Dear Ms Murphy

Resignation from the Ethics Committee

I write to resign my position as a Board-appointed member of the Ethics
Committee of St Josephs General Hospital in view of the hospitals disgraceful
policy regarding Medical Assistance in Dying (MAiD). Although the policy is
still awaiting formal publication physicians have been prohibited from providing
MAiD in the hospital ever since the law changed.
Since June 6, MAiD has been available to Canadians who are suffering intolerably
from a grievous and irremediable condition and who wish to have a dignified,
peaceful, gentle death. Having now provided a number of medically assisted
deaths I can testify to the relief that the exercising of this right brings to suffering
patients and their distraught families.
In common with other Catholic institutions St. Josephs has imposed a blanket
prohibition on the provision of MAiD within the hospital. The justification
claimed is that MAiD is contrary to the hospitals vision and mission. The hospital
requires that any patient who wishes to have MAiD must either be denied this
wish, be sent home, or be transferred to a facility where MAiD is permitted. This
means that patients too sick to return home must be sent either to Campbell River
Hospital (45 minutes to the north) or Nanaimo Regional General Hospital (one and
a half hours to the south). Such transfers to other hospitals or to home are fraught
with difficulty and run the risk of causing patients unnecessary additional pain and
suffering. Furthermore, there is no certainty that the patients family or friends
will be able to follow them out of our community. Many such patients are old and
have partners who are frail or disabled themselves.
Entirely predictably, this policy is now forcing dying patients to leave St Josephs
to exercise their right to MAiD. Even a patient so ill that they would, under
different circumstances, be deemed unfit to be transferred must submit to an
uncomfortable and unnecessary ambulance journey accompanied by distressed
family members. In the case of patients who request an expedited medically
assisted death due to the extremity of their condition, the delay caused by the need
to make the arrangements for transfer may be sufficiently great that the patient
loses legal capacity and thus, their right to a medically assisted death. This is the
cruellest hospital policy that I have ever encountered in over thirty years of
medical practice. St Josephs motto Care with Compassion rings hollow now.

St Josephs is owned by the Bishop of Victoria and the policy on MAiD is

controlled by him and a small number of people who are determined to apply the
dogma of the Catholic Church to the care of dying patients, regardless of the
beliefs of the individuals the hospital serves. In fact, 80% of Canadian Catholics
support MAiD, a rate of approval that is almost as high as that of the general
population. In any case, the last census showed only 12% of the population of the
Comox Valley is Catholic (and thus probably the staff is only about 12% Catholic,
too).
I fully support the right of individual health care professionals to decline, for
reasons of conscience, to participate in the provision of MAiD. However, it is
completely unacceptable for a bricks-and-mortar publicly funded health care
institution to claim a right to conscientious objection while denying dying patients
in its care a rightful treatment option. This is true for hospitals across Canada, but
it is especially glaring when that institution is the sole provider of acute care in a
community, as is the case with St Josephs.
In your position as CEO you have frequently asserted that palliative care is an
alternative to MAiD. Whilst good palliative care is indeed a choice for some
patients it is not an adequate substitute for all patients and should not be imposed
upon them simply because the legal alternative is being denied in an unethical
manner.
Some see this situation as a temporary issue that will be resolved by the ending of
St Josephs acute care role in the Fall of 2017 when the new Comox Valley
Hospital opens. Sadly, legally competent patients who are eligible for and who
wish MAiD but who are unfortunate enough to find themselves either in
residential care in The Views, or in the Hospice, will continue to suffer from this
heartless and immoral policy because both are on the St Josephs site.
In view of the Hospital Boards intransigence in the face of the unnecessary
patient suffering that it has already caused and will continue to cause through this
policy, and the Boards willingness to place dogma above patients dignity,
autonomy and legal rights, I hereby resign my position on the Ethics Committee
with immediate effect.

Yours sincerely

Jonathan Reggler MB BChir, FCFP

Copies:
Members of the Ethics Committee, St Josephs Hospital
Members of the Department of Family Practice, St Josephs Hospital
Cory Ruf, Communications Coordinator, Dying With Dignity Canada