Louis Brier, a Jewish elderly care home in Vancouver, has accused Dr. Ellen Wiebe, who specializes in medically assisted dying, of wrongdoing, for providing a medically assisted death to 83-year-old resident Barry Hyman, without the consent or knowledge of the care facility.
The home accused Wiebe of “borderline unethical” behaviour and has filed a complaint with the College of Physicians and Surgeons, but Wiebe is adamant that her actions were not unprofessional.
“By far the most important thing is the patient,” Wiebe told The CJN. “The second is the family. Mr. Hyman’s wish was to die in his home. People have all kinds of wishes and desires, but dying wishes are held to a higher standard than other wishes.”
Asked about the family’s agreement to abide by Louis Brier’s policies, and the dispensation given to the home by the Ministry of Health to exempt it from providing medically assisted deaths, Wiebe says that, “I’m not part of those agreements. My agreement is purely with my patient, not the facility, and since I don’t have visiting privileges at Louis Brier like I do at Vancouver General Hospital, I am not required to abide by the agreement between Louis Brier and the ministry.”
Wiebe was invited into the facility by Hyman’s daughter, Lola Hyman, and his other immediate family members, who wanted to honour Barry Hyman’s long-held wish to die on his own terms. Disabled by a stroke and diagnosed with lung cancer, Hyman had asked to die at the care facility, which had become his primary residence. Lola Hyman had broached the topic with David Keselman, the CEO of Louis Brier, who told her it was against their policy, which is formulated according to Orthodox Jewish law.
Lola Hyman told the Globe and Mail that she wanted to honour his wishes in a place that was comfortable for him, not somewhere that would be unfamiliar to him.
On the night of his death, she said, “the room was very quiet. We just held his hand and stared at him. My sister was sobbing, just sobbing. I was a stone. A complete stone. My heart was racing that someone would open the door.”
The Supreme Court of Canada struck down the Criminal Code prohibition on physician-assisted dying in 2015 and the federal government passed legislation legalizing it in 2016. The court recognized that doctors should not be coerced into performing the procedure against their will, but did not specify whether entire health-care organizations could refuse to comply.
In B.C., the Ministry of Health reached an agreement that allows members of the Denominational Health Association (DHA), including Louis Brier, to refuse to provide services that are inconsistent with their religious values.
“Anyone who comes here knows what our policy is, and if they don’t like the policy, they should go somewhere else,” Mark Rozenberg, the chair of the ethics committee of Louis Brier’s board, told the Globe and Mail.
My sister was sobbing, just sobbing. I was a stone.
– Lola Hyman
Keselman declined The CJN’s request for comment, saying that the board was in meetings to decide how to respond to the media exposure. The home’s rabbi, Hillel Brody, said he was not permitted to discuss Louis Brier’s policies with the press.
Shanaaz Gokool, the CEO of Dying With Dignity Canada, told The CJN that organizations like Louis Brier are not being asked to take part in medically assisted dying, but simply not to obstruct residents from a medical service they have a right to.
“The doctors bring in their own equipment. The health-care facility has no involvement in the procedure. By not allowing this, they are undermining the rights of the residents of Louis Brier who call it their home,” Gokool said.
It is not yet clear if institutions that refuse to allow medically assisted deaths on their premises enjoy the same charter-protected religious freedoms as individuals who refuse to provide the service, because the issue has not yet been tested in court.
A joint statement issued by Dying With Dignity Canada and the Canadian Association of MAID Assessors and Providers said that, “We support health-care professionals who, as a matter of conscience and compassion, help their patients overcome unfair barriers to access.… And we will defend clinicians who are attacked or punished for their participation in the lawful provision of MAID (medical assistance in dying). These courageous individuals should be applauded, not penalized, for putting their patients first.”
Louis Brier is one of a number of faith-based organizations that are in a quandary: although the centre is run in accordance with Orthodox Jewish law, not all residents are religious Jews, and it also has non-Jewish residents.
They are a funded by taxpayers and should abide by Canadian law.
– Shanaaz Gokool
A 2014 Ipsos-Reid poll conducted on behalf of Dying With Dignity Canada showed that 84 per cent of Canadians were in favour of allowing physicians to help someone die, if that person is suffering and wishes to die.
There is also the issue of public funding, as “67 per cent of the Louis Brier’s funding is public,” said Gokool. “They are a funded by taxpayers and should abide by Canadian law.”
Lola Hyman told the Globe that she was left feeling distressed, both at the possibility of Wiebe suffering on account of helping her father, and at having upset the front-line staff at Louis Brier, who were shocked by Barry Hyman’s sudden death. She said that all of this could have been avoided if B.C. went the way of Quebec and stopped allowing publicly funded organizations from obstructing the rights of their residents.
“Everyone is entitled to their religious beliefs and traditions and customs,” she told the Globe and Mail. “But when it comes to somebody who is very sick and dying, we need to have a different approach.”