Should Catholic hospitals have to provide access to medically assisted dying?

When religious health-care institutions block access to a doctor-assisted death, patients are stuck in the middle. Should the government step in?
Horst Saffarek had to move hospitals to access MAID, but his health declined in the process, and he died. (Lisa Saffarek)
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At the end of 2016, Horst Saffarek went to hospital when his lungs started to fail.

After a series of assessments and tests, he wanted to access Medical Assistance in Dying (MAID). But the hospital where he was being treated, St Joseph's General, a Catholic institution, did not offer the procedure for religious reasons.

St. Joseph's, which has since closed as a hospital though its residential care facility remains open, was the only hospital in Comox, B.C.

Horst Saffarek had to be moved to another hospital in Nanaimo, B.C., for the procedure, but his health declined after the transfer and he died before being able to access MAID.

"It was really stressful on us as a family, it was stressful on him, and it possibly contributed to him going earlier," Lisa Saffarek, Horst's daughter, tells The Current's Anna Maria Tremonti.

Horst Saffarek as a young man. (Lisa Saffarek)

Lisa Saffarek's sisters had planned to come spend time with their father in his final days, but they didn't make it in time, since MAID was scheduled for a few days later.

"He really wanted to have control over how he went," says Saffarek. "As opposed to just being able to be peaceful and enjoy his last days with his family, there was this ongoing stress."

Saffarek, who is a nurse but does not work in an area that provides MAID, says she sees the need to respect other people's values and ethics, but believes that in a publicly funded healthcare system, people should be able to access MAID wherever they are.

It took away from us being able to celebrate Dad, and just enjoy our last moments with him.- Lisa Saffarek

"We shouldn't have to move people," says Saffarek. "And we should ensure there are emotional and spiritual services there to support people as they make this decision and as they work through all the things that come along with it. I was just really sad that I think my dad felt really alone if I wasn't there."

Lisa Saffarek said the process of moving her father added unnecessary stress at a difficult time. (Lisa Saffarek)

"That move was really stressful on us as a family, it was stressful on him, and it possibly, you know, contributed to him going earlier. It took away from us being able to celebrate Dad, and just enjoy our last moments with him."

Saffarek says the support of the healthcare facility is particularly important for the patient for MAID.

"This is the biggest decision that you can ever make," she says.

MAID has been legal in Canada since 2016, although individual medical practitioners can say no to doing the procedure if it goes against their values and beliefs.

But stories like those of Horst Saffarek are raising questions over whether religiously based medical institutions should be able to refuse to do the procedure.

Robert Breen is the executive director of the Denominational Health Association of British Columbia — St Joseph's General in Comox, BC, was among their members.

Some members of his group do not allow MAID in their facilities — that decision is made by the institution's board.

I think the funding is a bit of a red herring. Just because something is being paid for doesn't mean that you should abandon your underlying principles and do it.- Robert Breen, executive director of the Denominational Health Association of British Columbia

"Some of our members basically see participating in that process, which means allowing it to happen on their site, as being complicit," Breen tells Tremonti. "And they have a very strong view that being complicit in the act is against their values."

Breen says the rules apply even if not all staff members of the hospital are of the same faith as the facility. Employees can perform the procedure if they choose to, but not on site and not on work time.

Religious healthcare facilities receive public funding in the same way as other healthcare facilities, but Breen feels this is not central to the issue.

"I think the funding is a bit of a red herring," says Breen. "Just because something is being paid for doesn't mean that you should abandon your underlying principles and do it."

Daphne Gilbert, an Associate Professor, Faculty of Law at University of Ottawa and a Member of its Centre for Health Law, Policy and Ethics, says she would like to see the federal government clarify the rights of religious healthcare facilities on this front. But she believes the question will likely end up in court instead, through a patient who is denied MAID at a religious facility.

"Obviously for that person it will not be resolved in time to help or be of assistance," says Gilbert. "It will just be a case that carries on in the name of that person by their family. And there's lots of brave people out there who will do that, but it's just unfortunate that it has to be done on the backs of a person."

Andre Picard, a health reporter and columnist at The Globe and Mail, says politicians aren't keen on tackling the issue. (andrepicard.com)

Religious institutions have been deeply involved in Canada's healthcare system since it began, running the system until public funding took over in the middle of the 20th century, points out Andre Picard, a health reporter and columnist at The Globe and Mail.

Questions around their right to refuse procedures that go against their values have come up before, but have never been fully resolved. Picard wants to see these issues dealt with reasonably and with as little conflict as possible.

"We don't want to throw out the good things that these institutions have brought into our healthcare system," Picard tells Tremonti.

"They do a lot of good. To this day, I'd say Catholic institutions are among the most progressive… They do really great social work in addition to medicine, so we can't forget that aspect."

But he doesn't see politicians jumping in to resolve the situation.

"No politician wants to touch this with a ten-foot pole," he says.​

Listen to the full audio near the stop of this page. You can share this story below.


This segment was produced by The Current's Kristin Nelson.