uncertainty and delays in medication administration. All of these factors much be considered as well.
In the end, none of us knows the suffering of the person who is near death, and the needs of the patient must come first.
It is up to us as professionals to respect the wishes of vulnerable people at the end of their lives.