Chronically ill man releases audio of hospital staff offering assisted death

CTV National News: Troubling questions An Ontario patient has released audio tapes of hospital staff mentioning the option of assisted death. Avis Favaro reports.

An Ontario man suffering from an incurable neurological disease has provided CTV News with audio recordings that he says are proof that hospital staff offered him medically assisted death, despite his repeated requests to live at home.

Roger Foley, 42, who earlier this year launched a landmark lawsuit against a London hospital, several health agencies, the Ontario government and the federal government, alleges that health officials will not provide him with an assisted home care team of his choosing, instead offering, among other things, medically assisted death.

Foley suffers from cerebellar ataxia, a brain disorder that limits his ability to move his arms and legs, and prevents him from independently performing daily tasks.

In his lawsuit, Foley claims that a government-selected home care provider had previously left him in ill health with injuries and food poisoning. He claims that he has been denied the right to self-directed care, which allows certain patients to take a central role in planning and receiving personal and medical services from the comfort of their own homes.

None of the claims in Foley’s lawsuit has been tested in court.

He is now sharing audio recordings of separate conversations he had with two health care workers at London Health Sciences Centre, where he has been stuck in a hospital bed for more than two years.

In one audio recording from September 2017, Foley is heard speaking to a man about what he has described as attempts at a “forced discharge,” with threats of a hefty hospital bill.

When Foley asks the man how much he’d have to pay to remain in hospital, the man replies, “I don’t know what the exact number is, but it is north of $1,500 a day.”

Foley expresses shock at the figure and tells the man that he’d just read an article that quoted the Ontario health minister saying it’s “not legal” for hospitals to coerce patients like that.

The man is heard saying that the hospital does not use “this conversation in every situation.”

“It is only in situations where somebody has a plan in the community that is feasible that they’re not going to accept and that’s OK,” the man says.

Foley then says that he hasn’t been informed of a plan for his care and that his rights as a patient are being violated.

“You have already violated my preferences…So what is the plan that you know of?” Foley asks the man.

“Roger, this is not my show,” the man replies. “I told you my piece of this was to talk to you about if you had interest in assisted dying.”

In a separate audio recording from January 2018, another man is heard asking Foley how he’s doing and whether he feels like he wants to harm himself.

Foley tells the man that he’s “always thinking I want to end my life” because of the way he’s being treated at the hospital and because his requests for self-directed care have been denied.

The man is then heard telling Foley that he can “just apply to get an assisted, if you want to end your life, like you know what I mean?”

When Foley says that he is being forced to end his life, the man protests and says that’s not the case.

“Oh, no, no, no,” the man is heard saying. “I’m saying if you feel that way…You know what I mean? Don’t get me wrong. I’m saying I don’t want you to be in here and wanting to take your life.”

In a statement to CTV News, Foley says he decided to release the recordings “to all Canadians as my situation got very bad recently where I almost died.”

He says he’s “not in a position to elaborate on that currently,” but he wants the public to know “the real truth before it is too late for my voice to be heard.”

“It is the real truth of what is going on in Canada regarding so many assisted deaths without appropriate safeguards, in combination with the lack of necessary care that is not being provided to persons who are suffering,” he says in the statement.

“I have not received the care that I need to relieve my suffering and have only been offered assisted dying.  I have many severe disabilities and I am fully dependent. With the remaining time I have left, I want to live with dignity and live as independently as possible.”

Lawyers for the hospital were sent the audio excerpts on July 19.  Foley and his lawyer have not received a response.

CTV News also asked the hospital for a statement. The hospital has not responded.

Foley’s lawyer, Ken Berger, says his client is in “a very tragic and troubling situation.”

“Here he is, needing society’s help and care and we turn our back on him and we’re in essence … asking him if he is interested in assisted dying rather than working with him to provide the services he needs,” Berger tells CTV News.

‘Sad and shocking’

Tim Stainton, a professor at University of British Columbia’s School of Social Work, says the two audio recordings “present a deeply concerning picture.”

“It would seem to indicate that the hospital has determined, not Mr. Foley, that MAID (medical assistance in dying) would be a reasonable option,” he tells CTV News.

Stainton says the recordings highlight issues that are “of great concern among many in the disability community with regards to MAID,” including the fear that assisted death will become

“a cheaper option to providing quality community supports.”

Berger says Foley’s case is “just a microcosm of the broader issue” of how patients with disabilities and high needs are treated.

“What we are suggesting is that there are too many individuals being assisted to their death and if you are going to put in place assisted dying, you have to ensure that you assist people to live,” he says.

Another ethicist, Tom Koch, says he found the recordings sad and shocking.

“The larger concern is when the issue of the care of the fragile becomes simply a matter of financial expediency,” he says. “When we are given the option for a rapid death rather than a complex life then we are all at risk.”

“I have heard from other friends of mine elsewhere in palliative care that they are all facing this enormous pressure towards the rapid, cost-effective ending rather than the complex and perhaps more expensive but skilled homecare that we all deserve.”

After Foley’s lawsuit was filed, Berger sent a letter to federal Justice Minister Jody Wilson-Raybould, demanding that she halt all medically assisted deaths until legislation is changed to ensure that all necessary services to help patients live are provided first.

At that time, a spokesperson for Wilson-Raybould said the federal government’s policy ensures safe and consistent access to medically assisted death for all Canadians, in accordance with all Charter rights.

With a report from CTV’s medical affairs specialist Avis Favaro and producer Elizabeth St. Philip