Mr. Speaker, I did not think I would have the chance to complete this speech, so I am pleased to use the eight minutes I have left to do that.
In the first part of my speech, I had noted some things that the bill’s sponsor could come back to in committee. I had also suggested that she include the first nations governments in the consultation, because that is crucial. Often, the cultural approach to death is not really incorporated. Given the federal government’s duty to the first nations communities, it is essential that they be at the discussion table to express their needs.
In addition, there are enormous needs for palliative care in indigenous communities, because there are virtually no projects. Often, the communities are too small, so the feeling is that resources cannot be allocated specifically to palliative care. A number of first nations communities have no long-term care facility. Elders are therefore cared for by their province’s health care system.
When we go out and meet with the people who provide palliative care, we see that they are interested in developing projects. I have been to the Maison du Boulot Blanc in Amos, right next to the community of Pikogan. It sometimes takes in people from the Pikogan indigenous community who need its services. The people who work there are very happy to do that, but they say themselves that it is not the same, that the community is much more involved and there are a lot of people who come to support the dying person.
They do what they can in terms of needs, but if there were some openness to allocating federal funds for specific projects for the first nations, they would very definitely be open to having a room set up and decorated based on the person’s needs. That would reflect the desired approach, which is to accommodate clients who need palliative care.
This is something that will have to be discussed in committee. I urge my colleague to give immediate thought to people from indigenous communities who might be interested in talking about their situations and how they could be involved in delivering palliative care.
Although the administration of palliative care itself falls under provincial jurisdiction, I believe that the federal government has a role to play in bringing all the stakeholders together to discuss best practices. It is not about taking a paternalistic approach and bringing everyone together to tell them to look at the best practices happening elsewhere. It is about creating room for dialogue, where everyone can share their successes and failures in order to move palliative care forward.
We often forget certain particularities associated with palliative care. Pediatric palliative care is extremely difficult. How do we support a child who is dying of cancer or some genetic disease? We have a lot to learn by sharing ideas on this.
For instance, it is important to ensure that children who need palliative care are not forced to choose between being close to home or in a pediatric care centre. They are often hospitalized for long periods and find themselves far from home. Parents sometimes decide to bring their child home when it is time for palliative care to begin. When we talk about a special client group, it is often those in remote areas who have a hard time getting the care they need.
It would be helpful, then, to be able to talk about our practices in order to overcome these challenges. If the various ministries, provinces, and agencies involved could share tools with the rest of the country, we would all be better off.
Other patients are often neglected. For example, how does one help a person with a fairly serious intellectual deficiency prepare for death?
I have had to do it over the course of my career and it is not easy. Caregivers do not always have all the tools they need. They are used to working in a context where the person understands death and what is happening to him or her. However, it is often more difficult to help someone outside that context. I therefore think it is important for caregivers to have that skill.
When it comes to palliative care, for example, some deaths will affect caregivers more than others. That is why it is also important to talk about the distress they experience. Regardless of where the caregiver works, some cases will cause a lot of pain and sorrow. It is also important to be able to talk about that aspect of palliative care so that caregivers do not carry that pain and sorrow with them throughout their careers and can resist breaking down at some point.
Take, for example, soldiers who are deployed overseas and who have to be there for someone who is dying because there is no other choice. Sometimes these experiences are traumatizing and become difficult to live with after many years in the field.
In my opinion, it would be worthwhile adding this other element to the bill on palliative care, that is, monitoring the distress of caregivers, because we are hearing more and more about this issue.
Working with death every day is difficult. I believe it would be beneficial to monitor the distress of caregivers, especially those working in palliative care centres and paediatric and neonatal departments, who do their best to save infants, but are sometimes confronted by the reality that there is no other option but to let them go. These life situations can be difficult, and it would be advisable to monitor this aspect of public health.
I would like to thank my colleague and the House once again for letting me finish my speech. I look forward to my colleagues' comments.