Thank you very much, Madam Chair.
I want to thank the witnesses for coming and giving their time so late in the evening.
I listened to the last meeting that we had and this meeting, and I am hearing different stories about palliative care. As a physician, I think I know what palliative care is, and I have heard some of our palliative care physicians explain what it is. It is a part, at the end of day, of a continuum of care. It is not the same care, and it is not necessarily parallel care, but it is a continuum of care.
I've also heard that there are competing resources. We had our Library of Parliament research some of this first, and I have not necessarily found that to be true.
With regard to money being given by the federal government for palliative care and a framework, that palliative care money goes to provinces. The federal government, except for indigenous people and the armed forces, etc., does not do this itself. It gives it to provinces, so it all depends on where provinces decide to put their money and their priorities. I know in some provinces there isn't enough money for home care within the palliative care system.
However, I would like to understand what happens if—and I'm going to ask Dr. Buchman this—a patient comes to you.... You pointed out three very important parts of end-of-life care: the physical care, the psychosocial care and the existential issue. Now the psychosocial care we understand. It's mostly women and a lot of people who live alone, obviously isolated, etc., but not a lot of people are talking—other than Dr. Viens, who talked about it today—about the existential care, about the fact that you can take away the pain, you can make people comfortable, and you can bring people around them to deal with their loneliness, but at the end of the day, there is that piece, that spiritual part, of a person considering what their options are.
If a patient came to you with a chronic disease and chronic pain, and you went to palliative care with them, and they seemed to be getting the help in the physical and psychosocial arenas.... After a while, patients have their needy sides from an existential point of view that this is not living. This is not quality-of-life care. This is not really living, and they want more, and they want to make a decision to probably end their life on their terms. What would you say to that person? Would you insist that they continue at palliative care or would you explain the options in a simple way, regardless of language, etc., allow them to make that decision and respect the decision of the individual about their person?