Samantha O’Neill never expected that, at age 34, she’d have to think about medically assisted dying.
Nor did her family expect that the hospital where she was treated for terminal cancer would deny her that right.
St. Paul’s Hospital in Vancouver is run by Providence Health Care, a Catholic health organization that opposes medical assistance in dying and will not let it happen in its 10 hospitals and care facilities.
O’Neill’s family and Dying with Dignity Canada say it’s unacceptable that a taxpayer-funded hospital like St. Paul’s — which is getting a $2 billion replacement in 2027 — forces dying patients to leave its facility to get MAID.
“It’s such a heartbreaking situation. The whole point of MAID is to die with dignity,” said her cousin Taryn Bodrug, who lives in Victoria and was with O’Neill in her final days. “She didn’t get that. There was no dignity in getting transferred to another place for a matter of policy.”
Canada’s federal legislation does not force any person or health care provider to carry out medically assisted death, so Dying with Dignity’s CEO Helen Long said such policies will remain in place unless there’s a successful court challenge.
In April 2022, O’Neill was working her dream job for the Canada Running Series in Vancouver and running marathons on the weekend when a severe pain in her stomach landed her in the emergency room at St. Paul’s.
Doctors found a tumour the size of a softball and O’Neill was diagnosed with Stage 4 cervical cancer that was inoperable, and terminal. O’Neill had chemotherapy and radiation to prolong her life, but by this February, the pain was so debilitating, she began considering MAID.
Bodrug shared her cousin’s text from Feb. 14 when she received news she had qualified for assisted dying: “it’s crazy to even be eligible. like how. i’m 34. this doesn’t seem real.”
O’Neill’s decision to die with the help of a physician added a layer of trauma her family wasn’t prepared for.
She would have to be transferred out of St. Paul’s Hospital because of Providence’s policy, which says it does not allow MAID in its facilities, “given the incompatibility of Catholic teaching with actions intended to terminate human life.”
Providence does allows its patients to be assessed for MAID by an external practitioner, but patients must transfer to another facility to get MAID.
That transfer on April 4, to St. John’s hospice run by Vancouver Coastal Health, stripped O’Neill of the dignity MAID is supposed to provide on the last day of her life, Bodrug said.
“For somebody who’s at the point where MAID is their only option, transferring to a different facility is not as simple as it sounds,” Bodrug said.
O’Neill was in excruciating pain — her lumbar ribs had fractured, a side-effect of the osteoporosis caused by the chemotherapy.
So she was medicated to unconsciousness before being lifted onto a gurney and driven by ambulance to St. John’s hospice. She did not regain consciousness again before she was given the life-ending medication, Bodrug said, so the transfer robbed her of her final hours with her parents, siblings and friends.
“Instead of having a goodbye, where she could just say goodbye to friends and family, she had to get heavily medicated to withstand the pain of just getting to the appointment,” her cousin said.
Especially upsetting was when O’Neill arrived at the hospice, the gurney barely fit into the room where the procedure was to be performed, leading to an awkward scene of paramedics and nurses pivoting the gurney a fraction at a time.
Bodrug said O’Neill received exceptional care from the doctors and nurses in St. Paul’s palliative care ward and her frustration is solely with Providence’s policy.
Shaf Hussain, a spokesperson for Providence, said the agency cannot comment on specific cases but “when there are such issues that patients or families have, we work with them, take in all feedback to learn from the experiences and try to improve processes to ensure transfers occur in a timely and safe manner.”
Providence said that since medically assisted dying became legal in Canada in 2016, 402 of its patients have made formal requests for MAID and 131 have followed through with a transfer to other facilities.
The B.C. Health Ministry’s policy on MAID acknowledges that not all doctors and nurse practitioners will provide medical assistance in dying because it may conflict with their beliefs.
“If a doctor or nurse practitioner does not provide medical assistance in dying as a matter of conscience, a person can still expect to be treated with respect and be provided with information on how to access this service,” the policy says. “This means health-care providers must not discriminate against people who make this request and must provide an effective transfer of care if they choose not to offer that care themselves.”
Health Minister Adrian Dix was not made available for an interview this week. Asked during an unrelated press conference about whether he’s concerned about Providence Health’s MAID policy, Premier David Eby did not directly answer.
“End of life issues are some of the most sensitive and challenging issues faced by British Columbians. I can’t imagine what that family was going through, facing someone with a terminal cancer diagnosis who they love,” he said. “And this is a profoundly challenging issue to make sure that we’re respecting dignity and ensuring that end of life and palliative care for people is delivered effectively in our province.”
Long, of Dying with Dignity, said all government-funded hospitals, care homes and hospices have a duty to allow medical assistance in dying.
Long said she respects individual clinicians’ right to conscientious objection and they should not have to provide MAID if it’s against their ethics.
“But we’re talking about a hospital and hospitals don’t have conscientious rights,” she said. The hospital should have a policy that allows outside physicians to come in and perform MAID without having to transfer the patient, she said.
The advocacy group does not keep data on how often people are transferred from facilities that do not perform MAID but Long said “one forced transfers is too many forced transfers.”
“It’s just a horrible situation to to put people in when all they want to do is say goodbye and spend a few minutes with their loved ones.”
