Learning to care for those who can't be cured

Canada's medical schools will soon teach the next generation of doctors how to care for those who can't be cured.

“Physicians have not been taught to deal with death,” says Dr. Larry Librach, director of the Temmy Latner Centre for Palliative Care at Toronto's Mount Sinai Hospital. “We've been cure-focused.”

In response to a submission by the Association of Canadian Medical Colleges (ACMC) and the Canadian Hospice Palliative Care Association (CHPCA), Health Canada recently announced it will commit $1.25 million over 5 years to ensure medical students get training in treating the terminally ill. Medical schools have already begun integrating the program into their curricula.

“We have a central project team and local teams in every medical school now — all 17 schools,” said Librach, a CHPCA board member and 27-year palliative care practitioner. “When students graduate, they will have basic core competencies in palliative care, as will every clinical postgrad trainee.”

Palliative care experts credit Manitoba Senator Sharon Carstairs, who chaired a Senate committee that produced the bombshell 2000 report Quality End-of-Life Care: the Right of Every Canadian, for highlighting the need for the training.

Palliative care training will become as essential as vaccines in a physician's education. “It will just be part of the drill,” said Dr. David Hawkins, executive director of the ACMC.

Exposure to the precepts of palliative care could also encourage more medical students to enter what, given the aging population, is a growing field. “But you will never get enough specialists,” Librach says, “so we would like every physician to have the basic skills.”

Although pain control used to be the most important issue doctors addressed in caring for the dying, it is now just one element of what they learn.

People “have spiritual, emotional, psychological needs,” says Librach. “We need to help people address their issues of suffering and address the end of life — to help people and their families understand that dying is part of life. The soul needs more than morphine.” — Joe Sornberger, Ottawa