British Columbia’s physician regulator has cleared a doctor of any wrongdoing for sneaking into an Orthodox Jewish nursing home that forbids assisted death and ending the life of a resident who wanted to die in his own bed.
In a letter dated July 5, 2019, the College of Physicians and Surgeons of British Columbia (CPSBC) dismissed an official complaint against Ellen Wiebe, saying the Vancouver doctor did not break any of the regulator’s rules when she helped Barry Hyman, 83, die inside the Louis Brier Home and Hospital.
“The committee determined that it was not critical of Dr. Wiebe’s provision of MAiD [Medical Aid in Dying] to the patient at Louis Brier, noting that the patient had consented and that Dr. Wiebe had met all requirements for provision of MAiD,” the college’s inquiry committee concluded.
The case could have important implications for physicians, grievously ill patients and the religious hospitals and nursing homes across the country that banned doctor-assisted dying on their sites after the procedure became legal in 2016.
The CPSBC decision is believed to mark the first time that a medical regulator has weighed in on the thorny question of whether doctors could be professionally punished for defying the wishes of a faith-based health-care facility in order to fulfill those of a patient eligible for a medically assisted death.
However, the self-regulating colleges in each province – all of which have the power to grant and revoke medical licences – generally keep their decisions secret unless they send a case to a formal disciplinary hearing.
In this instance, Dr. Wiebe shared the college’s letter with the advocacy group Dying with Dignity Canada and The Globe and Mail. The CPSBC declined to comment, citing privacy legislation.
“It was what I expected,” Dr. Wiebe said recently of the inquiry committee’s decision. “I had done the right thing and I trust our College of Physicians to recognize that.”
David Keselman, the chief executive officer of Louis Brier, criticized the college’s decision and said his organization has tightened its credentialing and privileging process to prevent others from following Dr. Wiebe’s example.
“I think [the college] disregarded many of the elements that were in the complaint,” Mr. Keselman said, stressing how upsetting it was to learn afterward that a doctor had managed to sneak into the home without staff’s permission.
“We have quite a number of Holocaust survivors in the building. This is a huge concern … as this came out, it created a very significant level of anxiety and chaos, specifically for those individuals," Mr. Keselman said.
Mr. Keselman said Louis Brier does not abandon residents who want an assisted death − the home allows eligibility assessments on site, just not the end-of-life procedure.
Assisted dying is “definitely a complex and difficult issue for all,” said Bob Breen, the executive director of the Denominational Health Association, an umbrella organization for 21 faith-based health-care providers with 44 sites in B.C., including Louis Brier.
He said he had not seen the college’s decision in Dr. Wiebe’s case and could not comment on it.
Mr. Hyman, the patient at the centre of the case, had lung cancer and had suffered a stroke when he sought permission for a doctor-assisted death at the Jewish nursing home in the spring of 2017.
After Dr. Wiebe and a second physician concluded that Mr. Hyman met all the eligibility criteria of the federal law, his daughter, Lola Hyman, asked Mr. Keselman by e-mail if her father could die in his room.
A lawyer with the BC Civil Liberties Association also wrote the Louis Brier a letter on Mr. Hyman’s behalf.
Mr. Keselman declined to grant the request, writing that the home’s board and leadership had decided to provide care in keeping with the “Orthodox Jewish stream,” which meant it could not condone assisted death at the home.
On June 29, 2017, Dr. Wiebe and a nurse hid their equipment and lethal drugs in oversized bags, slipped into the home unannounced and helped Mr. Hyman to die, surrounded by his family.
“The college’s decision reflects Dr. Wiebe’s professionalism and her commitment to putting the patient at the centre of their own care,” Lola Hyman said in a recent e-mail. “Because of her, my father realized his deeply held wish to end his life in peace without having to leave his home. For this, I will always be grateful.”
Cory Ruf, a spokesman for Dying with Dignity Canada, said the college’s decision recognizes that long-term care facilities are people’s homes. “Requiring a suffering person to leave their home in order to access assisted dying is unnecessary and wrong,” he said.
For her part, Dr. Wiebe said she hopes the college’s decision will make other health-care providers "feel confident that they can do the right thing, which is to honour their patients’ wishes as much as possible.”
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