No place for MAiD in hospice

Providing medically assisted dying is a contradiction of what hospice stands for, writer says.

I write in response to the recent article in the Chilliwack Progress informing Chilliwack residents of the Chilliwack Hospice Society’s pending decision regarding allowing Medical Assistance in Dying (MAiD) “in house.”

This matter is of utmost concern to me as I am a Chilliwack resident and was diagnosed with terminal brain cancer in October 2016. I have already lived past the average survival of individuals with my diagnosis. It comforts me greatly to know that my community has comprehensive palliative services. However, it alarms me that the society providing these services is considering allowing MAiD. I strongly petition you to NOT support MAiD within your programs and services.

I firmly believe that the vulnerable process of dying naturally is beautiful and allows a special bond of love to flow between the person breathing their last breaths and the loved one bearing witness to it. This is a beneficial and shaping experience and is what I desire for my own death. I make this decision with my personal experience of encountering the beauty and value of being present in the tender moments of my grandmothers’ last days.

As I see my own death approaching I’ve already begun to experience the beauty and vulnerability of dying. Until recently I was a pharmacist and a depended upon healthcare provider in our community. I am now the patient trusting my healthcare team. Additionally, as a mother I was accustomed to caring for my three young children. Now I am the fragile, dependent, and needy one. I’ve had to ask for and accept a great deal of help. Yet in receiving this help I’ve gained much more than the practical support I’ve needed. These beautiful acts of humanity have been life-giving gifts for both the givers and myself.

At the same time, my diagnosis is precipitating raw and vulnerable conversations. While rewarding, these are difficult waters to tread. This journey requires courage; in my frailty I rest on the shoulders of those supporting me to garner this courage. Meaningful and safe relationships are of utmost importance. I need to know that those supporting me are fully invested so I can lay bare my aches, disappointments, heart, and hopes to continue on this courageous journey. I need to ensure that my care will continually foster this unguarded openness. This is a vulnerable state requiring utmost trust in those I surround myself with. I am exposed. Because I am exposed I need to ensure that my circle of trust is not broken. As palliative care physician Dr. L. Herx states, “The foundations of our work in palliative care are trust and relationship.” She continues, “Is trust really engendered when we reach out with one hand inviting patients to engage in the hard and intense work of addressing their suffering, while in the other hand we hold the needle to end life?”

To ensure vital trust is protected at such a vulnerable time in life it is important to clearly segregate palliative and hospice care from any provision of MAiD.

Furthermore, I long for my care to be focused on living well while at the same time be fully committed to the arduous process of dying. Indeed, the World Health Organization defines palliative care as affirming life and intending to neither hasten or postpone death. I believe the Hospice Society has championed this definition by supporting the palliative patient through providing holistic care and comfort as a patient lives their last days. I am tremendously grateful a compassionate local environment like this exists where independence, as much as possible, is valued. This will enable me to live as fully as possible, while I’m alive. To provide MAiD in this setting would be utterly off-focus and contrary to the purpose of a hospice and palliative care. I plan to live until I succumb to my disease. This is an entirely different mind-set than choosing to die prematurely. These two mind-sets cannot co-exist, certainly not housed under the same roof. As Lincoln said, “A house divided against itself cannot stand.”

To continue providing this city, including myself, my husband and my three young children, with vital and life-bolstering care I sincerely urge the Chilliwack Hospice Society to safe-guard an environment of vulnerability, openness and whole-hearted support by not supporting MAiD within your programs and services.

Cheryl Rostek

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