To celebrate National Hospice Palliative Care Week, the Castlegar Hospice Society invited a nationally-recognized palliative care expert to give a talk on dying with dignity.
Dr. Harvey Chochinov is a distinguished professor of psychiatry at the University of Manitoba and the director of the Manitoba Palliative Care Research Unit at CancerCare. Monday night, he gave a talk called Dying with Dignity: A Palliative Care Perspective and answered Castlegar residents’ questions about the legislation before parliament on medically hastened death, Bill C-14.
Chochinov is the panel chair of the external panel reporting to the Supreme Court of Canada on doctor assisted death, and will speak before the Senate and House of Commons committees on Thursday.
Bill C-14, still in draft form, would allow doctors to provide euthanasia or assisted suicide (a prescription to take home) to an adult with “a grievous or irremediable medical condition,” whose “death has become reasonably foreseeable,” and who has given informed consent.
Chochinov said one of the main differences between euthanasia and assisted suicide, is that assisted suicide allows for ambivalence.
“If you’ve been given these pills, you may take them home, or you may take the prescription home, and say, ‘You know what, life isn’t so bad or I’m going to hang on for another day,’” Chochinov explained. “On the other hand, if you decide that you want euthanasia, you have to make an appointment with your doctor.… So you can’t exercise that ambivalence, that indecision the same way that you can if the pills are in your hand.”
Chochinov said that this impacts the numbers, with approximately ten times more people dying by euthanasia than by assisted suicide.
In his talk, Chochinov also talked about a study he published on the relationship between the will to live and pain, and the relationship between wanting to hasten death and the loss of dignity.
“The truth is, if you have poor care, if you’re in pain, if you don’t have good symptom management, if you don’t have good support, you’re more likely to find yourself in a state where you say, ‘Enough is enough. I don’t want this anymore,’” he said. “So that’s why people are saying palliative care needs to be involved. Not that palliative care is going to prevent all people from seeking a hastened death, but palliative care is substantively more likely to make sure that somebody has a good quality death.”
The National Catholic Women’s League of Canada is among those arguing for better palliative care. The group is circulating a petition asking the government to recognize palliative care as a defined medical service covered under the Canada Health Act so that better funding can be provided. Castlegar’s St. Rita’s is circulating the petition.
More funding for palliative care could allow the Castlegar Hospice Society to open a regional hospice centre here in Castlegar. Chochinov ended his talk with support for the centre and promised he’d come back if it was built.