(June 2021) We are pleased to share this report from the End-of-Life Care Unit at Health Canada.
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The report features many new practices and innovative tools that can improve the future of home and community-based palliative care – for example, making virtual care more accessible, increasing the availability of palliative symptom management kits, and giving family caregivers adequate support to provide palliative care for loved ones at home. It is hoped that sharing some of these new practices and tools may inspire readers to use and adapt them as required, or develop and share their own innovations. By sharing knowledge and experience, together we can come out of the pandemic stronger than before.
Thank you to Dr. Stephen Singh for participating in the discussions on behalf of the CSPCP.
(April 20, 2021) If passed as presented, the proposed 2021 federal budget includes:
Better Palliative Care
To provide Canadians, including those who live in long-term care and their families, with better palliative and end-of-life care, including culturally sensitive care:
- Budget 2021 proposes to provide $29.8 million over six years, starting in 2021-22, to Health Canada to advance the government’s palliative care strategy and lay a better foundation for coordinated action on long-term and supportive care needs, improving access to quality palliative care. Initiatives could include: raising awareness of the importance of palliative care; providing public education on grief; improving palliative care skills and supports for health care providers, families, caregivers, and communities; enhancing data collection and research; and improving access to culturally sensitive palliative and end-of-life care.
(March 2021). Bill C-7, An Act to amend the Criminal Code (medical assistance in dying) became law on March 17, 2021. Several of the amendments may have a significant effect on the practice of palliative care.
Key changes are summarized below.
- Removal of reasonably foreseeable death criterion. The law no longer requires a person’s natural death to be reasonably foreseeable as an eligibility criterion for MAID (Medical assistance in dying).
- Removal of the 10-day reflection period. For those whose natural death is reasonably foreseeable, the 10-day reflection period is no longer required between the written request for MAiD and the procedure.
- Waiver of final consent for MAiD. For those whose natural death is reasonably foreseeable, the requirement for consent at the time of MAiD procedure has been waived.
- Change in requirement for witness signing a request for MAiD. Only one instead of two independent witnesses are required to verify written consent for MAiD and that witness may now be a paid health care worker.
- New safeguards for those without a reasonably foreseeable natural death. There must be 90 days between the first assessment and MAiD procedure, which can be shortened if an individual is at risk of losing capacity to consent. The individual must have been seen by a medical professional with expertise in their underlying condition.
- Sunset clause on the exclusion of mental illness as a sole underlying diagnosis in 24 months. Individuals with mental illness as a sole underlying diagnosis will be eligible to qualify for MAiD starting on March 17, 2023.
Links for more details:
Department of Justice Web page “Canada’s new medical assistance in dying (MAID) law”.
The Bill and its amendment: https://parl.ca/DocumentViewer/en/43-2/bill/C-7/royal-assent
The CSPCP presented to the responsible committees studying the Bill for the House of Commons and the Senate. Our written briefs and oral presentations are posted here: https://www.cspcp.ca/cspcp-input-to-justice-committee-re-bill-c-7/. We also signed onto the attached Open Letter “Bill C-7 is not the answer”, prepared by the Vulnerable Persons Standard. While we do not support some of the language used in the letter, especially as it relates to Long Term Care, we felt it important to lend our support because of the implications this Bill may have on the practice of palliative care.
The first federal Annual Report on Medical Assistance in Dying in Canada (2019) was released on July 24, 2020.
If you have questions about the report, please contact the End-of-Life Care Unit in Health Canada: firstname.lastname@example.org