Yes, and I have several things to say about that.
First of all, there are no measures for the quality of palliative care. This is extremely important because people have trouble defining it, so actually measuring the quality is also an issue.
What we do know is that 20% had access to palliative care after they requested MAID. When you think about it, this means that someone can be suffering pain, loss of independence and loss of meaning for two years in the community, and if they finally request MAID and are admitted to a palliative care unit, they will be listed as having received palliative care. It's important to keep that in mind.
If you look at the people who did not receive palliative care, it is approximately 12%. However, it's said that palliative care was accessible 88% of the time. Was it refused because the MD was not aware, or was it refused because the MD did not understand palliative care and the fact that it could be provided? For instance, I've had people with MS who appropriately needed symptom management and were told that they were not able to have palliative care.
If you take the people to whom palliative care was not accessible—the 12% of the 1,474 people who didn't have access to MAID—that's 177 people who had no access. If advocates for MAID came to the government with evidence of 177 people not having access to MAID, I'm sure the media would pick it up and something would be done, but we are not seeing this kind of response to the palliative care needs of people.
I want to draw that to your attention. It is not a minuscule number of people who lack palliative care.