Canada's palliative care framework earns praise from advocates

OTTAWA – Palliative care advocates are applauding a new national framework document that has adopted an international definition of palliative care that excludes euthanasia and assisted suicide as elements of patient care. 

Released Dec. 4, Canada’s national palliative care framework has endorsed the World Health Organization (WHO) definition which states palliative care should “neither hasten or postpone death.”

“It’s a great thing that they decided to go with the World Health Organization definition,” said Conservative MP Marilyn Gladu. “That precludes people that are delivering palliative care from performing MAiD (medical aid in dying) as well.”

Gladu said there is pressure in British Columbia to include euthanasia and assisted suicide in palliative care. 

“It’s of great concern because people that are providing palliative care should not in any way be hastening death,” she said.

“That is the WHO definition and that’s what’s in place in provinces like Quebec and most of the rest of the country and that’s the model we should stick with,” she said.

Euthanasia Prevention Coalition executive director Alex Schadenberg applauded the approach of the framework.

“Palliative care is about caring for the physical, psychological, social and spiritual needs as a person’s life is coming to an end,” he said. “It’s not supposed to be about ending their life.” 

The national document was produced as a result of a private member’s bill by Gladu that passed into law a year ago with unanimous all-party support. It required Parliament develop a national framework for palliative care by Dec. 11, 2018.

The framework document reports that, although 75 per cent of Canadians would prefer to die at home, 60 per cent die in hospitals. Only 15 per cent of Canadians have access to palliative home care services, and those with access to these services are 2.5 times more likely to die at home than in a hospital emergency department or intensive care unit.

Tabled by Health Minister Ginette Petitpas Taylor, the framework calls for the creation of an Office of Palliative Care (OPC), funded by Health Canada, to co-ordinate and improve palliative care across federal, provincial and territorial jurisdictions. This office would also connect the many stakeholders in palliative care and raise public awareness.

Gladu welcomed the creation of the OPC, but said much depends on who the government appoints to run it.

“It needs to not be a bureaucrat,” she said. “It needs to be someone familiar with palliative care to help drive the plan forward.

“The framework contained all the elements we were hoping to see in there, from the training of different levels of health care providers, to infrastructures that may be needed to help get that consistent access across the country,” said Gladu. “We saw data collection and research — care and support for the caregivers. I think the right elements were there.”

But Gladu expressed disappointment that “the timelines look very pushed out.” 

“They are going to spend the next year or two to figure out exactly what they want to do,” she said.

Gladu is also disappointed that no new money was attached to the framework, and that very little of the $6 billion pledged previously by the Liberal government to go towards palliative care and home care has been spent. 

“In fact, they have extended the time line to now be from 2017 to 2027 in terms of how the $6 billion will roll out,” she said.

Overall, however, she said the “this framework does have the right elements, it is a plan marching us in the right direction to get consistent access for all Canadians.”