Foothills Country Hospice: Medical Assistance in Dying (MAiD)

A Message from the Board of Directors

On May 15, 2019 the Board of Directors of the Foothills Country Hospice Society voted in favour of the Hospice becoming a provisioning site for Medical Assistance in Dying (MAiD). This decision follows six months of information gathering, extensive study, and community engagement.

The decision was made by the Board in 2017 that the Hospice would not provide MAiD within the facility. As the Supreme Court decision and subsequent legislated changes to the Criminal Code were relatively new, the Board determined it was in the best interest of the Hospice to not implement MAiD at that time. The Foothills Country Hospice is currently the only non-faith-based Hospice in the Calgary Zone to not allow MAiD to be provided on site.

As is the case with many policies at the Hospice, periodic reviews are required to ensure the policies still align with the Mission, Vision, and Values of the Hospice, and most importantly, that the policies are in the best interest of the Hospice and the patients they serve. In late 2018 it was decided by the Board that a review of the MAiD policy was appropriate in light of two years of new data from local, Provincial, and National perspectives, and a great deal of first-hand observation of MAiD from other Hospices, health care professionals, and families whose loved ones chose MAiD at the end of their life.

In Alberta, between June 2016 and February 2019, 628 MAiD deaths occurred with 229 of these deaths occurring in the Calgary Zone. While MAiD is still a very small portion of overall mortality in Alberta (approximately 1%), demand for MAiD is increasing. Despite the fact that the overwhelming majority (99%) of Foothills Hospice residents will not choose MAiD, the decision to choose this as an end of life option is an individual choice to be made by each individual patient.

Committee Work 
A committee was established in November 2018 comprised of Board members, volunteers, and select Team Leads employed at the Hospice. The mandate of this committee was to gather information to inform the Board decision, to support transparency, and community engagement.

Over the next six months the committee put in a great deal of time and effort to gather information about MAiD, both quantitative and qualitative, to use an ethical framework to analyze the MAiD decision, to increase understanding of the MAiD process, to gather opinions and perspectives, and to assess implications for families, staff, volunteers, and stakeholders.

The work of the committee culminated in a public MAiD Townhall on May 4, 2019. More than 100 individuals were in attendance to hear an expert panel speak on the MAiD process, ethical considerations, and explore opinions – for and against MAiD. Perspectives of family members regarding MAiD were also shared. The Townhall concluded with small group discussions involving all individuals in attendance where concerns were raised, opinions expressed, and questions noted. The dialogue from each small group discussion was recorded and shared with the Board.

The final work of the committee involved synthesizing all the information gathered over the prior six months, including the Townhall meeting and many letters written from various stakeholders. All information was shared with the Board in advance of the May 15th vote. 
In order to ensure the MAiD policy is thoughtfully and carefully implemented, the Board determined that the provisioning of MAiD would not occur at the Hospice until sometime in the first quarter of 2020. This will allow time for the Hospice to give careful consideration to ensuring processes are in place to respectfully balance the opinions and requirements of staff and volunteers with the needs of those patients who request MAiD at the Hospice.

The Board wishes to give their heartfelt appreciation and gratitude to those in the community who thoughtfully shared their perspectives and concerns throughout this process. The Hospice is a wonderful facility filled with tireless, compassionate, community-minded people who provide the highest standard of end-of-life care for the patients they serve. The Board recognizes that the amazing work the Hospice performs would not be possible without the staff, community partners, and an incredible army of volunteers who give freely of their time and talents to make the Hospice such a special place. We are confident that as we work together to implement this sensitive policy change, the great work of the Hospice will continue, and the Hospice will remain an integral part of the Okotoks and Foothills communities.

For more information about Medical Assistance in Dying, visit Alberta Health Services’ website.