"Palliative care development follows a public health model developed by the WHO that emphasizes policy, education, medication availability and implementation.. .. Types of policies needed include: laws that acknowledge and define that palliative care is part of the healthcare system..." - WHO and the Worldwide Palliative Care Alliance, Jan. 28, 2014
On May 14, Timmins-James Bay NDP MP Charlie Angus will ask Parliament to approve his private member's motion M-456 to establish a Pan-Canadian Palliative and End-of-life Care Strategy. The World Health Organization would applaud the initiative.
First tabled on Oct. 21, 2013, the motion arose out of Angus' participation in a 49-member cross-party parliamentary committee studying the Canadian experience on the issue.
"I will continue to speak with Conservative and Liberal MPs on the importance of Parliament speaking up on palliative care," said Angus, who believes support from the 30 Conservative committee members will be crucial to success of the motion.
One of those Conservatives is West Vancouver-Sunshine Coast MP John Weston who said, "If the strategy is the right one, supported across Canada by stakeholders and the people who need it, I would support it."
That multi-part caveat might have too many loopholes for anyone already wondering why the motion has taken over six months to reach this point.
A peek at the 20-year history yields clues:
In June 2010, thensenator Sharon Carstairs tabled her report, Raising the Bar: A Roadmap for the Future of Palliative Care in Canada. The report was the culmination of Carstairs' work on the issue, which began with her appointment to the Senate Committee on Euthanasia and Assisted Suicide in 1994.
That committee's June 1995 report, Of Life and Death, marked the beginning of Canada's 20-year journey to Motion M-456 - a cross-country saga of in-depth research, reports and recommendations through a succession of federal and provincial governments.
The discussions that led to the 1995 report changed Carstairs' focus to such an extent that, in her foreword, the then-senator said she had become "convinced that before we could have a debate about euthanasia and assisted suicide in Canada, we should be providing equitable access to quality, integrated palliative care."
Professionals, associations, a growing
number of hospices and palliative care units, families and caregivers - all those and more contributed their knowledge and experience to those years of Carstairs' "work in the field of public policy relating to palliative care."
Following substantial milestone reports in 2000 and 2005 that reviewed progress made on myriad recommendations, Carstairs now says that, despite
"significant improvements in providing quality palliative care. .. there are still Canadians needlessly dying in pain and with unnecessary suffering."
If M-456 is approved, are we there yet? Regrettably, the answer is no; approval of the motion would be one small step. In order to turn that success into a giant leap for Canadians, federal and provincial governments
would need to buckle down and write the legislation.
And the first major hurdles will relate to definitions and cost.
In May 2012, the Canadian Hospice Palliative Care Association recognized that "90 per cent of Canadians who die can benefit from palliative care."
More recently, the Feb.
8, 2014 editorial Palliative
Care: a Peaceful, Humane Global Campaign is Needed, published by The Lancet medical journal, also recognized that although palliative care is often associated with cancer in people's minds, the need for such care extends to adults and children who suffer from a wide range of conditions - debilitating heart disease, diabetes, chronic obstructive lung disease, dementia and more.
When I asked Weston whether costs have been estimated for the demographics involved and whether the costs of not having a pan-Canadian strategy outweigh those of taking action, he replied, "That is exactly the point of the motion - we have to define those costs."
Unfortunately, costs are not mentioned in the wording of M-456, so whichever government grasps the nettle to translate the motion into law could do worse than turn to CHPCA and other organizations for some of the numbers.
M-456 does say Canadians should be encouraged to "discuss and plan for end-of-life care."
That must surely apply to the 70 to 84 per cent of sufferers who, according to CHPCA, do not yet have access to or receive the "hospice palliative and end-of-life care" discussed in the March 2014 update to its 2012 Fact Sheet (chpca. net/projects-and-advocacy/).
The motion tabled by MP Charlie Angus is but the latest milestone reached after a costly 20-year struggle by a multitude of dedicated individuals and organizations - including many here on the North Shore.
It is up to Canadians - to us - to urge our MPs to support this milestone and ensure that struggle does not go in vain.
