04/14/2015 09:09 EDT | Updated 06/14/2015 05:59 EDT

Dying With Dignity is Part of a Life Well Lived

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The importance of quality palliative care gets overshadowed by our national debate over euthanasia or medically assisted death. There is a lack of understanding by Canadians about what palliative care means and how it can help to ensure that we and those we love are able to make that journey to the end of life with dignity.

In my last post, I wrote about how more companies are providing paid leave that allows employees to be caregivers for family members or close friends at a time of catastrophic illness. I received lots of feedback and also some questions about end of life care. Last month's Supreme Court of Canada decision to strike down the ban on doctor assisted suicide has driven discussion in coffee shops and around kitchen tables across Canada. And with the Government having been given one year to find a solution, we can expect vigorous public debate to continue among politicians, healthcare professionals and the general public. They're not easy conversations; no one wants to talk about death. But there is a necessity to address this issue.

Palliative care is a subject that I am quite familiar with since my days as a member of the Quebec National Assembly. As I became an advocate for innovation and quality healthcare, I also began to realize that dying with dignity is part of a life well lived. That's when I began to work with community representatives to establish the West Island Palliative Care Residence in the Montreal riding in which I served. Since it opened its doors in 2002, the Residence has offered support to 2,200 terminally ill patients and their families.

As the World Health Organization tells us, palliative care is designed to improve the quality of life of patients and their families as they face life-threatening illness. It's a holistic approach designed to affirm a person's life both physically and spiritually, manage pain and provide support for bereaving families. Palliative care "intends neither to hasten nor postpone death."

A report by the Royal Society of Canada Expert Panel in 2011 says that 95 per cent of Canadians would benefit from palliative care and yet, "as many as 70 per cent of Canadians lack access because hospice and palliative care programs are unevenly distributed across Canada." The same report concluded that "the better it is, the fewer requests you will have." Indeed, the jurisdictions that allow physician assisted death, such as Belgium and the Netherlands, have strong palliative care programs and, as a result, it is argued that demand for physician assisted death is relatively low, comprising less than 3 per cent of all deaths.


There is an increasing awareness about the need to address these gaps and improve programs and services. For instance, Quebec increased its support for palliative care when it incorporated medically-assisted death into its health legislation. Surveys have shown by an overwhelming margin that Canadians would rather die at home or in a hospice setting. But most end up taking their final breath in a hospital. For most Canadians, this isn't aligned with their wishes. Further, this is more costly for society.

As uncomfortable as it can make us, the fact remains that despite huge advances in medicine and healthcare, all of us will die one day. With our aging demographic in Canada, the Canadian Hospice Palliative Care Association estimates that by 2026, the number of Canadians dying each year will increase by 40 per cent to 330,000.

So how can we begin to fill the gaps? The first step is having the conversation. By making our wishes known to our friends and family, we are participating in "advance care planning." April 16 has been designated as Advanced Care Planning Day and Canadians are encouraged to speak up and talk about their values and how they want their lives to end.

Secondly, access to quality palliative care needs to be expanded so that it includes not only those who live in large cities but also in rural settings. It also needs to be tailored to meet the needs of patients regardless of their illness.

As Canada's doctors have said, we need a national strategy on palliative care. By improving programs and services throughout the country, we can ensure that as many Canadians as possible have a good death.