Revamping end-of-life care planning
Re How doctors are failing us in death, Opinion Sept. 20 With sincere condolences to author Mohamed Dhanani and his family, I could not agree more with the magnitude of unmet need in end-of-life care planning.
Canada is uniquely positioned to be a global leader in this field, with the streamlined organization of our health-care system, world-class clinicians and researchers in the field and a unique alignment of stakeholders who are uniformly incentivized to solve this enormous problem facing each of us and our families.
The solution does not lie with a single group of health-care providers, as the author asserts, but rather in the creation of a healthcare delivery process that enables high quality and consistent advance care planning across the entire population.
Health-care professionals, such as nurses, nurse practitioners and social workers, should be specially trained and empowered to guide individuals through this life-long process, working closely with their physician colleagues. Medical education for physicians should have an increased emphasis on advance care planning and end-of-life care.
The health system should fund dedicated care pathways and protected time for these critical conversations to occur well in advance of a sudden illness and ensure that these wishes are documented and available across the health-care system.
As a co-founder of an early stage health-care technology company focused on improving advance care planning, I also firmly believe that technology must be leveraged to support individuals, families and health-care professionals through this complex process. Technology can ensure the creation of accurate documentation, bring educational materials to the point of care and bridge the current health-care data silos that prevent this critical information from flowing between care settings.
As an intensive care physician who has practiced on both sides of the border, knowing an individual’s care preferences at the time of a sudden illness provides essential context to provide the best possible care and to support families through decisions related to the use of life-sustaining treatments.
Too often, however, both the care team and family are put in the tragic situation of making difficult treatment decisions in the stark absence of the most important opinion in the room. Dr. Ryan Van Wert, St. Michael’s Hospital and Ryerson University, Toronto