Since 2016, 109 Albertans have had to endure a needless ambulance ride in their final days and hours on this earth because we continue to allow publicly funded Catholic hospitals and continuing care facilities to deny health care. Known as forced transfers, these 109 people account for more than five per cent of all Albertans who have accessed medical assistance in dying (MAID) since it became a part of our health care system.
Covenant Health is the operator in question.They are a faith-based institution and the largest Catholic healthcare provider in Canada, operating 17 sites across the province with a focus on senior care, palliative and end of life care.
Covenant Health should not receive any public funding until they commit to placing patient needs before religious beliefs. They are failing to provide culturally competent, trauma informed, and patient centered care. This should be the minimum expectation for any publicly funded healthcare provider.
Covenant Health’s policies adhere to, and are informed by, Catholic moral and ethical traditions. One specific point of Catholicism informing Covenant Health policy is to “uphold the sanctity of life at all stages” and is used to justify the refusal to provide MAID at all Covenant Health facilities. Policies shaped by this value are also problematic in emergency medicine and reproductive care.
Culturally competent care requires institutions to deliver health care services that meet the social and cultural needs of the people they serve. Providing culturally competent care must include consideration of the different belief systems, norms and values of cultural groups of those in your care. Giving an institution’s Catholic moral tradition more consideration in the provision of care than the patient’s own moral beliefs is culturally incompetent care.
Culturally competent care can not exist without a trauma informed lens and the recognition of past abuses by colonial institutions. Facilities operated by Covenant Health are taxpayer funded and exist to serve people in the surrounding communities. Individuals from all religions, cultures, and backgrounds receive care in Covenant Health facilities, which often are often the only point of healthcare access in many rural communities. Given the history of the Catholic Church in Alberta and populations that access these facilities it is extremely problematic to have religious insignia reminiscent of past abuses lining the walls and prayers recited over the intercom. We must acknowledge this truth in order to begin reconciliation.
The Grey Nuns Community Hospital in Edmonton is operated by Covenant Health. Image via Covenant Health.
As a Registered Nurse, my code of ethics states that it is my job to advocate for a full continuum of accessible health care services at the right time, in the right place, and by the right provider. This standard should be even higher when applied to an entire organization. Operating facilities that specialize in end-of-life care but refusing to provide MAID is a failure to provide the appropriate services, at the appropriate time, in the appropriate place. This is not a decision based on lack of resources, they are choosing not to provide this service and in doing so are placing institutional values over individual patient rights. Forced transfers for the comfort of the institution without consideration for the comfort of the patient is not patient centered care.
Allowing religion to be the judge of which procedures can or can not be performed at a public hospital is not possible without passing judgement onto the patient. The implication that an individual’s choice to access MAID is so morally reprehensible that they must be removed from the premise and taken to another location further reinforces the stigma of this procedure. The Supreme Court of Canada granted the right to medically assisted death and it should be offered as an option alongside other approved treatments when appropriate.
The priorities of Covenant Health are not inline with the needs of populations they serve. Refusing to provide MAID on a palliative care unit is unacceptable, culturally incompetent, and institutionally centered. Using Catholic tradition as a reason to place unnecessary barriers for those seeking federally approved treatments should not be tolerated by our government.
Covenant Health has continued to demonstrate that they are unwilling to put patients before religious ideology and should be denied the funding and the privilege of providing health care to vulnerable Albertans until they are willing to do so.