Like other Canadians, there are Veterans suffering from terminal illnesses who are choosing to proceed with Medical Assistance in Dying (MAiD) as a means to end their suffering. If a Veteran has chosen to pursue MAiD with their primary care provider and calls to inform Veterans Affairs Canada (VAC), employees can help the Veteran and their family understand the VAC benefits to which they would be entitled, as well as to discuss any other supports or services that might be relevant in the Veteran’s circumstances. This support can include resource coordination and navigation such as connecting a Veteran and their family to community resources, mental health practitioners, grief counsellors, pastoral outreach or other local resources. This support does not include VAC employees providing advice or suggestions on MAiD-related considerations.
On 21 July 2022, a Veteran contacted the VAC call centre to file a complaint alleging that a VAC employee had inappropriately raised MAiD to the Veteran during a phone conversation earlier that day. The Veteran alleged that the employee also referred to having provided information on MAiD to another Veteran. The Department took immediate action by apologizing to the Veteran and reassigning the Veteran’s file to the employee’s manager.
Recognizing the seriousness of the allegation, management initiated a fact-finding process on July 22. The files of the other Veterans assigned to the employee were reviewed and analyzed to look for indications of conversations about MAiD.
On August 19, the Minister of Veterans Affairs instructed the Department to conduct a full and thorough investigation of all aspects related to the situation and to ensure all possible steps were being taken to ensure an incident like this does not occur in the future.
On August 22, the review of the Veterans’ files assigned to the employee uncovered a second incident where MAiD had been inappropriately discussed with a Veteran. The next day, written guidance on MAiD was immediately shared with all Veteran-serving staff and five information sessions were held over the following four weeks to reinforce that initiating conversations with Veterans about MAiD is completely unacceptable and to give staff an opportunity to engage on the issue. At these sessions it was evident VAC staff understood they were not to raise MAiD to Veterans and that if Veterans raised it, they were to advise that MAiD considerations should only be discussed with their primary care provider. The file review was expanded to include an additional 2,153 files which the employee had worked on since 2016 when MAiD became legal.
While the review was ongoing, the Department proactively reached out to Veterans and stakeholders to discuss the issue and reiterate that MAiD is not a VAC service and that VAC employees have no role or mandate to recommend or raise it with Veterans or family members. Veterans who may have had similar experiences were strongly encouraged to come forward.
In November 2022, the Department became aware of two more Veterans with whom the same employee had raised MAiD.
In the meantime, the Department reviewed all 402,000 files in its client databases, dating back to June 2016 when MAiD legislation came into effect. This search and analysis did not uncover any instances where MAiD had been raised inappropriately with the exception of the four incidents already identified. While additional allegations were brought forward – through appearances at the Standing Committee on Veterans Affairs, media and correspondence to the Department – VAC was able to thoroughly investigate allegations which included a Veteran’s full name. No information was found to validate any of these allegations that inappropriate discussions related to MAiD had taken place.
Based on the review and analysis of the employee’s 2,153 files; a search of all 402,000 files in VAC’s databases; discussions with case managers, Veteran service agents and their managers; a review of all incoming communications to the Department on this issue; and feedback from staff training and information sessions, VAC has concluded these were four incidents completely isolated to a single employee. The employee no longer works for the Department. Further, it has concluded that this is not a widespread, systemic issue, nor is it a reflection of the work of hundreds of case managers and Veteran service agents who interact with the utmost care, compassion and respect with Veterans every single day.
This investigation has brought to light a number of opportunities for improvement in how VAC manages and oversees significant incidents related to Veterans’ well-being. While the Department took action to address the specific issue raised by the Veteran and new measures are in place to prevent this type of incident from happening again, processes and procedures can be further improved. In 2023, the Department’s Audit and Evaluation Division will conduct an independent and objective review of the escalation process. This will include the processes and procedures in place in the Service Delivery Branch for the identification, reporting and following up on sensitive/significant incidents raised by Veterans (or brought to the attention of VAC). Opportunities for improvement identified in this review will be fully implemented.
The Department is committed to maintaining Veterans’ trust in Veterans Affairs Canada. Veterans and their families should always feel confident they will receive the care, compassion and respect they righty deserve from VAC.
VAC has referred the four incidents to the Royal Canadian Mounted Police for their consideration. The Department will continue to review any allegations brought forward; to date, all additional allegations have been confirmed to be unfounded.
The purpose of this report is to provide an overview on what the Department’s investigation found and what the Department has done to ensure this situation does not happen again. The report outlines:
- The details and circumstances of what happened and what actions the Department took as new information was brought forward.
- The methodology the Department used to investigate whether other Veterans were impacted through similar experiences.
- The steps VAC is taking to improve staff training, quality assurance and management oversight of significant incidents, as well as plans to consult Veterans on the issue of recording their conversations with VAC employees.