MESSAGE FROM THE PRESIDENT
Dear Colleagues
C
Carol Leet, MD
College President
photo: D.W. Dorken
For this policy to
be meaningful and
relevant, we knew
communication had
to be the cornerstone.
anadian research shows
that patients who have
Advance Care Planning
(ACP) conversations with family
and health-care professionals require
fewer aggressive medical interventions at end-of-life, and rate quality
of life higher in the terminal phase
of an illness. With an advance care
plan, family members also have
higher ratings of satisfaction during
a terminal illness or in the months
following their loved one’s death.
Given those outcomes, shouldn’t
more of us be broaching this topic
with our patients?
Recently, I chaired a working
group struck with the responsibility
of reviewing and revising a College policy providing guidance and
direction to physicians on the issues
of end-of-life care. For this policy
to be meaningful and relevant, we
knew communication had to be
the cornerstone. We also came to
understand that conversations about
death and dying should not wait until the onset of catastrophic illness.
Speaking to your patients about the
importance and benefits of advance care planning and choosing a
substitute decision-maker should be
part of routine care in every ongoing physician-patient relationship
and certainly should be part of the
conversation after significant life
events, such as the birth of a child,
or a diagnosis of a serious illness.
While it is not easy to talk about
death when it appears far away, it
is even harder to talk about death
when it is imminent. Palliative care
has its own dynamics. Members of
any health-care team recognize that
this is, for patients and their families,
the most intense, raw and vulnerable
experience of their lives. And that
is why communications is of such
paramount importance.
The Planning for and Providing
Quality End-of-Life Care policy,
which was just approved by Council, makes it clear that physicians
must communicate effectively and
compassionately with patients and/
or substitute decision-makers, in a
manner and tone that is suitable to
the decisions they may be facing.
This includes initiating communication as early as possible and as regularly and as often as is necessary to
share information, helping patients
and/or substitute decision-makers
understand the information shared,
Issue 3, 2015 Dialogue
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