Kicking off the New Year is a good time to put the task of making your end-of-life wishes at the top of your to-do list.
On June 6, the Supreme Court of Canada’s decision making physician-hastened death legal will come into effect. A parliamentary committee asked to help the government plot how that would roll out in Canada has made some far-reaching recommendations, well beyond what was contemplated by the court in Carter v. Canada.
The moment we are born, our lives take flight; and the longer we are airborne, the greater the chance of encountering turbulence along the way. While every flight is destined to land, some landings are harder to contemplate than others.
Who but those who have experienced it can appreciate the soul crushing anguish of mental illness? Afflictions of the mind can be paralyzing and fundamentally change the way we perceive ourselves (I am worthless), anticipate the future (my prospects are hopeless), and experience the world (life is unfair and unforgiving). The combination of self-loathing, hopelessness and despair can tragically lead to suicide.
Canadians likely had many important conversations with their loved ones over the holidays, but probably most didn’t talk about what should happen in the event they could no longer speak or make medical decisions for themselves.
Our healthcare system remains focused on acute – emergency — care and the “therapeutic imperative” to fix everything we can fix when a patient is ill. But when someone is approaching the end of life, this approach may no longer be what the patient and their families need or want most.
We are about to become a country that extends patients the right to a hastened death, but offers no legislative guarantees or assurances that they will be well looked after until they die.
Doctors are not generally well trained to engage in end of life conversations, meaning that goals of care often remain unclear; and patients may not receive the care they want, nor the opportunity to live out their final days in the place they would want to die.
Ignorance and lack of skill in attending to the needs of dying patients are still tragically common in Canada.