Palliative Care vs Federalism: Where do we go from here?
Healthcare in Canada is at a crossroads. The population is both aging and living longer. However, with this comes increases in Canadians living with chronic illnesses.
Historically, as palliative care has been used interchangeably with end-of-life care, the discussion, education, and training in this type of care has been minimal. Why? Likely in part due to the taboo nature surrounding death and dying. People don’t want to think about or hear about the care that is available when you are diagnosed with chronic or long-term illnesses, so why focus on that?
Except by not talking about palliative care, our governments and even health care practitioners, the very people who are supposed to deliver palliative care, don’t know what it is! For so long it has been used interchangeably with end-of-life care that we are now suffering the consequences.
Palliative care is geared at team-based care to manage illness and keep a patient’s quality of life high. The team can be composed of the primary physician, nurses, specialist(s), health care aides, counsellors, spiritual leaders, financial advisors, and so on. End-of-life care is care meant to ensure comfort to patients in their final six months of life, ensuring their wishes are communicated.
We have a healthcare workforce not comfortable with delivering palliative care because they were never trained to do so. We have governments who don’t have policies in place for education standards or quality in palliative care delivery because we never bothered to learn the difference between palliative and end-of-life care.
Yet here we find ourselves, a society that is facing chronic illnesses, illnesses in which patients would benefit from palliative care in order to improve their quality of life.
This isn’t about death and dying, this isn’t about fatal illness, this is about managing symptoms and improving the quality of life for chronic illnesses. Do we not owe it to ourselves to be able to have coping and treatment options for chronic illnesses? Do we not owe it to our medical students, the doctors of tomorrow to instill proper palliative care training so that when we ourselves or someone we care about face a chronic illness we know what supports are available to them?
The Framework on Palliative Care in Canada, put forth by the federal government in 2018, called for the provinces to implement stronger education standards. While provinces and their respective health authorities did take steps to increase their education standards for palliative care, these efforts were minimal. With Canada’s system of federalism, and jurisdiction of healthcare defaulting to the provinces, the Government of Canada implemented this framework and then sat right back down.
It is time for the federal government to step in and implement national standards for palliative care. It is time for the federal government to set the guidelines and not be a bystander while provincial governments implement insignificant changes to show that they at least did something.
Standards for palliative care, from mandates for education, quality and delivery of care, need to be implemented nationwide. Every Canadian, rural, urban, young, old, deserves to know that if or when they need it, proper palliative care is available to them. Why? Because Canadian healthcare depends on it.
About the Author: Stephanie Durante completed her Bachelor of Arts in Sociology from Mount Royal University. She is currently a Masters student at the School of Public Policy. As a recipient of the Carpenter Medical Corporation Studentship, Stephanie is conducting research with Dr. Jennifer Zwicker and Dr. Travis Carpenter about demography changes and associated policy development regarding alternate levels of care in Canada. In her spare time, she enjoys visiting the mountains, watching hockey, and spending time with friends and family.