Category Archives: Advocacy & Partnerships

CSPCP Statement on Continuous Palliative Sedation Therapy

Continuous Palliative Sedation Therapy (CPST) is receiving increasing attention recently as it is often being offered as an alternative to MAiD. This means that more physicians may be considering using the treatment – without necessarily being familiar/competent to use it.

The Canadian Society of Palliative Care Physicians (CSPCP) strongly recommends that all physicians create or adopt a specific policy on CPST for their practice group or institution. This will ensure that CPST is a transparent practice that is easily distinguished from practices that hasten death and subject to best practice.

We have prepared a statement to this effect. It includes links to sample policies.

View the statement here

Help us promote Canada’s first National Bereavement Day – Nov 21st

One of the Missions in the CSPCP’s Vision, Mission and Goals is to “Advance the quality of life of patients and families living with life-limiting conditions from time of diagnosis through death and bereavement by advancing the field of palliative medicine.”

The CSPCP is proud to participate in Canada’s First National Bereavement Day on November 21, 2017, organized by the Canadian Hospice Palliative Care Association (CHPCA). We encourage all physicians to join us in using the tools and materials on CHPCA National Bereavement Day website and in using the official hashtag #GriefDayCA2017 to promote the day on social media.

On National Bereavement Day, Canadian Virtual Hospice (CVH) will release new materials for supporting children and youth – “KidsGrief”. To be notified when the site goes live, enter your email at http://KidsGrief.ca.

CVH is providing a FREE public web forum called KidsGrief Q&A on November 16 from 2:00 – 3:00 EST. Andrea Warnick, a national children’s grief expert, will answer questions about supporting children and youth who are grieving a death or an expected death. To participate, email: KidsGriefQA@virtualhospice.ca OR to access the webinar at the time of the event link in here: https://canadianvirtualhospice.adobeconnect.com/kidsgriefnov/

CSPCP urges physicians to learn about appropriate opioid use in palliative care

(Nov 6, 2017) The CMAJ published a letter from the CSPCP today: “APPEAL TO PHYSICIANS – OPIOIDS HAVE THEIR PLACE – Let’s avoid an unintended tragedy!” http://www.cmaj.ca/content/189/40/E1270/reply#cmaj_el_733573

Please read the letter and share amongst your networks as you see fit.

An excerpt from the letter is below. (Detailed rationale, references, and names of contributors are provided in the full letter)

“A well-known tragedy has occurred with respect to opioids – the crisis of overdose deaths from opioids that were obtained from various legitimate and illegitimate sources. This has necessitated urgent government and public action.

A second, preventable tragedy is beginning to occur as an unintended consequence of the first. The stigma around opioid use has become so strong that patients, families, and health care practitioners are afraid to receive or prescribe them, leaving patients to suffer unnecessarily.

We are referring specifically to palliative care, a context where opioids are sometimes the most appropriate choice for pain and dyspnea management. This is clearly outlined in our August 2016 Position Statement on Access to Opioids for Patients Requiring Palliative Care.

The 2017 Canadian Guideline for Opioids for Chronic Non-Cancer Pain made recommendations for opioid prescribing in the chronic non-cancer pain population based on a systematic review of the literature specific to that population. The guideline clearly states that exceptions are appropriate under some circumstances, including palliative care and cancer pain.

Unfortunately, many physicians have misunderstood the guideline to apply to all patients, including those appropriately receiving a palliative approach to care. Many physicians have expressed reluctance to prescribe opioids for such patients, even those approaching the end of their lives. Some physicians have stopped ordering opioids altogether. Unaddressed and unnecessary suffering is the result.

The Canadian Society of Palliative Care Physicians believes that patients with palliative needs who require appropriately prescribed opioids to manage symptoms should not have opioids withheld in an attempt to adhere to guidelines that are meant for a different patient population, or due to fear of regulatory oversight.

We encourage practitioners to assess the risk of misuse and diversion in patients receiving a palliative approach to care and to prescribe opioids (and appropriate adjuvant analgesics) in whatever doses are needed to control symptoms, within accepted principles of palliative care, utilizing appropriate monitoring and safe prescribing strategies depending on individual patient risk factors.”

See full letter for rationale, references and contributors.

CSPCP PRESENTATION TO SENATE COMMITTEE

CSPCP President Dr. David Henderson will present to the Standing Senate Committee on Social Affairs, Science and Technology on October 19, 2017. He will advocate for acceptance of Bill C-277 on behalf of the CSPCP.

Dr. Henderson recommends that the Federal Government “Establish a well funded secretariat and form a small nimble high level working group made up from key national organizations to start working on implementation. Focus needs to be on administrative cost containment so funds see their way to delivery of services!” Links to his presentation are below.

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