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Vocal audience for CMA’s second meeting on end-of-life care

How interested are Canadians when it comes to the issues surrounding end-of-life (EOL) care? If the turnout for the CMA’s March 24 town hall on the topic is any indicator, they are very interested indeed.

The meeting, held in Vancouver, drew more than 225 people, one of the largest crowds attracted since the CMA started organizing town-hall discussions on different health care topics in 2011.

“We always knew the interest was there,” CMA President Louis Hugo Francescutti said following the meeting. “The crowd tonight simply confirmed it.”

The Vancouver meeting was the second in a national series of five town halls designed to garner Canadians’ thoughts on issues ranging from physician-assisted dying to palliative care and advance care planning. It was held in partnership with Maclean’s and in association with the Canadian Society of Palliative Care Physicians and the Canadian Hospice Palliative Care Association.

Unlike the first town hall on EOL issues, which was held in St. John’s in February, the audience in Vancouver loudly applauded speakers who supported euthanasia or physician-assisted dying for those who wanted to select this approach or in cases where suffering could not be relieved adequately by palliative care.

However, others supported the CMA position, which favours the provision of adequate palliative care.

Francescutti opened the meeting by stating that physicians have “heard loud and clear” that Canadians want to discuss EOL issues, and then described the “excellent” palliative care his mother received in Montreal prior to her death in 2013.

The town-hall moderator, Maclean’s Vancouver editor Ken MacQueen, noted that the Supreme Court of Canada is due to rule on the use of euthanasia later this year as a result of a case arising in British Columbia.

Panellists in Vancouver were Dr. Doris Barwich, president of the Canadian Society of Palliative Care Physicians and soon-to-be executive director of the new BC Centre for Palliative Care, as well as Dr. Jeff Blackmer, the CMA’s director of ethics, and Louise Donald, who has volunteered for 20 years on hospice issues for the Vancouver Coastal Health Region and is also primary care giver for both her parents and younger brother.

The meeting opened with two videos designed to clarify the language surrounding EOL care, and the audience was then asked about the availability and quality of palliative care services in their communities and the importance of advance care planning. It coincided with the release of a discussion document on advance care planning by the Doctors of BC. Its president, Dr. William Cunningham, said physician-initiated discussions about advance care planning for the end of life “normalizes the process” for everyone involved.

Barwich described advance care planning as a “win-win” situation for patients because it allows them to make decisions about future care before becoming very sick or incompetent. She said it also helps providers offer the care the patient really wants.

“It’s really, really good to have this conversation, even when you’re young,” said Donald, who noted that the need for such planning can arise abruptly.

A 73-year-old audience member, who has survived breast cancer, described how she spent several hours talking to her adult children about her EOL wishes, and said they were relieved to have had the discussion.

The importance of proper funding for palliative and hospice care services was stressed by many speakers, with some arguing that these services should not be dependent on volunteers.

Future public town halls will be held in Whitehorse (April 16), Regina, (May 7) and Mississauga, Ont. (May 27).

The CMA is also consulting with members via a parallel series of town-hall meetings, and is hosting an online consultation for members. Almost 700 members have already registered for the online discussion.

The first two member town halls were held in St. John’s and Edmonton, and upcoming meetings will be held in Fredericton (March 28), Vancouver (April 2), Whitehorse (April 17) and Regina (May 10). Members interested in attending can contact Carole Deburggraeve.

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