Assisted death shouldn’t eclipse patients’ need for palliative care
People need to know all their options, Pippa Hawley writes.
Last week, a B.C. woman suffering from multiple sclerosis became the first person in the province to be granted a legal exemption for physicianhastened death. This case illustrates a need for clarity on who will help patients end their lives in our province.
Palliative care physicians see first-hand how serious illnesses can lead to intense suffering for both the patient and their loved ones. Their working lives are dedicated to relieving that suffering.
In Canada, palliative care physicians recognize the choice to die must be legally respected.
Some have even publicly advocated for this as a right. And by June 6, the Canadian government must have crafted a law to regulate assisted death.
Would it not be a failure of new legislation if patients resorted to ending their lives without first being offered quality care as a choice?
Palliative care physicians feel it is critical that Canadians have access to quality palliative care so they can confidently seek treatment to improve their quality of life without fear of an accelerated demise.
Palliative care is often misunderstood as being appropriate only at the very end of life when there may be only days or weeks to live, often too little and too late.
Many believe that palliative care leads to an accelerated demise despite clear evidence to the contrary. Fear and misinformation abounds.
Sadly, a large proportion of B.C. residents and Canadians die from chronic progressive illnesses without any contact with a palliative care service at any point in their illness.
Early access to specialist palliative care has been proven to improve quality of life for patients, families and caregivers, and to be asso- ciated with the same or longer survival than in those who do not receive it.
The World Health Organization’s definition of palliative care explicitly affirms a patient’s right to refuse unwanted prolongation of life and choose quality over quantity.
It is for these reasons that palliative care physicians must not be the actual providers of physician-hastened death and remain the advocates for the life preceding death.
Palliative care physicians must advocate that all Canadians have ease of access to appropriate care that includes access to palliative care and supports.
We must also advocate that universities and health authorities train all physicians to incorporate palliative care as a core tenet of their practice to best serve the needs of their patients.
Palliative care physicians must also continue to be engaged in clinical care and carry out research to assist their patients’ right to live as well as possible until death occurs.
Palliative care physicians will never abandon their patients. They will ensure that all patients are provided with the best possible care and support, irrespective of whether they choose physician-hastened death.
They will continue to work in partnership with all health professionals involved in the care of patients, including providers of physician-hastened death, to allow choice to prevail.
Dr. Pippa Hawley is head of the UBC division of palliative care.
Early access to specialist palliative care has been proven to improve quality of life for patients, families and caregivers, and to be associated with the same or longer survival than in those who do not receive it.