Palliative care top of mind in Central Alberta

Canada’s proposed law to allow doctor-assisted dying introduced in Parliament on Thursday has Central Albertans talking about more access to palliative care.

Canada’s proposed law to allow doctor-assisted dying introduced in Parliament on Thursday has Central Albertans talking about more access to palliative care.

Red Deer-Mountain View MP Earl Dreeshen said during the election the Liberal government promised to invest $3 billion in long-term care and an effective strategy for palliative care.

“What we don’t see from this government is the dollars they said would be associated with increasing palliative care,” said Dreeshen from Ottawa on Thursday.

The Conservative MP said if Canadians are making end of life decisions, the government has to follow through on its commitment to help people through such a difficult time by increasing palliative care.

The bill recognizes Canadians who have “a grievous and irremedial medical condition that causes them enduring and intolerable suffering who wish to seek medical assistance dying.”

Among the requirements, people have to be eligible for health services funded by a government in Canada, at least 18 years old and mentally competent, have made a voluntary request without external pressure, and requires a mandatory 15 days for people to reflect on their decision.

At St. Mary’s Catholic Church on Sunday, about 500 people attended a talk on doctor-assisted dying led by Edmonton Archbishop Richard Smith, a hospital chaplain who works with the dying and a doctor specializing in chronic pain.

Smith said the church has been advocating for increased access to effective palliative care.

“One of the tragedies in this whole thing is that rather than putting all of our efforts and resources into making palliative care more accessible, now we have efforts that take the opposite direction and want to make death more available for people. It’s kind of a sad commentary on where our society is moving,” Smith said from Edmonton.

“(Palliative care) is a beautiful way of surrounding people with love and affirmation of their value, and giving them care and support — not just physical — but also psychological, spiritual. Whatever they need, and any family members who may also be in need,” Smith said.

He said after reading the proposed legislation, his message remains the same.

“It is seeking to make legally acceptable in some circumstances what’s morally wrong in every circumstance. This is something that we need to continue to, in my view, speak out against,” Smith said.

Rev. Paul Cadieux, of St. Mary’s Church, said forcing doctors to participate or to refer patients is not right and education about palliative care is also lacking.

“A lot of people still don’t know about palliative care. Families need to know about it for family members,” Cadieux said.

Cheri Purpur, RN and nurse manager at Red Deer Hospice, agreed.

“At this point we don’t have great numbers of people in the waiting pool. But I don’t know if that’s an accurate reflection of how many people would benefit from hospice care. I think there is still a very large lack of public education,” Purpur said.

The 10-bed hospice admits about 160 patients a year and is often full.

“If the people who are considering physician-hastened death, if they truly understood what palliative care can provide them, I honestly believe they would not be asking for this service. Because we can provide them with what they’re looking for in the way of dignity and comfort. They just don’t know that we can.”

She said Red Deer Regional Hospital Centre has a 10-bed tertiary palliative care unit for people who need pain and symptoms brought under control before they go home, into long term care or a hospice. But there is not enough long-term care, at times no bed in hospice, and not enough home care to have comfortable home deaths.

Currently Red Deer Hospice, like other hospices and health care centres, has to determine whether to allow doctor-assisted death in their facilities.

“We have a committee who is in the process of developing a hospice policy,” Purpur said.

Mara Grunau, executive director for Centre for Suicide Prevention in Calgary, said more mental health services are also required to identify who is looking for doctor-assisted death and who is suicidal. A very specific screening process is needed.

“Our fear is not that it will increase suicides per say, but I think it’s inevitable that it will normalize dying not by natural causes. The risks we’re afraid of is that the people who are suicidal will be misclassified into the physician-assisted death stream,” said Grunau, whose agency is not taking a stand on doctor-assisted dying.

“People who are looking for physician-assisted death want to hasten death. So they know that their dying is inevitable and they want the suffering to end. Suicidal people actually don’t want to die. They are looking for someone to help them. They don’t see a way out. They don’t see another option,” Grunau said.

Pastor Paul Vallee at Living Stones Church said the doctor-assisted dying bill is a reflection of our culture’s impatience.

“We’re the microwave generation. Let’s speed everything up,” Vallee said.

As a pastor for over 30 years, Vallee said he believes in miracles.

“There are situations when even the medical people would say they shouldn’t have recovered, and they live another two years or 10 years.

“In some cases, yes they are terminal and they will die. There are other situations where people have recovered. In the future, those (who chose doctor-assisted death) won’t recover,” Vallee said.

Dreeshen said Conservatives want the legislation to safeguard vulnerable people and to make provisions for the conscientious rights of physicians and other health care providers. He said further discussion and assurances are required.

Red Deer-Lacombe MP Blaine Calkins said an overwhelming majority of his constituents didn’t want to go down this road and are “very, very concerned about the slippery slope that would be created by this legislation.”

“I’ll be working to respect my constituents wishes and to make the restrictions for assisted dying as stringent as possible,” said the Conservative MP.