How a country cares for its most vulnerable reflects our national values and priorities. Those approaching the final stage of life are, unquestionably, among our most vulnerable. While much of the conversation around end-of-life issues in Canada has focused on what is often referred to as “Medical Assistance in Dying,” far too little attention has been paid to palliative care.
As a comprehensive approach to end-of-life challenges, palliative care combines pain management with efforts to attend to a patient’s psychological, emotional, social and spiritual needs, as well as caregiver support. There is a broad consensus across the political spectrum that palliative care is an indispensable part of our health care system and should be available to every patient who desires it.
We affirm the World Health Organization’s definition of palliative care, as well as the official positions of the Canadian Society of Palliative Care Physicians, the Canadian Hospice Palliative Care Association, and the Canadian Medical Association that the practice of palliative care does not include interventions which intentionally cause the death of the patient. This has been central to the philosophy of palliative care and is a fundamental distinction that must be maintained.
Indeed, the proportion of Canadians likely to seek palliative care far exceeds those who would request “Medical Assistance in Dying.” Unfortunately, the Canadian Hospice Palliative Care Association (CHPCA) has estimated that a mere 15 per cent to 30 per cent of patients nearing
According to the CHPCA, “compared to usual acute care, hospital-based hospice palliative care may save the health care system approximately $7,000 to $8,000 per patient.” They further cite a 2013 Ontario study that estimated expanding in-home palliative care could save $191 million to $385 million in health care costs annually. It notes that residential hospices are far more cost-effective than acute care settings, with daily costs of approximately $400 versus $1,000, respectively.
While economic figures reveal the significant cost-savings associated with palliative care, our interest in this issue is rooted not in dollars and cents, but in the incalculable worth of every person.
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