At least two places in Ontario have stopped providing medical assistance in dying because of the coronavirus pandemic.
The Champlain Regional MAID Network, which serves Ottawa and the surrounding area, issued a notice on Wednesday that it was shutting down the service in hospitals and homes to prevent the transmission of COVID-19 and to conserve health-care resources.
Hamilton Health Sciences, a hospital network with 10 sites, has also stopped providing assisted dying within its walls.
As the new coronavirus has swept across Canada, hospitals, physicians and local health authorities have been making wrenching decisions about which health-care services to cancel or postpone so that beds and staff can be redirected to fighting COVID-19, the disease caused by the virus.
In the case of medically assisted dying – which has been legal in Canada for nearly four years – some regions and hospitals are pausing the service during the pandemic, while others have deemed it essential and are loosening the rules to allow for more virtual assessments of eligibility for a medically hastened death.
With its MAID program suspended, Hamilton Health Sciences is offering to refer patients to willing MAID providers in the community, assuming grievously ill patients are capable of leaving the hospital.
“It’s not a decision that we have taken lightly,” said Andrea Frolic, director of the office of ethics and the MAID program at Hamilton Health Sciences. “It’s heartbreaking for us, as it is for patients and families seeking this care."
Several of the hospital network’s MAID providers have already been redeployed and elective procedures of all kinds are being delayed to make room for an expected surge of coronavirus patients, Dr. Frolic added.
The decision to suspend MAID in the Ottawa area was communicated in a bulletin dated March 25 and obtained by The Globe and Mail.
“After careful consideration of the principles to prevent COVID-19 transmission and conserve health-care resources, and in alignment with the provincial ramp-down of elective services, effective immediately, we will not be providing community MAiD procedures or in-patient procedures at The Ottawa Hospital,” said the note from the Champlain Regional Medical Assistance in Dying Network.
“Additionally, our partners at Home and Community Care will not be in a position to provide nursing support for independent practitioners who wish to provide MAiD in the community.”
The Ottawa Hospital and the program manager who sent the notice did not respond to requests for comment.
The Champlain Local Health Integration Network referred questions to the Ontario Ministry of Health, which said in an e-mailed statement that, “the ministry has not taken any action to limit access to MAID as a result of COVID-19.”
“I think it’s really unfortunate. I don’t know their rationale for having shut it down completely," Chantal Perrot, a Toronto MAID provider, said of the Ottawa decision. “I don’t understand how they could not see MAID as an essential service for people who are at end of life.”
Unlike Ottawa and Hamilton, the University Health Network in Toronto is continuing to provide MAID to inpatients during the pandemic. But the network will no longer offer short-term beds to UHN outpatients seeking MAID, except in extraordinary circumstances, Mark Bonta, director of MAID at UHN, said.
The network will refer outpatients to doctors in the community instead.
“We had to make some very difficult decisions with respect to other services and programs that were put on hold or shuttered during this pandemic," he said. "Given that MAID is something that is listed as a human right for our patients … we recognized it was important that this be deemed an essential service.”
Stefanie Green, a Victoria doctor and the president of the Canadian Association of MAID Assessors and Providers (CAMAP,) said the health authority on Vancouver Island has also deemed assisted dying an essential service.
Island Health is even making kits of personal protective equipment available to doctors who are still willing to help patients with grievous and incurable medical conditions die in their homes, Dr. Green added.
CAMAP sent letters this week to the regulatory colleges that govern doctors and nurses in every province asking them to allow for more virtual care in the lead-up to providing an assisted death while the pandemic rages.
British Columbia and Nova Scotia have already temporarily amended some of their MAID rules in a bid to expose fewer health-care professionals to the risk of catching the coronavirus.
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