Palliative care Motion 456 debated in Canadian parliament

By Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Charlie Angus

Tuesday April 1, Charlie Angus MP (Timmins - James Bay NDP) had his first hour of debate on his private members motion (M 456) for a National Palliative and End-of-Life Care Strategy in Canada.

I was fortunate to witness the first hour of debate in Ottawa in the House of Commons. Link to the debate in parliament.

The Euthanasia Prevention Coalition (EPC) wants its supporters to contact their Member of Parliament to ask them to support M 456. Link to the Member of Parliament contact information.

Motion 456:

That, in the opinion of the House, the government should establish a Pan-Canadian Palliative and End-of-life Care Strategy by working with provinces and territories on a flexible, integrated model of palliative care that: (a) takes into account the geographic, regional, and cultural diversity of urban and rural Canada; (b) respects the cultural, spiritual and familial needs of Canada’s First Nation, Inuit and Métis people; and (c) has the goal of (i) ensuring all Canadians have access to high quality home-based and hospice palliative end-of-life care, (ii) providing more support for caregivers, (iii) improving the quality and consistency of home and hospice palliative end-of-life care in Canada, (iv) encouraging Canadians to discuss and plan for end-of-life care.

Angus, the sponsor of M 456 spoke first to the Motion. He first thanked the many groups and individuals who have supported M 456 from across Canada he stated:

I would like to thank the medical leaders, medical organizations, front-line service providers who are serving people in need, and the social workers, pharmacists, nurses and doctors, for the support that we received. I would also like to thank members of the various spiritual communities of Canada who have supported this motion.

Not to be Forgotten

Angus then acknowledged the work of the Parliamentary Committee on Palliative and Compassionate Care who published an all-party report on these issue. Angus stated:

I would also like to thank the incredible work of the all-party committee. The Parliament of Canada is known as a relatively toxic place at most times, but members of all parties came together on this vital issue and worked hard. I would like to recognize the members of the Conservative, Liberal, and New Democratic parties who worked on the study and wanted to bring forward to Parliament the need for us to establish this pan-Canadian strategy on palliative care. I believe that the motion I am bringing forward is carrying forward the work of this all-party committee.

Angus then explained how Motion 456 came together. He stated:

One of its key recommendations (Parliamentary Committee on Palliative and Compassionate Care) is that the committee strongly urged that the federal government re-establish a palliative care secretariat for the sake of developing and implementing a national palliative and end-of-life care strategy. In honour of the work that my colleagues in the other parties and New Democrats did on that committee, we are bringing forward that motion tonight.

Angus then looked at the Canadian Medical Association (CMA) definition of Palliative Care:

"Palliative care is an approach that improves the quality of life of patients and their families facing the problems associated with a life-threatening illness. [It involves] the prevention and relief of suffering by means of early identification, assessment and treatment of pain and other physical, psychosocial, and spiritual symptoms."

We can see from the Canadian Medical Association's definition that palliative care is not just about dealing with someone in their final bleak hours. It is the notion of an integrated health strategy that is there for families in their homes. It is not just about the alleviation of suffering, but allowing the individual to have a higher quality of life than they might have otherwise had. It also assures support for the family, community members, and loved ones, who sometimes face an extremely traumatic time.

Angus then establishes that this is the time for improving palliative care in Canada. He stated:

I believe this is a moment when all parliamentarians can come together in a positive way. We all have to face the death of a loved one. We have all faced it. We all have our own stories. These are moments in the life of a family that is at a crossroads, the closing of one chapter and the opening of another.

Angus then urges members of parliament to support as real form of dying with dignity in Canada. He stated:

When there is a better model out there, one that saves money and that ensures better access for people, I think it is incumbent upon us to say, let us embrace this model and let us show what dying with dignity in 2014 should be about, to ensure that we have everything in place around the person, around the loved ones, around the families so that they can make that transition and so that we, as their family members and loved ones, will also be able to make that transition to the next level of our own communities. 

I am hoping to get the full support of the members of Parliament. I am certainly counting on the members who did the extraordinary work on the palliative care committee. I think this is something on which we can all agree. I would ask my colleagues to work with us to support this motion and then begin to push for its full implementation. 

From this Parliament, it is incumbent upon as well to begin this discussion in Canadian society. This is a common sense solution that is staring Canadians in the face. This is a discussion that we need as Canadians. It is a positive discussion. It is a discussion that brings people in to talk together, as opposed to leaving people on the outside. 

I would like to think that out of this motion can begin a positive discussion across this country.

Parliamentary Committee on
Palliative and Compassionate Care

Angus then entertained questions from several members of parliament. Dan Albas Conservative MP and Libby Davies NDP MP asked Mr Angus questions about the Parliamentary Committee on Palliative and Compassionate Care. Angus responded:

Mr. Speaker, this is definitely a moment when we can praise the work of other parliamentarians who have led the way on this file. Certainly in the Conservative caucus, the member from Kitchener (Harold Albrecht MP) has done extraordinary work on this. In our caucus, the member from Windsor (Joe Comartin MP) led the work on this committee. 

It was when I saw that Perram House had shut down, and I began to look around and realized that there are huge gaps, that I went back and read the report that had been sitting on my desk. I saw that parliamentarians from all different parties had really looked at these issues. 

This is one of the great things about being able to bring forward private member's initiatives. 

If we as the Parliament of Canada said that we believe in an integrated vision of palliative care, it would certainly set a conversation at the provincial level and at the communal level. We could actually build a better health care system, a better way of serving the population that is looking to us for leadership at this time.

Dan Albas Conservative MP then commented on M 456. Albas is the Secretary to the Treasury Board. Albas stated:

The question that is most often raised, and at times debated, is how best we can provide that support. One way to improve end-of-life care is to integrate palliative care through the health care system, in all settings where people spend the end of their lives. Integrated care systems, for which our government delivered $3 million in economic action plan 2011 to support the development of this, has shown promise. This funding supports the development of community-integrated palliative care models, fostering collaboration among all jurisdictions and the health care community. The $3-million investment to the Pallium Foundation of Canada announced recently by the Minister of Health will also support training in palliative care to front-line health care providers. 

The motion before the House today highlights the need for integrative models of palliative care and the need to encourage Canadians to discuss their wishes for end-of-life care. It also focuses on taking into account the geographic, regional, and cultural diversity of Canada, both urban and rural. The federal initiatives from our government to date, implemented through non-governmental organizations with expertise in palliative care, align with a number of the components that the member for Timmins—James Bay raises in Motion No. 456.

Libby Davies NDP MP then spoke about a friendly amendment to M 456. She proposed:

I move that the motion be amended by replacing the words “Canada; (b) respects the cultural, spiritual and familial needs of Canada's first nation, Inuit and Métis people” with the words “Canada, as well as Canada's first nation, Inuit and Métis people; (b) respects the cultural, spiritual and familial needs of all Canadians”.

Charlie Angus accepted this as a friendly amendment.

Other Members of Parliament also spoke to Motion 456.

The Euthanasia Prevention Coalition supports Motion 456 and urges its supporters to ask their member of parliament to support Motion 456.

Links to other articles on this topic:
● Palliative care Motion to be debated in Canada's parliament on April 1.
● Canadian government is committed to increasing palliative care training.
● Euthanasia: End of life care hinges on recognizing and treating pain.
● Parliamentary Committee on Palliative and Compassionate Care offers great hope to Canadians.