An Edmonton woman says her terminally ill best friend, who had ALS and was effectively paralyzed, had to sign his assisted-dying request form in a bus shelter because Covenant Health would not allow it in St. Joseph’s Auxiliary Hospital, where he had been a patient for five years.

And when the time finally came for 72-year-old Bob Hergott to receive his medically assisted death, Verna Young said it was “horrible for him.” She said he took a cab to the Royal Alexandra Hospital with a St. Joseph’s staff member and a woman from the ALS Society of Canada.

“He couldn’t talk, he couldn’t verbally scream or he would have,” Young said.

Hergott’s story is the second to emerge from a CBC News investigation into a Covenant Health policy on medical assistance in dying (MAID) that experts say is inhumane and infringes on patients’ rights.

Last week, CBC News revealed ALS patient Doreen Nowicki, 66, underwent her MAID assessment on the sidewalk in May 2017 after Covenant Health,  Alberta’s publicly funded Catholic health provider, abruptly revoked permission for her to have it by her palliative bed at the Edmonton General Continuing Care Centre.

In response, Health Minister Sarah Hoffman released a statement saying Covenant had assured her that Nowicki’s ordeal was an isolated incident. Hoffman, however, has repeatedly refused to directly answer questions on the issue, saying she will provide more information after she meets with Nowicki’s family.

Covenant Health says facilitating medically assisted deaths is contrary to the faith that underpins its medical care. It won’t even allow patients to complete the form requesting the procedure, or undergo eligibility assessments, on its property, save for “exceptional” circumstances.

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The provincial government has exempted Covenant from having to offer these services.

Covenant Health declined an interview request from CBC News about its treatment of Hergott. In an emailed statement, the health provider said Hergott, who was the first Covenant patient to request MAID, regularly left the St. Joseph’s site for medical appointments “and other social and volunteer activities.

“His care team and the Alberta Health Services navigator involved in his care determined he was able to have an off-site assessment safely in keeping with the Covenant Health policy,” the statement said.

Covenant also said it is reviewing the language in its policy “related to the use of the term ‘exceptional’ in identifying patients who may require onsite MAID assessments.

“The interpretation of that word may not have been what was intended in some cases and we are reviewing to ensure improved clarity going forward,” the statement said.

Couldn’t eat, could barely move

Young and Hergott were best friends and roommates for 25 years. Describing their relationship as “like brother and sister,” Young remembers Hergott as a thoughtful friend who had overcome a difficult past.

When he was diagnosed with the neuromuscular disease ALS (amyotrophic lateral sclerosis) in 2009, Young became his caregiver, taking on the bulk of household chores.

Eventually, Hergott’s care needs grew too complex for her to fulfil alone. In June 2011, he became a patient at St. Joseph’s, a Covenant Health hospital in south Edmonton.

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Young said the choice to move Hergott to a facility run by a Catholic health provider was not intentional.

The ALS Society of Canada “was desperate to find a residence for him,” she said. “They were all just filled up.”

Two or three times a week, Young would ride public transit 75 minutes each way to visit with Hergott. She watched his condition worsen.

Young says by the time Hergott requested an assisted death, he couldn’t speak or eat, and could only communicate through typing on a tablet with one finger. (Verna Young)

Young said every morning, hospital staff would use a lift to put him into a reclining motorized wheelchair. She said he would stay there all day because he didn’t want to bother the staff to put him back into his bed for a rest.

“And he couldn’t eat towards the end,” Young said. “He just sort of basically refused to eat because he was embarrassed that he couldn’t eat.”

Hergott’s wishes were clear: he wanted to die. Young said her friend was “so happy” when the federal government legalized medical assistance in dying in June 2016, but he soon learned that Covenant Health wouldn’t allow him to access any of those services in its hospital.

She said Hergott received a letter from Covenant Health that said “there would be no correspondence on their property, no correspondence of any kind and no people that were going to discuss anything about (MAID) in there.”

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Young said she read the letter but she could not locate it for CBC News.

“He was really disappointed,” Young said, adding Hergott may have had the letter torn up. “He was so upset about it.”

Signed form in bus shelter

Covenant Health’s position meant Hergott could not even sign his form requesting a medically assisted death while he remained on the property.

Instead, he had to steer his motorized wheelchair off hospital property and across the street, where he met Young and her daughter, the two witnesses for his form.

“It was pouring rain and just a horrible day,” Young said. “And we waited in the bus shelter there because the car was parked further away.

“We went and did it in the bus shelter across the street from the [hospital],” she said. Young also said the experience clearly upset her friend.

Hergott also had to complete his MAID assessments off hospital property; Young went with him to every appointment. He was ultimately approved for a medically assisted death and the procedure was scheduled for Aug. 17, 2016.

Covenant Health’s refusal to allow patients like Hergott to access assisted-dying services on its property baffles Young.

“I don’t understand it,” she said.

If someone you know has had a similar experience, or you have information about this story, please contact us in confidence at cbcinvestigates@cbc.ca.

@jennierussell_

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