palliative care

We Need to Advocate for More & Better Palliative Care NOW!

Do you want palliative care to be available for yourself, family members and for all Canadians? If you do, now is the time to make your voice heard.

To be clear, palliative care, as defined by Hospice Palliative Care Ontario, “is a special kind of health care for individuals and families who are living with a life-limiting illness that is usually at an advanced stage. The goal of palliative care is to provide comfort and dignity for the person living with the illness as well as the best quality of life for both this person and his or her family.”  (For more information on palliative care please visit the Hospice Palliative Care Ontario website at http://www.hpco.ca/)

On February 6, 2015 the Supreme Court of Canada unanimously struck down the ban on physician-assisted dying (also called physician assisted suicide or medical aid in dying). Since that ruling, it has not been a question about whether this emotionally charged and contentious issue is legal, but rather what will be the laws and policies that will guide the process.

More recently, on October 28, 2015 The Canadian Conference of Catholic Bishops and The Evangelical Fellowship of Canada presented a Declaration on Euthanasia and Assisted Suicide  at a news conference on Parliament Hill. This declaration was also signed by some Jewish and Muslim leaders.

Kudos to these religious leaders for advocating for palliative care!  Part of their declaration states the following: "We urge federal, provincial and territorial legislators to enact and uphold laws that  ...  make good-quality home care and palliative care accessible in all jurisdictions”.

According to a CBC news report, “Ottawa Rabbi Reuven Bulka said while the religious groups oppose assisted death, they do not want to impose their will on Canadians. Instead, they want to be heard in the process of enacting new policies, which he says should focus on universal access to palliative care and improved supports for the terminally ill and their caregivers.”

It has been argued for many years that fewer persons will request a doctor –assisted death or resort to a self-inflicted one, if quality palliative care is available. Rabbi Bulka echoed this opinion with the statement that “We are convinced that were this choice [palliative care] available to everyone, Canadians would overwhelmingly choose it. But without access, Canadians are unfairly deprived of this life choice."

While Canadian standards for palliative care rate well internationally, shockingly only 16% to 30% of Canadians (depending on where they live) have access to hospice/palliative care services. (Canadian Palliative Care Association Fact Sheet) Paradoxically, perhaps, the “availability and quality of palliative care are better in some countries that permit assisted suicide. For example, Belgium and the Netherlands rank higher than Canada ...” (Health Law Institute, Dalhousie University) These small countries, however, do not face Canada’s geographical challenges that make the provision of quality palliative care difficult especially in the out-lying areas of our country.  How can this issue of accessibility be addressed?  How accessible are palliative care services in your own communities?

Canada now waits on what our new Federal government may do about creating legislation, as directed by the Supreme Court, on the issue of “medical assistance in dying”.  It can be expected that our federal legislators may be influenced by Quebec's Bill 52, “An Act respecting end-of life care”, passed by Quebec’s ‘National Assembly’ in 2014. Please do read the entire Bill.

While many readers may disagree with Bill 52’s assertion on the right to receive “medical aid in dying”, this Bill also gives the right, for the first time in Canada, to palliative care!  In fact, Bill 52 provides for the following:

  • Article 4 gives “Every person whose condition requires it has the right to receive end-of-life care”.  The Bill defines “end-of-life care” as “palliative care provided to end-of-life patients and medical aid in dying”.
  • Article 12 requires “a private room for the final few days preceding the patient’s death”
  • Article 13 states that “Palliative care hospices determine the end-of-life care provided in their premises “
  • Article 50 says that “A physician may refuse to administer medical aid in dying because of personal convictions, and a health care professional may refuse to take part in administering it for the same reason”.  

No matter what your personal position is on the issue of “medical aid in dying”, NOW is the time to speak up, not only to family and friends but also through grassroots political action by contacting your MPs and MPPs, writing letters to the editor of your local newspapers, connecting with your local hospital board members ...  to do whatever you can to ensure quality palliative care for all Canadians!

