We need to talk about hospice palliative care first

In March 2012, the Special Commission on Dying with Dignity (Commission spéciale sur la question de mourir dans la dignité) released the report, Dying with Dignity. The Committee made 24 recommendations to the Minister of Health and Social Services as to how end-of-life care should be improved in Quebec. The Commission report was a strong first step towards implementing standardized hospice palliative care in Quebec so that all patients may have the highest quality of life and quality of dying, however, there were also several recommendations around the legalization of physician assisted suicide in Quebec. Please click here to read the full report.

On June 14th, 2012 the government of Quebec mandated a committee of legal experts to review and strategize the implementation of the recommendations put forth in the Dying with Dignity report. In January 2013, the committee reported back on their findings, suggesting not only that hospice palliative care services be improved in Quebec, but also that “medical aid in dying” or “terminal palliative sedation” be legalized. Please click here to read the summary of the report (available in French only).

The Canadian Hospice Palliative Care Association (CHPCA) and their Euthanasia Task Group have aligned themselves with the position put forth by the Réseau de soins palliatifs du Québec (RSPQ) on January 16th. They are also in the process of crafting an official response to the Minister of Social Services’ report. Although we commend the provincial government on their commitment to improving hospice palliative and end-of-life care services in Quebec, our response will enumerate that above all, “medical aid in dying” or “terminal palliative sedation” are not and will never be considered a part the practice of hospice palliative care.

The CHPCA and the RSPQ also want to make the distinction that hospice palliative care is not a “treatment,” rather another step in the patient’s continuum of care. Hospice palliative care aims to relieve suffering and improve the quality of living and dying, we strive neither to extend life nor hasten death. Furthermore, foregoing treatment, the cessation of treatment, palliative sedation, refusal of treatment and pain relief are all different, and are not the same as euthanasia or “medical aid in dying”.

Should a legislation allowing physician assisted death be passed by the Quebec government in the future, the dedicated and committed personnel who work in hospice palliative care should not be expected to participate in this practice. For more information and definitions of hospice palliative care, euthanasia, and physician assisted suicide, please take a look at the “Let’s Talk About Hospice Palliative Care First” campaign launched in October 2012.