Across the country, Canadians were given a forum to discuss end-of-life care, thanks to the Canadian Medical Association (CMA) and Macleans. The Town Hall style meetings were an inspired idea. I attended the meeting in Mississauga and was pleased to see the combination of structure and informality in the program. Participants could come away with a common vocabulary, a sense of having been heard, an appreciation of other points of view, and direction for personal action. All of this in a two hour period. Within a month of the last town hall, the CMA has released its report, End of Life Care: A National Dialogue. It is essential reading for all families.
Perhaps the best feature of these Town Hall meetings is that the hot-button issues of euthanasia and physician-assisted dying were set into the much larger context of end of life care. That context includes discussion of end-of- life wishes, the preparation of advance care directives, the art of communication and the science of symptom management.
As someone who gave much thought to end of life care in the course of writing Autumn’s Grace, and who continues to worry about palliative care in rural Canada, I was delighted to see that the CMA’s conclusions included the following items:
- A national palliative care strategy should be developed
- All Canadians should have access to appropriate palliative care services.
- Funding for palliative and hospice care services should be increased.
- More education about palliative approaches and as well as how to initiate discussions about advance care planning is required for medical students, residents and practicing physicians. (The CMA was addressing its own discipline, but I would add to the list: nursing students, practicing nurses, pharmacy students and practicing pharmacists, etc.)
Thank you to Dr. Louis Hugo Francescutti, the panelists and Macleans for initiating a national dialogue that I hope will result in changes to practice, policy and funding for palliative care…in my lifetime.