Covenant Health in Edmonton. Photo from Grandin Media

Euthanasia case results in apology from Catholic health care provider in Alberta

By  Thandiwe Konguavi, Canadian Catholic News
  • October 29, 2018

EDMONTON – At what point does a health care provider become complicit in the act of medically-assisted death? 

As more patients seek euthanasia or assisted suicide in Alberta, Covenant Health, one of the country’s largest Catholic health care providers, is gaining more experience in making that call, including from a case that made headlines and prompted an apology from the institution. 

As of Sept. 30, there have been 486 assisted suicides in Alberta since so-called Medical Assistance in Dying (MAiD) was legalized in June 2016. Of those, 64 patients were transferred from a faith-based facility that does not provide the service. 

Covenant Health was not able to provide the number of its patients who have been transferred from its sites for assessments, but at least one of those transfers didn’t go smoothly. 

In the spring of 2017, Doreen Nowicki was 66 and terminally ill with amyotrophic lateral sclerosis, also known as ALS or Lou Gehrig’s disease. She was receiving palliative care at the Edmonton General Continuing Care Centre operated by Covenant Health. CBC News revealed in a report on Oct. 23 that she was forced to have her assessment for assisted suicide on the sidewalk outside the facility after the hospital refused to allow it on their premises, despite having originally approved it. 

The event went against Covenant Health’s mission to provide compassionate care, said CEO Patrick Dumelie. 

“We ultimately concluded that we didn’t do everything we should’ve done to support this patient and family,” he said. “It’s really important for us as a compassionate, caring organization living our mission, that we don’t abandon people when they’re at their highest need. And so if you’re contemplating taking your own life, there’s no time that you’re more vulnerable. Something like this is really an adverse event. This isn’t how the system functions.”

Nowicki’s request for assisted death was eventually met through Alberta Health Services and she died June 5, 2017. For its part, Covenant Health has apologized to the family and learned from the experience, Dumelie said. 

Covenant Health considers health care an “immense responsibility and a calling,” Ed Stelmach, the board chair and former Alberta premier, said at its annual community meeting on Oct. 24. 

“It’s also challenging work and sometimes we don’t get it right, as you might have read in the news,” said Stelmach. “It requires humility and a commitment to learn and improve.”

Dr. Owen Heisler, Covenant Health’s chief medical officer, said the Catholic health care provider has since improved its system of determining who may have medically assisted death assessments done on its premises and who should leave their facility for assessments.

Covenant Health participates in some of Alberta Health Services’ five stages that people go through when they are considering medical assistance in death, including the “Pre-Contemplation” stage, where a patient is seeking information, and the “Contemplation” stage, where they might make an informal or formal request for more information.

“We’re happy to have that discussion with them,” said Heisler. 

Covenant Health does not participate in the third stage, “Determination,” where assessments are done to see if they meet the criteria, or the fourth stage, “Action,” where the patient’s life is ended.

The fifth stage, “Care after Death,” is where grief support and follow-up is provided for the family.

“After that happens, there’s a lot of distress. We’re more than happy to participate in five, talking to the family to make sure the loved one is respected and the family is respected,” said Heisler. 

The assessment stage, where an AHS navigator, or coordinator, meets with the patient and the family to determine whether the patient is a candidate for medical assistance in dying, is not allowed to be done on Covenant Health premises. Exceptions can be made in the case of “an extraordinary need,” said Heisler.

The Covenant Health policy providing exceptions to having assessments done on site is a measure of compassion, Dumelie said. 

“We don’t want to do more harm to the individual. We don’t want to treat them in a way that could even push them toward medical assistance in dying.”

When a patient is considering medical assistance in dying, Covenant Health’s policy is to seek ways of improving their palliative care, Dumelie added. 

(Grandin Media)

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