Tuesday, September 3, 2013

Quebec's Bill 52: An Act Respecting End-of-Life Care

Everyone is having their say on this issue. Dying with Dignity proponents have been lobbying l
ong and hard to allow those a choice.

It requires two participants.
1. The doctor or the nurse practitioner who will provide the tools for dying.
2. The patient will make the choice that their pain, their suffering, or their lack of dignity, means they are no longer able to stay in this world.

This issue is different than delivering end-of-life palliative care.
No one else can or should be involved. THis prevents the 'slippery slope' people are warning us about.

There are barriers to the successful creation of such a law, which would permit a Quebec citizen to die  with dignity.
Firstly, there are some physicians who are against it.
Secondly, hospice organisations are worried that they will be required to participate in physician-assisted suicide.

Doris Barwich, president of the Canadian Society for Palliative Care Physicians, says 
"A recent survey of the CSPCP (to which almost half of members responded) showed that an overwhelming majority of our physicians were opposed to the legalization of euthanasia (88%). Furthermore, 90% of responding members would not be willing to participate in the act of euthanasia."
 A recent survey of Canadian Medical Association members' views on major end-of-life issues has found that only 20% of respondents would be willing to participate if euthanasia is legalized in Canada, while twice as many (42%) would refuse to do so. 

From Rick Ferth, Hospice Palliative Care Ontario
We believe that Canadians need to ensure that there is universal access to quality hospice palliative care before any introduction of physician-assisted suicide or euthanasia.

Assisted suicide, physician-assisted dying, and euthanasia is an important public dialogue, but the hospice palliative care community should not be expected to provide these services.  HPCO promotes the Let's Talk About Hospice Palliative Care First campaign, which provides information on the importance of hospice palliative care. 

Their philosophy:
The CHPCA and the CSPCP believe that hospice palliative care is about ensuring a good death for all Canadians through an interdisciplinary approach that includes pain and symptom management, psychological support, spiritual care, bereavement care, and much more to address the suffering of patients and their families.
Furthermore, the CHPCA and the CSPCP would like to distinguish the difference between palliative sedation therapy and the proposed “terminal palliative sedation,” where the intent is to cause death.   Published standards define “palliative sedation therapy” as the practice of relieving intolerable suffering through the intentional lowering of a patient’s level of consciousness in the last days of life by the proportional and monitored use of non-opioid sedative medications[i]. “Palliative sedation therapy” does not prolong dying or hasten death but addresses refractory suffering. To learn more about this terminology please consult: www.chpca.net/hpcfirst.

[i] Fraser Health. Refractory Symptoms and Palliative Sedation Therapy Guideline. 2011; p. 2. 

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