02/09/2015 05:54 EST | Updated 04/11/2015 05:59 EDT

Assisted Suicide Is on Canada's Radar, But What About Palliative Care?

Hospice worker holding elderly man's hand UK. (Photo by: Photofusion/UIG via Getty Images)
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Hospice worker holding elderly man's hand UK. (Photo by: Photofusion/UIG via Getty Images)

Last week's Supreme Court decision has put the issue of assisted suicide square onto the government agenda. However, it would be a real loss for Canadians if Parliament does not look at the much broader issue of how we care for Canadians suffering from incurable illnesses.

Last spring Parliament supported the New Democratic Party's Motion 456 to establish a pan-Canadian strategy on palliative and end of life care. But since that vote the Conservatives have done little with the issue. This is odd, as they knew the Supreme Court decision on assisted suicide was coming down. Opening a conversation on palliative options would have given Canadians a sense that the Harper government is ready to tackle the complexity of issues facing end of life care. But taking a leadership role in working with the provinces on improving health care just doesn't seem to be in the Conservative DNA.

And so now the government has had their hand forced. Either they will move forward with a national vision for end of life issues or be forced to deal in isolation with the very difficult issue of assisted suicide. Over the last year I have had the fortune to meet with front line providers of palliative care across Canada. I have learned that palliative care is about ensuring patients and their families are able to experience death with dignity. There are some incredible models of delivery providing the best pain management options for patients while ensuring emotional and spiritual support for families. The problem is, these services exist as a patchwork across the country.

As it stands now, only four provinces (BC, ON, QC, PEI) have a provincial strategy/framework for palliative care. Even in provinces with a palliative commitment, there is a huge discrepancy in availability of services. This is true whether you live in downtown Toronto or in the rural north. Over 70 per cent of Canadians do not have access to quality palliative services.

The question that needs to be asked is how can the Federal government respond to the spirit of the Supreme Court ruling unless it also deals with this patchwork of end of life services in this country? While the delivery of palliative services (outside of First Nation and the military) is a provincial or territorial responsibility, the Feds have a role to play in to helping coordinate a national set of benchmarks for improving services

Such leadership isn't just the right thing to do -- it also makes huge financial sense.

As it stands now, 1 per cent of the population uses of 30 per cent of the nation's health care budget -- the vast majority being spent on terminal illnesses and end of life care. In areas without coherent palliative services, the cost of dealing with these patients can be much higher with much poorer outcomes for patients and family. Palliative programs on the other hand, saves the system enormous amounts of money. The "savings" from pain, emotional fatigue and stress on family and patients are enormous.

A national palliative approach doesn't need to be rocket science. If a good model for palliative services exists in Sudbury or Saskatoon, such services are replicable in other communities and regions.

The Supreme Court ruling has pushed the issue of dying to the forefront of debate in Canada. But without a fulsome discussion about palliative options, this issue could become polarizing or too narrow in focus. The government has an opportunity to show real leadership. Unfortunately this government has had a bad track record of dealing with both the Supreme Court and with polarizing social issues. It would be a shame for Canadians if the government doesn't recognize the opportunity to make something positive out of the position they are in and close the gaps on palliative and hospice care.

All of us will have loved ones die and all of us will eventually die. We hope that such moments come without unnecessary suffering. We also know that the vast majority of Canadians prefer to die at home in the presence of loved ones. And so as the government grapples with the ruling of the Supreme Court it needs to recognize that only 16 to 30 per cent of Canadians have access to hospice palliative care and end-of-life services.

New Democrats have been pushing for national leadership on palliative care. Now is the time to make this a reality.


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