SMA News Digest (Summer 2014): V54, I2 | Page 21

HEALTH CARE perience with her chronically disabled son who, in response to the media attention given to the Latimer case, felt the need to clarify with his family, that no matter how much it hurt, he could take it and they didn’t need to kill him. Deeply affected by this experience she added, “So there are vulnerable people who will be living in a sense of risk, if we don’t resolutely say that we are here to heal.” Another physician offered an alternate perspective, and questioned whether we have the right to limit a person’s right to die solely on the grounds that we do not agree with their choice. He emphasized that physicians must not judge patients’ choices regarding medically assisted dying or abandon them on the basis of these choices. “We don’t have to do anything we’re not comfortable doing,” he said, “but we must not abandon them – we need to support and care for them.” Palliative care Several physicians commented that the demand for medical aid in dying is a consequence of inadequate or inaccessible palliative care. This is in line with reports from some palliative physicians who say that requests from their patients to assist in dying are extremely rare or non-existent. According to the Canadian Hospice Palliative Care Association, only 16-30% of the population who should be receiving palliative care, is getting it. This number is grossly inadequate considering 100% of people are going to die. This statistic is due in part to lack of resources but also to lack of awareness in both the physician population and the public on what exactly palliative care is and when it should be initiated. ‘‘ Too often patients are referred to palliative care only in the days before death or not at all, noted Dr. Blackmer, despite the urgings of palliative care specialists that physicians start palliative care, not during the dying process but during the living process, when there’s been a life-limiting illness diagnosed. If palliative care is started earlier, better attention can be given to maintaining the highest quality of life possible throughout the illness trajectory. “There is still a lot of education we need to do around what palliative care is and when to start that,” he emphasized, if palliative care access is to be improved. A palliative approach to care Accessibility is a particularly relevant issue here in Saskatchewan where a full third of the population live in rural parts of the province where access to palliative care may be limited; and where it is available, the commute might be too strenuous for patients or their families. A partial solution to this may be what palliative specialist Dr. Jose Pereira calls “the palliative approach.” “The word palliati ٔ