Assisted suicide ‘like a cancer’ in palliative care programmes

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Canada’s palliative care programmes are suffering while assisted suicide programmes are “growing like a cancer”.

Fewer than 50 percent of patients wanting palliative care can access it.

These findings contradict  the Government’s stated plans to its improve its palliative care provision.

Evidence is mounting that assisted suicide is actively damaging the already inadequate palliative care system.

Some patients are choosing to die rather than to continue to live without adequate palliative care.

The Catholic Church has long supported palliative care for patients living with a life-threatening illness.

It calls euthanasia or medically assisted suicide an “intrinsically evil” act.

What palliative care experts say:

Three palliative care experts say since Medical Assistance in Dying (MAiD) legislation was passed in June 2016, palliative care provisions and services have reduced.

“It’s like a cancer growing within the palliative care programmes”, Dr. Neil Hilliard says.

“(MAiD) is starting to take over to a certain degree. But still only five percent of people are choosing MAiD; 95 percent would prefer to live well until they die naturally.”

His comments support recent testimony from two of Canada’s leading palliative care physicians to a Special Joint Committee of Parliament.

The Committee is reviewing the country’s assisted suicide legislation.

Dr. Leonie Herx told the Committee that only 30 to 50 percent of Canadians who need palliative care have access to it.

“Currently, Canadians have a right to medical assistance in dying, but not to medical assistance in living.

“Having accessible, high quality palliative care needs to be a universal health care right in Canada.”

Only a “very few,” or about 15 percent, have access to specialist palliative care, she said.

The physical, emotional and spiritual suffering can lead patients to feel depressed and hopeless, and a burden to others. There are many factors driving requests for MAiD.

“Earlier palliative care can alleviate suffering before it becomes irremediable.”

She said “significant deleterious effects” MAiD has had on palliative care include diminished resources and increasing distress experienced by palliative care clinicians.”

She is especially concerned that:

Places where euthanasia is incorporated into palliative care has led to palliative nurses leaving their jobs because they felt unable to provide such care.

Hospice palliative care nurses are expected to provide assisted suicide.

Palliative care clinicians are suffering increasing moral distress from forced participation in MAiD; if they don’t participate, hospices and palliative care units lose funding.

There is a critical shortage of specialist and generalist palliative care physicians.

Time is spent on administrative issues related to MAiD instead of providing palliative care.

There is decreased access to specialised palliative care when beds are taken by patients to have MAiD administered.

About patient fear – some won’t access palliative care because of their association with assisted suicide. Some fear palliative care will hasten their death or they might be euthanised without their consent.

Another specialist told the committee assisted suicide needs to be “distinct and separate” from palliative care to ensure that the latter does not suffer.

“MAiD assessors and providers are in a conflict of interest if providing palliative care at the same time.”

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