Mr. Speaker, I am quite pleased to be able to speak this evening to this very important topic and this motion put forward by the good member for Timmins—James Bay. This motion we have before us calls on the federal government to develop a nationwide palliative and end-of-life care framework or strategy, “framework” being what we Conservatives prefer. Either way, we do need to get this under way in our country, based on some very good recommendations from a committee of this House.
As mentioned before, in 2010 several members of Parliament formed that all-party Parliamentary Committee on Palliative and Compassionate Care, and in 2011 they published their report, “Not to be Forgotten: Care of Vulnerable Canadians”. Several of their excellent recommendations are embodied in this motion before us. As was mentioned, the Conservative member of Parliament for Kitchener—Conestoga co-chaired that committee, and Motion No. 456 benefits from the excellent work done by a number of other members from all parties in the House. Other Conservative members, as I note, included my colleague from Saskatoon—Rosetown—Biggar and the MP for Newmarket—Aurora.
I do want to thank the member opposite, the NDP MP for Timmins—James Bay, for bringing this motion forward. It is time for this discussion to be had in the country. In fact, it is just on the very front edge, thankfully we think, but not any too soon.
The committee's comprehensive report came out with 14 recommendations, including:
Developing and implementing a National Palliative and End-of-Life Care Strategy;...the development of a flexible integrated model of palliative health care delivery, able to take into account the geographic, regional and cultural diversity of Canada;...strengthen the home care delivery program for First Nations, Métis and Inuit communities, developing home delivered palliative care resources, sensitive to community, cultural, familial and spiritual needs....expand the provisions of the E.I. based compassionate care benefit......set up a Canada Pension credit for family caregivers....
That is a pretty big package of things, actually. However, we are focused today on a framework, from a Conservative point of view, whereby we have the provinces and we have these various people co-operating, working together, and sharing what is already out there such that the public is better informed and better understands those resources.
We see various priorities reflected in Motion No. 456, calling for:
...working with the provinces and territories on a flexible, integrated model of palliative care that: (a) takes into account the geographic, regional, and cultural diversity of urban and rural Canada; (b) respects the cultural, spiritual and familial needs...
It has:
...the goal of (i) ensuring all Canadians have access to a high quality home-based and hospice palliative end-of-life care, (ii) providing more support for caregivers, (iii) improving the quality and consistency of home and hospice palliative end-of-life care in Canada; (iv) encouraging Canadians to discuss and plan for end-of-life care.
I had the privilege, in a younger era of my life, of working in seniors care homes as a health care worker, as an orderly in a hospital and also in a seniors care setting. In those early days when I thought the whole of my life stretched before me, I was a young guy with all these possibilities and was also interacting with, serving, working with, and ministering to those who were in their sunset years of life. As I had those interactions and got good advice from people and enjoyed the conversations and the wisdom of their years, I also began to more and more realize that I was vulnerable, that I was not invincible, and that I would not live forever. My parents, thankfully, and others had informed me of that same thing already, but it kind of affected me a little more as I looked into the wrinkled faces and frail eyes of the individuals who were in those home care situations.
There is all the more need today, as we have the aging baby boomers moving to retirement years. More pressure is being placed on society and on governments to discuss the needs and the concerns, including end-of-life care. The issue of euthanasia keeps coming up, and assisted suicide. Elder abuse and quality of life are things we should be talking about, and we should be standing in the way of abuse of our dear senior people as they live out their final golden years.
An aging population means that doctors and nurses will be increasingly facing the population and the public with end-of-life issues. I believe that at the core and heart of it is support for human dignity, as we are all individuals made, in my view, in the image of God, from a Judeo-Christian point of view and that of some of the other world religions as well, so there needs to be that respect and support for human dignity and quality of life, with investments in pain management and other palliative care tools. That is where the Canadian conversation definitely needs to go.
We do not want to go down the dangerous and failed route of assisted suicide or euthanasia tried by other countries. We need better, consistent, end-of-life and palliative care in Canada. Palliative care and emotional support are necessary and appropriate responses to those who suffer from terminal illnesses and are near death.
Effective palliative care will also reduce the pressure to legalize assisted suicide and euthanasia. The Canadian Association of Palliative Care distinguishes four main reasons that patients request death: pain and physical suffering; loss of control over their illness, their lives, their bodies; the desire not to be a burden; and depression and psychological distress linked to their illness.
Palliative care is the most prominent alternative to the legalization of assisted suicide and euthanasia. As opposed to therapeutic obstinacy, aggressive treatment that might prolong a patient's life to the detriment of his or her quality of living, palliative care instead aims to provide “better medical care for pain and symptom control and to attend more appropriately to the personal, emotional and spiritual issues at the end of life”.
Advance care directives are also important to talk about in this conversation. I am sure members in the House are familiar with that, so that should take place well before the time comes for any of us. I do not have an advance care directive, but I am certainly reminded in the midst of these days and this topic that every one of us should be having those discussions with a spouse, our children, and with loved ones, about the kinds of measures that can be taken and the kinds that are beyond what we would want or require, the heroics, so to speak, that sometimes do not end in proper end-of-life care.
As an end-of-life treatment, it addresses the psychological and existential factors that influence requests for assisted suicide and euthanasia. We need to have instead these other topics of discussion: advance care treatment, advance care directives and also the kind of palliative care and pain relief that we would desire. Palliative care targets the sources of a patient's anxiety, therefore renewing his or her will to live, the overall quality of his or her life and ultimately, the quality of his or her death.
I would like to share a couple of brief anecdotes that look at life on the ground in Canada as Canadians serve those who need special care at the end of their lives. These accounts come from the March/April issue of the magazine Faith Today.
In the small eastern Ontario town of Perth, the O'Dacre family provides care at the end of life. They operate a funeral home, and they are supporting an initiative to bring a hospice to their community. Janey O'Dacre and her husband John both worked as nurses who provided palliative care prior to entering their present field.... “Our focus is supporting families with end-of-life decisions”, she explains. “But we're not just there for families when there is a death. We know exactly what it's like to be caregivers to the dying too, how emotionally, spiritually and physically exhausting it can be in that role”. They look forward to the day when local families who can't tend to dying loved ones at home can select hospice care, rather than hospitals or long-term care facilities.
The author of the article about palliative care also shared her own story, concluding this way. She said:
I'll forever be grateful for the privilege of helping to care for my father during his last days. As his life ebbed, he continued to communicate love for his family, and to receive the love we offered through our care. That exchange of love was a final, precious and intimate gift. And when he died, we found solace knowing that we would see him again, and that we had eased his final journey.
The world of palliative care continues to grow as the need expands and technology advances, but much more is needed. In recent years, each time the budget period rolls around, I have been urging the finance minister to commit more funds to palliative care. The passage of this motion would be a clear indication of Parliament's support for such a move.
Much more could be said in the way of dignity therapy, and members can google this. I would have mentioned in my speech, had I had more time, the work of Dr. Harvey Max Chochinov of the University of Manitoba, a very novel therapeutic intervention for suffering and distress at the end of life. Much can be said about pain relief at the end of life and there is a lot that can be done that is not much understood by the Canadian public, a crucial part of palliative care and what we need to be doing to provide the end-of-life relief for people as they fade from this life to the next.