NDP MP Joe Comartin, flanked by Parliamentary Committee on Palliative and Compassionate Care co-chairs Liberal MP Frank Valeriote (left) and Conservative MP Harold Albrecht, discusses the findings of the Parliamentary Committee on Palliative and Compassionate Care. CCN Photo.Bishops' conference applauds recommendations
By Deborah Gyapong
The Canadian Catholic News

OTTAWA (CCN)--Days after a Royal Society of Canada report advocated for euthanasia and assisted suicide, an all-party Parliamentary committee named suicide prevention, effective palliative care and elder abuse intervention as the three pillars of care for vulnerable Canadians.

The Parliamentary Committee on Palliative and Compassionate Care (PCPCC) report entitled “Not to be forgotten” is silent on the legality of euthanasia or assisted suicide. Instead, it stresses the need for pro-active measures to make good, end-of-life care available across Canada.

At a news conference releasing the report Nov. 17, PCPCC co-chair and co-founder NDP MP Joe Comartin said only 16 to 30 per cent of Canadians have any access to palliative care.

“That means that the balance of Canadians have little to no access,” he said, noting that research on palliative care services is spotty.

Comartin added that even within cities like Toronto or Montreal, access can vary. While Canada does a good job in dealing with acute health care issues, it is less prepared to deal with chronic conditions, chronic pain, and mental health problems.

The report recommends the creation of a Palliative Care Secretariat to conduct research and facilitate the collaboration of those involved in palliative care and health officials at all levels of government from municipal to federal, Comartin said.
Canadians as a whole must engage in more planning for their own personal need for palliative care later in life, he said.

Doctors need more training in pain management and efforts must be made to reduce the need for extended long-term care, which is far more expensive than home or hospice care, he said.

The report outlines the palliative care philosophy as “person-centered, family-focused and community based.”

“It recognizes that the psycho-social and spiritual dimensions have profound impact upon health and well-being, and that a variety of specific conditions may be operating on different levels in the chronically ill or dying person’s life,” the report says.

Canadian Medical Association President Dr. John Haggie told the news conference questions of assisted suicide and euthanasia reflect “the failure of access to adequate palliative care across the country.” Speaking as someone who recently lost his wife, and as a physician serving in a part of Newfoundland where there is no patient-centred palliative care system, he described the problem as “urgent.”

Haggie said the creation of a national palliative care system could be a step in a transformation of how Canada deals with both acute and chronic conditions.

The Canadian Conference of Catholic Bishops (CCCB) welcomed the report. In a Nov. 17 news release, CCCB president Edmonton Archbishop Richard Smith said the bishops are “pleased” that MPs have held “extensive consultations” and “published this report out of their personal concern to see established in our country a national system of compassionate and effective care for some of our most vulnerable citizens.”

“The Bishops of Canada share that concern,” Archbishop Smith said. “The inherent beauty and dignity of human life from its beginning until its natural end summons us to attend to this need without delay.”

Archbishop Smith described palliative and compassionate care as “an essential priority (that) responds to all dimensions of their humanity, including the spiritual.”

“As follow-up to this report by the Parliamentary Committee, the Catholic Bishops of Canada will carefully monitor how our national, provincial and municipal institutions implement these important recommendations on palliative care,” Archbishop Smith said.

The Catholic Health Alliance of Canada (CHAC) also applauded the recommendations, describing them as “an important step toward improving palliative end-of-life care in Canada.”

"There are many challenges and areas that require improvement: the need for equitable access and stable funding; support for family caregivers, and the pressing need to address the great confusion that exists regarding palliative care - its goals and effectiveness" said CHAC ethics and health policy advisor Dr. Nuala Kenny in a Nov. 17 news release. "The recommendations put forward by the committee, if implemented, would represent important steps forward in addressing those challenges."

The PCPCC was set up a year and a half ago in the wake of the defeat of Bloc Quebecois MP Francine Lalonde’s euthanasia and assisted suicide private member’s bill. It involved 55 MPs and 24 hearings across the country, involving hundreds of people in the preparation of the report. Comartin described the report as an historic, non-partisan effort.

Canadian Cancer Society public affairs director Dan Demers said all patients deserve palliative care that respects their dignity and provides freedom from pain when a cure is not possible.

Because of disparities in care, “some people suffer needlessly,” he said. “People at end of life are vulnerable; we must not abandon them.”

Palliative care was only one of the urgent problems addressed by the PCPCC.

Suicide is almost always preventable, said PCPCC co-chair and co-founder Conservative MP Harold Albrecht, but active prevention programs depend on where one lives in Canada.

“These deaths do not ease the pain,” he said. “They just transfer the pain to others.”

Ten Canadians die a day by suicide, almost 4,000 a year, the report says. It is the second leading cause of death among young Canadians; rates of Aboriginal youth suicide are five to seven times higher than those of non-Aboriginals. The report calls for a national suicide prevention strategy.

Canada also needs a national elder abuse prevention strategy, perhaps a campaign like those in previous decades that raised awareness of spousal or child abuse, said Liberal MP and PCPCC co-chair Frank Valerioti.

Some estimates see as many as 20 per cent of elderly people being abused in some form over their lifetime. As Canada’s population ages, the problem could become worse, he said.

Though abuse is often not reported, Valerioti echoed the report, which says any senior could become a victim, and perpetrators could be “family members, friends, neighbors, caregivers or persons’ paid to carry out work for them.”

Abuse takes different forms, but includes “physical violence, sexual abuse, financial abuse, neglect, and various forms of institutional abuse,” the report sys.

Comartin said national strategies for suicide prevention and combating elder abuse will be easier to tackle than palliative care.

“We can’t do everything overnight,” he said. But he said the report provides a framework with recommendations that can be implemented in steps.

The creation of a national palliative care system requires “some will” from national, provincial and territorial leaders, said Haggie, who said Canadians have stated clearly “this is what they wanted us to do.”