New Brunswick

Palliative care improvements are 'urgent,' Moncton doctor says

Moncton palliative care specialist Dr. Pamela Mansfield says it is urgent the New Brunswick government act on a report that is now two-years old to improve care for dying patients and their families.

Dr. Pamela Mansfield worries patients will choose doctor-assisted suicide unless palliative care improves

Quebec city's healht agency has confirmed the first known case in Canada of someone legally receiving medical aid in dying. (Canadian Press)

The New Brunswick government must make urgent changes to improve care for dying patients and their families, according to a palliative care specialist.

Dr. Pamela Mansfield, the clinical director of palliative medicine for the Moncton area with Horizon Health Network, says with doctor-assisted suicide soon to be legal in Canada it is urgent that the provincial government start making changes based on the recommendations of a June 2013 report.

"It gives direction for how do we deliver equitable, good quality palliative care for everyone in the province no matter where you live," Mansfield said in an interview on Information Morning Moncton on Monday.

CBC News has contacted the Department of Health to find out what is happening with the report but so far there has been no response.

The Supreme Court of Canada struck down the ban on physician-assisted dying in ruling on Feb. 6, saying the prohibition violated Canadians' charter rights. The court gave the federal government one year to come up with a new law.

Palliative care specialist Dr. Pamela Mansfield says it is urgent that New Brunswick improve care for dying patients. She worries patients will choose doctor-assisted suicide because quality palliative care isn't available. (CBC)
Last week, CBC News reported the incoming Liberal government is considering asking the Supreme Court for a six-month delay so it can draft a new law.

Meanwhile, religious leaders from several faiths demanded Canadian politicians to improve palliative care and respect human life as the debate over doctor-assisted dying continued to heat up.

Mansfield said she worries patients will choose doctor-assisted suicide over the palliative care that is available to them in New Brunswick.

"It would be a shame that someone chooses physician-assisted suicide because they didn't have good quality palliative care," she said.

"There are many things we're failing at in New Brunswick that really should have been acted on more than two years ago but nothing has happened, and we really do need to make some progress."

Doctors continue to pressure government

Mansfield says doctors with the Horizon Health Network regularly ask the provincial government officials when action will be taken and they are told it is being studied. 

The Supreme Court of Canada struck down the ban on physician-assisted dying in ruling on Feb. 6, saying the prohibition violated Canadians' charter rights. The court gave the federal government one year to come up with a new law. (Adrian Wyld/Canadian Press)
"There have been numerous studies that have been done that show palliative care is actually cheaper than standard care and you save money in the long run," she said.

"Not only is it good quality care with higher patient and family satisfaction and less suffering for the patient and family it actually costs less than the standard care we are providing today."

Mansfield says the care provided in New Brunswick depends on where a person lives. 

In Moncton, for instance, there are palliative care specialists who work with family doctors but in Miramichi there are none.

She said there are no palliative care specialists at the Vitalité Health Network.

"They have some family physicians who have some extra training in palliative care that are granted a few hours to work with palliative care patients," Mansfield said.

"But there is no one who has a full-time position to look after palliative care patients or to do any home visits."

'I'm really afraid'

Mansfield says good quality of care at the end of life means pain management and the ability for people to "live until they die."

"It really strikes fear... into a lot of people because they say, 'Oh I am going to suffer and therefore I will choose physician-assisted suicide,' when the reality is the majority of patients can have a good quality life," sh esiad.

She said  one recent experience shows how good palliative care can make all the difference for dying patients.

After visiting a patient she made minor changes to her medication, which allowed her to visit with family and go for walks.

On a return visit, Mansfield says the patient was very grateful.

"She said, 'Why didn't I meet you three months ago?' and I have no answer to that other than the resources aren't there," she said.

Mansfield said people do not want to be a burden to their families, however many don't want to go into hospital either.

"I'm really afraid we aren't doing better for our patients and families," she said.

She said many patients are dying in hospital right now when the better option would be a hospice.

There is a hospice currently open in Saint John, while community groups in Moncton, Miramichi and Fredericton are raising money to open hospices in their cities.

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