Scott Douglas Jacobsen: To start, are you an atheist, an agnostic, or some other non-theistic title?
Cheri Frazer: I am a lifelong atheist, 4th generation on one side of my family.
Jacobsen: What is Dying With Dignity, as a movement and organization?
Dying With Dignity Canada is the national organization committed to improving quality of dying, expanding end-of-life choices, and helping Canadians avoid unwanted suffering.
We defend human rights by advocating for compassionate end-of-life choices and by providing personal support to adults suffering greatly from a medical condition who wish to die on their own terms.
We educate Canadians about all of their legal end-of-life options, including the constitutional right to medical assistance in dying (MAID), and the importance of advance care planning. We also support healthcare practitioners who assess for or provide MAID.
We are part of a growing international movement seeking to stop suffering and help ensure peaceful deaths for people at the end of their lives.
We enthusiastically support the Supreme Court’s 2015 ruling in Carter v. Canada, which established medical assistance in dying as a right for competent adult Canadians who are suffering intolerably as the result of a “grievous and irremediable” medical condition. We believe rules for assisted dying must, at the very least, comply with the Supreme Court’s decision and ultimately, the Canadian Charter of Rights and Freedoms.
Jacobsen: How can people become involved in it?
Frazer: There are plenty of ways people can get involved, from running workshops to writing for our blog to witnessing applications for medical assistance in dying. Readers can visit http://www.dyingwithdignity.ca/volunteer to explore the options they’re interested in. Winnipeg announces its events here: https://dwdwinnipeg.weebly.com.
Jacobsen: What makes this movement more noble than the idea that a religious authority can determine what Canadians can do with their, arguably, most important decision of their life – how they die?
Frazer: I think that if a person subscribes to a particular religion and believes in that religion’s views on assisted dying (or dying in general), then that’s the definition of “noble” for that person. Actually, I think “dignified” is a better descriptor. In my years with the Winnipeg chapter I’ve met people from many different religions (and no religion) who support medical assistance in dying, and sometimes that support is at odds with their religion’s stated beliefs. To me, dignity comes in having your choice for your own end-of-life respected. If a Catholic person comes to me for advice on making an end-of-life plan that does not include medical assistance in dying, then I’m happy to help that person find all the answers needed. If another Catholic who believes in MAID comes to me for advice, I’d give the same advice but with one more option added. Our service is about the patient, not about forcing our personal beliefs on others—an approach I wish religious authorities would take as well.
Jacobsen: Have there been any attempts to prevent assisted dying from moving forward in Canada? How, and by who? Is it a fair series of attempts or not?
Frazer: Yes, attempts are being made to prevent MAID from moving forward, both legislatively at the federal level, and physically at “faith-based” institutions. Initially, a federal panel that was assembled to study the current law was chaired by a vocal opponent of MAID; he has since been replaced. Institutions all across Canada that call themselves “faith-based” are denying patients access to legal medical services, sometimes resulting in painful, traumatic patient transfers to different facilities, assuming there are other facilities nearby, and that those facilities will accept such transfers.
You’ve probably heard about the situation at St. Boniface Hospital in Winnipeg, where a Catholic-controlled board of directors was ‘stacked’ in order to re-vote and reverse a democratic decision among staff to allow medical assistance in dying (MAID) on the premises in certain circumstances (e.g., where a transfer would be painful or traumatic). Please note that this is not a criticism of the hospital or its staff; the staff there are dedicated professionals who provide excellent care, and the majority of them support their patients’ right to make their own health care decisions. The issue at stake is the control of hospital policy by a religious board of directors.
This is a serious issue because in our publicly funded health care system, patients frequently do not have the opportunity to choose the hospital in which they are treated. Many services are consolidated at certain sites and not offered at others – so even if a patient goes to the emergency room at the hospital of their choice, they could end up being transferred to another. Ambulances are directed to hospitals according to both service and bed availability, so in an emergency, the patient has no say whatsoever. This means that all publicly funded hospitals must be able and willing to accommodate all patients. An institution has no right to limit access to legal services to patients who have different beliefs than they do, if a publicly funded institution can claim to have “beliefs” at all.
It’s time for Canadians, the majority of whom support MAID, to speak up and demand that something change. Recently, the Pallister government required that all institutions in Manitoba that provide health care declare whether they are “faith-based” and whether they will allow assisted dying on their premises. DWDC has been gathering this information on institutions all across Canada in their “Shine a Light” project, which provides an online map of institutions near you and their policies on MAID. What’s important to note in Manitoba, that’s different from all other provinces and territories, is that no healthcare worker is required to participate; we have one central team that services the entire province. The institution doesn’t have to be involved in any way either, since the team comes to the patient.
For more detailed information on this issue, you can read DWDC’s report, “Challenges to Choice: Bill C-14 One Year Later”, found here: http://www.dyingwithdignity.ca/challenges_to_choice.
Jacobsen: Any final feelings or thoughts?
Frazer: We stand up for the rights of the dying, the weak, and the vulnerable. We believe in a Canada that respects the rights of people who are suffering intolerably as a result of a devastating medical condition. The person — their rights, interests, and choices — is at the centre of our work.
In our society, the way we express love is to say “do everything you can to save grandma” in an emergency; but if grandma didn’t want to be saved, then that’s a cruelty rather than an act of love. Better to know each other’s wishes and values before you’re faced with a terrible decision in an emergency.
No matter what your age or health status, if you are a competent adult you should fill out an Advance Care Plan (health care directive) and discuss your values with your friends and families. Kits are available free to download from the DWD website, and two of the Winnipeg chapter members have posted ours publicly in the hopes it will help people to fill in their own answers. Please note that the kits are province-specific, so be sure to get the right one!
“This is a serious issue because in our publicly funded health care system, patients frequently do not have the opportunity to choose the hospital in which they are treated.”
Last summer, August 2016, I went through this with a lifelong friend. In Saskatoon, it seems that only St Paul’s Hospital was providing end of life care. The staff there were very kind and helpful. The problem was that there was no assisted dying available. The death turned out to be a long drawn out affair. For two weeks or so the patient was drugged out of any awareness. His dying had already gone on for three weeks prior to the drug induced oblivion.
Hospitals that don’t offer assistance should be removed from providing this service.