Enhancing the quality of end-of-life care in Canada

A recent "Commentary" pointed out deficiencies in end-of-life care in Canada, in particular that many people receive unwanted life support, and are cared for in institutions when they would prefer to die at home.

Unfortunately the discussion fails to even mention the obvious corollary to avoidance of unwanted life support, namely making available the option of ending a life which is becoming daily more intolerable. The lack of such an option in Canada must be a fundamental component of any discussion of end-of-life care.

It may be that skilled nursing and appropriate medication in a modern palliative care setting can alleviate most physical suffering, but for some people the chief misery at the end of life comes not from physical symptoms but from the loss of privacy, dignity, purpose and independence.

Even though suicide itself is a legal act, assisting someone to end their own life, for whatever reason, remains a criminal offense. In spite of polls indicating that a majority of Canadians believe such assistance should be available if requested , the present federal government has made it clear it will not change the law, and the CMA also seems to prefer the status quo.

In the end it all comes down to one simple question, "Whose decision should it be?"

The answer can be found in another question: "Whose life is it?"

Reference

1. Cook,D, Rocker G, Heyland D: Enhancing the quality of end-of-life care in Canada. CMAJ 2013, 185(16) 1383-4

Conflict of Interest:

None declared