Ontario proposal threatens to entrench unfair barriers to assisted dying access

Update: Bill 41 passed in the Ontario legislature on Dec. 7, 2016. The provision strengthening the ability for religiously affiliated public hospitals to opt out of allowing assisted dying remained in the legislation and is now law.

Dying With Dignity Canada is raising the alarm on the Ontario government’s recently tabled Bill 41, which, if passed un-amended, will further empower publicly funded hospitals to deny or otherwise obstruct Ontarians’ right to medical assistance in dying (MAID).

Dubbed the Patients First Act, Bill 41 gives Ontario’s health minister the power to issue binding directives to the boards of public hospitals in response to a provincial investigation into their operations. However, the bill states that the health minister is not allowed to “require the board of a hospital organization that is associated with a religious organization to provide a service that is contrary to the religion related to the organization.” This sub-amendment did not appear in the version of the bill that was tabled at Queen’s Park in June. Rather, it was quietly added in October, when Health Minister Eric Hoskins re-introduced the bill to the legislature.

The leading organization helping Canadians to avoid unwanted, unnecessary suffering at end of life, Dying With Dignity Canada (DWDC) says this rule will further entrench one of the greatest barriers facing desperately ill Ontarians looking to access their right to assisted dying: publicly funded hospitals that refuse to allow the provision of MAID on their premises.

“This policy suggests the Liberal government is not prepared to take on tax-funded public hospitals that willfully impede catastrophically ill Ontarians who want to access their right to a compassionate, dignified death,” said DWDC CEO Shanaaz Gokool. “This is extremely discouraging, and it raises serious questions about the government’s stated commitment to putting patients first and defending their Charter rights.”

The updated bill, Gokool added, effectively gives members of unelected hospital boards — who are not necessarily accountable to the general public — final say over whether assisted dying will be allowed at their facilities.

According to a report in the Ottawa Citizen by journalist Elizabeth Payne, the sub-amendment was added at the request of the Ontario Hospital Association.

Gokool’s comments come less than a month after DWDC issued a statement urging the country’s provincial and territorial governments to ensure that MAID is available at all public hospitals, hospices and long-term care facilities that care for dying individuals. Allowing these public healthcare institutions to refuse to allow MAID on their premises imposes unnecessary suffering and harmful delays upon residents who want to access their right to an assisted death. In Ontario towns and cities whose only public hospital is operated by a religious organization — as is the case in Pembroke, Mattawa and Elliot Lake — individuals who request MAID may have to be transferred outside their communities in order to receive treatment.

“Canadians expect to be able to access a full range of end-of-life care options, no matter where they live,” said Gokool. “They should not have to endure the physical and emotional hardship or the indignity of having to leave their hospital, and perhaps even their community, to exercise what is their right to a peaceful death.”

Through a Freedom of Information request, DWDC learned last week that the Ontario Ministry of Health and Long-Term Care is not even tracking which hospitals are refusing to allow MAID on-site.

“By refusing to monitor which hospitals are opting out of assisted dying, the province is failing in its duty to monitor what barriers to access exist in the healthcare system,” Gokool said. “They can, and must, do better.” 

(Header photo credit: Benson Kua/Flickr)

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