Ann Steadman, Associate

 

 

Hike for Hospice-A New Twist on an Old Format

Name almost any charity and you’ll likely learn about a fund raising walk to accompany its financial needs. This year, St. Joseph’s Hospice London spiced up the “walk” format and netted over $25,000.00. The enticing switch-up included a starting point which branched into a number of north London hiking paths of various duration. If you missed this year’s sunny Sunday event, be sure to take part next year. There were various levels at at which people could participate. Sister Dorothy Ann Howley (pictured at the right) found the perfect costume for her participation in the "Turtle Toddle" hike path!

  • Turtle Toddle – 2k paved walkway accompanied by a mascot
  • Hare Hop – 2.5k crushed gravel path
  • Hare Raiser – 5k more challenging path through the woods
  • Deer Dash – 7.5 run/walk for the fleet footed

Adding to the excitement were cheerleaders along the routes and nature and fitness challenges. The big finale included food and drink for all, entertainment and special honouring of the walk/run winners and major pledge raisers. Of course everyone was a winner from those who joined in the joy of knowing that their contribution will help to support the wonderful, compassionate work of Hospice and to supplement their ongoing programs that help to ease the lives of all who find themselves in need of comfort and support when facing palliative situations. Be sure to join Hike for Hospice in 2015!

View more photos from the Hike for Hospice event HERE.

Jean Moylan CSJ

My Body Knows How to Die

The current debate about redefining euthanasia as a ‘medical aid in dying’ has prompted me to draw from my social work experience with persons in the end-of-life stages and surface the following considerations.

If my life’s path is to take me through death’s portal by a prolonged terminal illness, I can trust my body’s biological wisdom to know how to prepare itself and how to carry through my Creator’s given design. While I am capable of making health care decisions or while I am legally capable of instructing another on my wishes (Living Will), I can make my end of life decisions. I can allow my body to embrace the dying process when being healed is no longer a possibility. Stephen Levine, poet and writer, known for his work on death and dying, captures this concept in asserting that one can choose to allow the body to heal itself into death when healing into life is no longer anticipated.

Medical advances can seek to prolong my life as if life did not have its already determined span. Loved ones might want to use all available means to keep me physically among them. However, when the time for me to die has come, I believe my body will know. It will gradually signal its inability to take in food or liquid or to even breathe. Lack of food or liquid in a terminal phase is not painful for the body. Breathing can be eased with oxygen.

"It is important to remember that as the physical body is dying, the vital organs are shutting down, and nourishment is no longer required to keep them functioning. This is the wisdom of dying, and the body knows exactly what to do." (Hawaii's Hospice and Palliative Care Organization)

One might consider doing violence to life’s natural processes by asking another person to end one’s life because the anticipated pain associated with terminal illness is unbearable. Not just the physical pain but the encompassing pain that is physical, spiritual, mental, and emotional. Individuals might mistakenly want to be euthanized, to have another end their lives, unaware that death will occur naturally by simply allowing the body to shut down in its own way. 

What I actually need from medical professionals and my loved ones is not to do violence to my dying process by ending my life, by euthanizing me, but to help me bear well with the manifestations of pain through appropriate pain management and attention to my physical, spiritual, emotional status. I need to know with certainty that appropriate pain management and the best palliative care will be in place for me as well as everyone else, just as they are right now for a number of people, albeit a fortunate few.[1]

If I happen to be demented at the end of my life, my hope remains the same. However, I know that some will question my quality of life. What if simply being alive until the natural end of my days is quality of life for me?

Should not the debate be about the provision of the best palliative care for everyone rather than about a law that would redefine euthanasia as medical aid?

Nicole Aubé CSJ

Note:

[1] The Canadian Hospice Palliative Care Association in its May 2010 Fact Sheet states that 16%-30%  of Canadians who die [depending on where they reside]have access to or receive hospice palliative and end of life care. Canada ranks ninth in an international “Quality of Death” index released July 14, 2010.