Physician-assisted death divides Canadians, medical panel hears
Everyone should discuss end-of-life wishes with their families and loved ones, doctors say
Canadians are divided on physician-assisted death and other end-of-life care issues that need to be discussed with families and loved ones, a national tour by the Canadian Medical Association has heard.
The medical group released its final report from its end-of-life tour in Ottawa on Tuesday, based on the findings of town hall meetings in five Canadian cities.
"We had been concerned that assisted death was sucking up all the attention from the crying need for palliative care in this country," CMA president Dr. Louis Hugo Francescutti said in a release that lauds last month's unanimous, non-binding federal resolution calling for a pan-Canadian strategy on palliative care.
During a news conference, Francescutti said that this Saturday is the one-year anniversary of his own mother's death. She "was going through hell" before she was transferred to a palliative care residence in Kirkland, Que. While the family grieved the loss, they were reassured she had the best possible death, which all Canadians should be afforded, he said
"The main driver is that baby boomers will not accept the level of care in terms of end of life that they see their parents and loved ones getting right now. My generation is a boomer and when I talk to boomers they say to me off the line that 'Doc, this isn't good enough. What I just experienced with my father or mother is not something that I expect.'"
A common thread was that people said they don't want to die in pain, die alone or be a burden to their loved ones, Francescutti said. Better palliative care would go a long way toward addressing those concerns.
Fewer than 30 per cent of Canadians who die this year will have access to palliative care, which the medical group said.
Many participants at the town hall meetings decried a lack of comprehensive palliative care services, particularly outside major cities.
The group's conclusions include:
- All Canadians should discuss end-of-life wishes with their families or other loved ones.
- All Canadians should prepare advance care directives that are appropriate and binding for the jurisdiction in which they live.
- A national palliative care strategy is needed.
- All Canadians should have access to appropriate palliative care services.
- Medical students, residents and practising physicians need more education and training about palliative care approaches and greater knowledge about advance care directives.
- Should Canada change laws to allow physician-assisted dying, strict protocols and safeguards are needed to protect vulnerable individuals and populations.
At the CMA's town hall in St. John's, Donna Walsh recalled asking her elderly mother to prepare an advanced care directive — instructions in case she became sick.
A year ago, Walsh's 83-year-old mother was diagnosed with Alzheimer's disease, and she died recently. Walsh was grateful to know what her mother's wishes were.
"It helped tremendously. I didn't have to make a decision, she did it."
Last week, Quebec's Bill-52, also known as an act respecting end-of-life care, passed in a free vote.
Quebec Health Minister Gaeton Barrette said he believes doctors across the country will have to answer the will of the public on physician-assisted death.
"I think it is the easiest path for doctors to say, 'Well, this is something we cannot do.' That to me falls into political correctness."
The CMA didn't provide figures indicating the level of support for physician-assisted dying, saying there wasn't unanimous support on one end of the spectrum or the other on the issue.
- Quebec passes landmark end-of-life-care bill
- Quebec's end-of-life-care law may violate Criminal Code: Ottawa
- Quebec end-of-life-care law means new era for health providers
- Doctor-assisted suicide ban upheld in B.C.
- Assisted suicide debate needs constructive dialogue, doctors say
The Supreme Court of Canada is scheduled to hear a key appeal on end-of-life care in October. If the top court strikes down the laws prohibiting physician-assisted death when it hears an appeal by the B.C. Civil Liberties Association, the family of Kay Carter and others, doctors could be left in a legal vacuum, according to a commentary in the Canadian Medical Association Journal.
The federal government has said it has no intention to change the criminal law against physician-assisted dying.
"It's certainly not our intention as a Parliament, as a federal government, to reopen the debate," said Justice Minister Peter MacKay.
The CMA's town halls were also held in Vancouver, Whitehorse, Regina and Mississauga from February to May. Online comments were also considered.