Balancing Religious Freedom with Medical Accountability in Assisted Dying

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How are rights to access medical assistance in dying (MAID) to be balanced with the rights of faith-based hospitals to refuse the service because of their religious values? This is a difficult question with no simple answer. On October 26th, 2017, members of all parties of the Manitoba Legislature seemed to share a common spirit when New Democratic Party Leader Wab Kinew noted that “we have to grapple with the tough issues, respecting the religious freedoms of practitioners but also the charter rights of those who may seek medical assistance in dying.” Allison Fenske of the Public Interest Law Centre has stated that the issue becomes “even more complex when you have … a religious institution that’s asserting a right to religious freedom but is also accepting public dollars. When they’re publicly funded, the government also has certain responsibilities in terms of respecting the rights of its citizens in the provision of its services.”

“We have to grapple with the tough issues, respecting the religious freedoms of practitioners but also the charter rights of those who may seek medical assistance in dying.”

It seems that a reasonable balance between these competing rights can be achieved, and Manitoba’s policy on MAID attempts to do just that. Manitoba’s policy was instituted in June 2017 when the federal government amended the Criminal Code to allow health professionals to offer MAID services. The provincial policy allows faith-based facilities to opt-out of providing MAID services if they so choose, but conscientious objectors such as Winnipeg’s St. Boniface General Hospital and Concordia Hospital have generally put in place policies to help patients inquiring about MAID services learn how to access them in a timely manner.

The current procedures, however, seemed to have let down 88-year-old Cheppudira Gopalkrishna at the Misericordia Health Centre. Gopalkrishna suffers from a form of Lou Gehrig’s disease and has been bedridden for months now at Misericordia, a religious institution that has chosen not to provide MAID services. Gopalkrishna was provided with a MAID contact card upon his inquiry into the services in May, but due to his illness, he was unable to use the phone to make the call until an anonymous Misericordia volunteer later assisted him in October. Since Gopalkrishna contacted MAID in early October, Misericordia has significantly delayed the usual process by fumbling with their responsibility to forward medical records to MAID services and stalling Gopalkrishna’s required medical assessment. MAID services claim to have only received the medical records after having the Winnipeg Regional Health Authority intervene in the situation. MAID services further allege that after receiving the records, Misericordia continued to prevent the required medical assessment from being scheduled because of “an executive being away.”

Typically, medical records are provided to MAID within days of the request. Likewise, the required medical assessment usually occurs seven to ten days later. In this case, a process that usually takes no more than two weeks occupied nearly the entire month of October, taking a total of twenty-five days. Misericordia notes that this was their first time dealing with MAID services, but Professor Arthur Schafer of the University of Manitoba had harsh criticisms of Misericordia, saying “the [MAID] committee requested the hospital to provide them with the patient’s records, because they can’t proceed without seeing whether the patient is eligible based on their medical records. And the hospital obstructed those efforts.” He concluded that Misericordia was “obstructing the rights of the most vulnerable, frail patients to have access to information about their legally entitled end of life options. It’s shameful, it’s cruel, and it’s inhumane.”

“They are obstructing the rights of the most vulnerable, frail patients to have access to information about their legally entitled end of life options. It’s shameful, it’s cruel, and it’s inhumane.”

Although Gopalkrishna’s situation was unfortunately and unnecessarily delayed, it is possible that Misericordia will make a sincere effort to do better going forward. Physicians and hospitals should certainly be able to refuse to provide services they have ethical objections to, but it is important that institutions taking public money work towards giving our most vulnerable citizens proper and humane treatment regarding end-of-life care. As both Manitoba and Canada adjust to the realities of medically assisted dying, we can only hope to do better for people like Cheppudira Gopalkrishna.

 

This blog post was written by a CCLA-PBSC RightsWatch student. Views expressed do not necessarily reflect the views of the CCLA or PBSC.

About the Author

Ryan Poirier
Ryan Poirier is a second year Law student at the University of Manitoba. He holds a Bachelor of Arts with a double major in both Political Studies and Economics.