The CMA, which launched a discussion on the role of advance care directives in Canadian health care during its 2013 annual meeting in Calgary, is now broadening the debate.
Advance care directives are used to spell out a person’s wishes concerning medical treatment in the event they become incapacitated. During last year’s annual meeting, General Council passed three resolutions, one concerning patients and two focusing on physicians themselves:
- the CMA should support physicians’ efforts to help patients and families understand and develop advance care plans
- the CMA supports the development of training in advance care planning, which should be available to all physicians
- the CMA encourages all members to complete their own advance care plans
Those recommendations have advanced on several fronts since 2013.
In February, the Board of Directors recommended that the CMA support the use of a national advance care planning toolkit website, which would provide links to provincial and territorial resources that would help physicians discuss advance care planning with patients.
The same month, the CMA’s first public town hall on end-of-life (EOL) care — held in St. John’s — focused heavily on the need for patients to outline their wishes concerning EOL care so that such wishes are known if they become incapacitated.
A month later, the CMA launched a members-only discussion about advance directives that centred on this question: “Would more widespread use of advance directives resolve issues that can arise between physicians and families during a patient’s last days. If so, why?”
CMA President Louis Hugo Francescutti says the discussion is only beginning. “The end-of-life issue seems to be everywhere now, from legislatures to court houses, and advance directives are an essential part of that discussion,” he said. “Our goal here is to keep members informed about issues as they arise and encourage physicians to discuss them when patients ask questions.”
He noted that the CMA is currently revising its policy surrounding advance care directives