Much of the recent attention in Canadian news and politics has focused on Bill C-14, a bill designed to allow specific terminally ill patients to receive assisted suicide. This legislation, if passed in the Senate, allows doctors and nurses to participate legally in assisted suicide. Although euthanasia is a controversial, but important, issue, it is essential that not the entire spotlight is stolen from other issues omnipresent in the Canadian healthcare system. While we are helping people die with dignity, we should also look to help those that are choosing to live on. Important issues, such as funding for prescription drugs, must never be ignored, nor neglected. Not enough emphasis is being placed on the accessibility of specific services, notably palliative care.
Palliative care is an approach to specialized medical care for those with serious or terminal illnesses. It can entail doctors assisting these patients in the hospital, or nurses and caregivers helping patients die peacefully in their own homes [1]. Palliative care is essential in relieving or minimizing the suffering of patients and their families, especially those nearing the end of their lives. However, there is a need for more widespread access to palliative care. While satisfaction with the quality of palliative care in Canada is quite high, only 16% to 30% of Canadians, varying with place of residence, will receive end-of-life services, especially palliative care [2].
Considering that the majority of Canadians would prefer to die in their own homes, surrounded by loved ones, the lack of access to palliative care is disturbing [2]. Palliative care extends to households, but to die peacefully at home, a nurse or caregiver is often required. Consequently, many end up dying in hospitals. Given that a majority of deaths occur in hospitals, it is obvious that there is a need for improved access, especially in households, to palliative care. The main issue is that not enough people, especially in isolated locations, have access to these end-of-life services in their homes. Canada fails to provide palliative care to upwards of 70% of Canadians [2].
However, issues related to end-of-life services extend beyond the accessibility of palliative care. A patient’s psychological and mental well-being, as well as their family’s, must be considered. Providing support to the patient and their family and friends, both emotionally and financially, is essential. The cost of medical care is a significant portion of a family’s finances, and when combined with the cost of medications, many families require financial support. The financial strain may also leave an emotional strain, and can end up being just as taxing for the patient and their family. Accessibility of palliative caregivers should be extended to more people nation-wide, but we must not ignore the financial and emotional impact. Emotional support can be achieved through services such as grief counseling, while financial support can be in the form of reductions of the costs of medical bills. Federal programs providing this support can be incredibly beneficial to the families of patients.
All Canadians have the right to palliative care – why are only some Canadians receiving it?
[1] http://www.who.int/cancer/palliative/definition/en/
[2] http://www.chpca.net/media/330558/Fact_Sheet_HPC_in_Canada%20Spring%202014%20Final.pdf
Illustration: Sheri Kim
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