B.C. cuts funding to hospice that refuses to provide medical assistance in dying

Open this photo in gallery:

A community-built hospice in Delta, B.C., that refused to allow its patients access to medical assistance in dying will lose its public funding and could forfeit its building for its failure to comply with provincial policy.

The Irene Thomas Hospice, a 10-suite facility run by the non-profit Delta Hospice Society, receives 94 per cent of its operating funds from the Fraser Health Authority. It is also built on land that is leased from the province for $1 annually. B.C. Health Minister Adrian Dix said Tuesday that the society’s contract will be cancelled in one year, a delay designed to allow the province time to develop alternate hospice beds in Delta.

“The recent decision by the Delta Hospice Society to ignore the choice of an individual to have access to needed services at the Irene Thomas Hospice is contrary to our provincial policy,” Mr. Dix told a news conference in Victoria.

He said the health authority exhausted its options in seeking to persuade the hospice society to allow patients to seek medical assistance in dying, or MAID, in accordance with provincial policy. That policy has been in place since 2016, when Canada legalized doctor-assisted death. Last fall, the board of the Delta Hospice Society finally agreed to comply, but then at an annual general meeting in November, a new slate of directors was elected that reversed the previous board’s decision to allow MAID at the hospice.

“There’s been a lot of patience shown here,” Mr. Dix said. Access to MAID “is not a decision that any organization can influence or impose on patients. Put simply, an individual has the right to make a choice to receive medical assistance in dying, where they reside, in British Columbia.”

Since MAID was legalized, more than 3,000 British Columbians have opted for a doctor-assisted death. Although most of those deaths occurred in a residential home, the province requires that hospitals, care homes and hospices that receive at least half of their funding from the public purse must allow MAID access. The rationale is that those places may serve as a terminally ill patient’s final home, but faith-based facilities are exempt.

Terry Lake, the former Liberal health minister who devised the policy, said Mr. Dix has taken “a reasonable approach" in this case. “The law has been out there a long time,” he said in an interview. “He can’t allow one hospice to make up its own rules.”

Ellen Wiebe, a physician who provides MAID and is a clinical professor at the University of British Columbia’s faculty of medicine, said Mr. Dix needed to take a stronger stand on behalf of patients’ rights, but he opted for the “political way forward” instead. She said she is familiar with cases of patients who are denied access to MAID because they happen to be living in a faith-based facility.

“It’s happening all the time, and it’s horrible,” she said. “These are people who are so vulnerable, they can’t take care of themselves, it is much harder for them to advocate for themselves.”

It’s not clear what will happen to the Irene Thomas Hospice when the contract is cancelled. The province has the option to take it over, or the hospice society could seek its own sources of funding to replace the $1.5-million paid by the health authority each year. Officials from the Delta Hospice Society would not comment.

The Health Minister said his goal is to ensure hospice services are not disrupted in the community, and that patients who are legally eligible for MAID are not denied that right.

“It provides individuals with agency at a moment when everything else in their lives has been stripped away,” Mr. Dix said. He likened the challenges at this facility to the battles over access to abortion services in B.C. in the 1980s, when the election of hospital boards became battlegrounds between pro-choice and anti-abortion factions.

“A debate in this way is not the appropriate thing,” he said.