Thursday, November 20, 2014

Doctors debate end-of-life care at Canadian Medical Association meeting

OTTAWA — Doctors tackled the delicate question of medically assisted death on Tuesday at a session devoted to end-of-life care at the annual conference of the Canadian Medical Association.
Long lines of physicians queued up to share their opinions on how end-of-life conditions for ailing Canadians must change as the population ages.

Their input followed an often heart-rending video from a series of town halls the CMA conducted across the country earlier this year that featured elderly and ailing Canadians pleading for better palliative care — or the right to die at a time of their choosing.
Some doctors suggested Canadians wouldn’t clamour for euthanasia or assisted suicide if the quality and availability of palliative care vastly improved in Canada.
“The driver for this discussion is a desperate lack of palliative-care services,” John Haggie, a Newfoundland physician, told the conference. “We don’t have a hospice in the province anywhere.”
Haggie responded with an “unequivocal no” to a question posed by the CMA to its members on whether their patients have access to adequate palliative care.
Another urged family physicians to start taking on palliative care, saying it shouldn’t be handed off to specialists as their longtime patients age and face frightening, life-threatening illnesses.
“Palliative care has become a specialized service in most areas of the country and we must, as family physicians, take palliative care back into our practices,” Suzanne Strasberg, a Toronto family doctor, said to applause.
“It’s time to start talking about palliative care as part of the regular job as a family doctor ... our job is to relieve pain and to relieve suffering.”
But another doctor pointed out that as many as 20 per cent of Canadians don’t have family doctors, and so palliative specialists are often necessary.
Still another suggested family pets and farm animals that are dying are often treated in a more humane and dignified manner than their human owners at the end of life.
The first-hand experiences of physicians from coast to coast vividly illuminated a paucity of available palliative care, a simmering health-care crisis in Canada as the baby boomer generation enters old age.
The association’s members had come together on Tuesday to debate whether to revise the current CMA policy on euthanasia and assisted death.
The session ended with an overwhelming vote — 90 per cent — in favour of an advisory resolution that supports “the right of all physicians, within the bonds of existing legislation, to follow their conscience when deciding whether to provide so-called medical aid in dying.”
The CMA defines “medical aid in dying” as, essentially, euthanasia or physician-assisted suicide.
Follow Lee-Anne Goodman on Twitter (at)leeanne25

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