When a hospital denies MAID: A forced transfer story

Personal Stories | June 21, 2024 | Vicki Moulder

Home / Personal Stories / When a hospital denies MAID: A forced transfer story
Two images of Vicki's father being transferred by stretcher from the hospital to his home

In April 2023 my father invited me to a doctor’s appointment where we discussed his end-of-life care with a physician. At this time, he made it known that he wanted medical assistance in dying (MAID) rather than spend months suffering from end-stage COPD. Breathing had become increasingly difficult, and he was experiencing major anxiety not being able to do the things he liked to do. The doctor clearly understood his directives. In February 2024, my father was suffering from extreme loss of breath and excruciating pain and was admitted through the emergency department at the hospital he had been receiving his ongoing COPD care. 
The emergency physicians administered a talc pleurodesis (TALC) to prevent the continued build-up of fluid in his lungs. They discovered he had a compression fracture in his spine likely caused by his osteoporosis. In addition, he had a perforated eardrum, glaucoma, and possible UTI. 
The doctors assured him that in a transitional care facility he may be able to be rehabilitated to the state he was in prior to his hospital admission. At this time, he stated he wanted to move forward with MAID. This request reshaped the kind of care moving forward. He was transferred from a room on the diagnostic floor to the one on the palliative care ward. 
Finally, after three weeks of requesting MAID, my father learned that the hospital did not support this procedure because of its religious affiliations. Instead, they offered palliative sedation. You can read more about palliative sedation here. The belief is, by administering high doses of pain medications and inducing a coma your loved one will die naturally with comfort care. My father did not want palliative sedation; this meant our family was now responsible for arranging his release from the hospital and transport via ambulance, to a place where MAID could be administered. 
With all the love in my heart, I cannot emphasize enough having to transport a dying loved one out of a hospital so that they can receive MAID in my opinion is cruel and promotes undue suffering. Our family was so thankful for the support of MAiDHouse who were able to provide resources and immediate one-on-one support. 
There was resistance from the hospital to allow my father to go home a day before the MAID procedure. They explained that it is difficult to care for a person who is dying. The MAiDHouse representative gave us the confidence that it was my father’s right to leave the hospital if he wished, and that there are resources we could utilize to care for him over a 24-hour period. With this new information, I explained to the hospital, again, that we were ready to take him home. Ultimately, what moved things forward was my father’s granddaughter who is an RN. The hospital reacted much more favourably to his release knowing she would be present for the duration of his care. 
The day before, the ambulance attendants wheeled him out of his room, onto the street and half a block to where they could find a parking spot. He was shuffled through his senior apartment building lobby which was deeply disturbing for him and the residents. The building was ADA compliant, so it was easy to maneuver the gurney to his unit. Fortunately, he was strong enough to be able to help himself and with assistance to get to the bed. 
In preparation for his arrival, we had pre-purchased a mattress cover, a large mattress pad, handrail and a foam wedge so that he could sit up and not smother from the fluid collecting in his lungs. We had also bought him food of his choosing and comforts that he would not have had in the hospital. In a lot of ways, it was beautiful to have him at home surrounded by the people he loved, and for that I’m truly grateful. On the other hand, it was egregiously punitive under the circumstances. 
These are the lessons learned from our experience: 
1) Meet with your loved one’s palliative care team in advance. Let your loved one make their wishes known if they are electing to have MAID as part of their end-of-life care. 
2) Understand the funeral arrangements. Make sure your loved one and you have a clear understanding of what they would like done after the MAID procedure. 
3) When considering what hospital or provider you get your care from, consider whether or not the hospital will perform MAID; not all hospitals support MAID. In Ontario, some hospitals that support MAID will not accept patients transferring for the purposes of receiving MAID. 
4) Understand that most hospitals are understaffed and just don’t have the resources. From his prolonged stay in the hospital, my father’s bed sores had deepened and had become very painful. In a nutshell, the hospital only had two alternating air mattresses in the entire palliative care ward that were in use. 
5) If you and your family are forced to transport your loved one out of the hospital to receive MAID, know this: there is support through the Dying With Dignity Canada network, the family is your loved one’s best advocate, and you will find the strength and courage to be present! 
My hope is that families who are assisting a loved one through the MAID process receive the emotional and spiritual support needed. It is an incredibly rewarding and difficult journey to arrange and transport a loved one out of the hospital so that they can die with dignity. It is hard to believe hospitals are requiring family members to step outside of their grief and become advocates. The reality is, in order for my father to receive medical assistance in dying for his end-of-life condition he was required to be transported out of a publicly funded hospital causing undue hardship. 

If you or a loved one have experienced an Institutional Religious Obstruction to health care such as a forced transfer to receive MAID, you can write a letter and tell your local representative that all health care facilities that receive taxpayer funding must permit MAID onsite, and you can share your story with us at DWDC. 

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