The CCRL Files Submission to Health Canada’s Public Consultation on Palliative Care

Toronto, ON July 17, 2018 – The Catholic Civil Rights League filed a submission today with Health Canada in response to their public consultation “a framework for palliative care in Canada”. According to the federal government this framework “will help support improved access to palliative care and will provide a useful reference point across jurisdictions to help identify opportunities, address gaps, and share promising practices”.

Our complete submission is as follows:

A Framework for Palliative Care – Submission of the Catholic Civil Rights League (CCRL)

The Catholic Civil Rights League (CCRL) advocates in support of law and policy compatible with a Christian and reasoned understanding of human nature and the common good, and in particular, law and policy that promotes fundamental Christian morals and values, including the sanctity of life and respect for human dignity.

Palliative Care Remains Limited as Assisted Suicide and Euthanasia Expands

Thank you for the opportunity to make the following submission.

The CCRL has previously argued that the regime of assisted suicide enshrined in law by the Liberal government had failed to address or take into account the inadequacy of palliative care as a treatment option in Canada.

Prior to assisted suicide and euthanasia several studies indicated the crisis in Canada regarding the lack of comprehensive palliative care. For example, according to a study in 2007, only 16% to 30% of Canadians who died in that decade had access to hospice based palliative and end-of-life care services – depending on where they lived in Canada, according to the Canadian Institute for Health Information, Health Care Use at the End of Life in Western Canada (Ottawa: CIHI, 2007).

In 2011, The Parliamentary Committee on Palliative and Compassionate Care (PCPCC) sought means of addressing the nation’s shortfalls. The PCPCC’s report “Not to be Forgotten: Care of Vulnerable Canadians” focused specifically on three areas: palliative care, suicide prevention and elder abuse.

The CCRL supported the House of Commons motion in 2014 seeking action on palliative care, calling for the federal government to cooperate with the provinces and territories to ensure access to “high-quality, home-based and hospice palliative care,” to provide more support to caregivers, and to encourage Canadians to “discuss and plan for end-of-life care.” The CCRL supported this motion and the assertion by Mr. Angus and other MPs that PAD and euthanasia had no place in that national dialogue. Yet the SCC’s decision in Carter and the assisted suicide and euthanasia law has completely undermined this dialogue.

In fact, as suggestions are now being made to expand assisted suicide and euthanasia to “mature” minors, to the mentally ill, and to all through advance directives, which the CCRL opposes, the need for expanded palliative care options is more urgent.

The correlation between the propagation of assisted suicide and euthanasia with the decline in other medical options has been noted in other jurisdictions that have had legalized regimes for over 10 years. In fact, with just over two years of the current regime, various studies have identified that assisted suicide has already reached a comparative level in Canada that took Belgium and the Netherlands many years to achieve.

Dutch ethicist Professor Theo Boer, who once supported euthanasia laws in the Netherlands, changed his opinion of the practice. In an article published on July 17, 2014 in the Calgary Herald, Dr. Boer admitted that he was “wrong – terribly wrong” to have supported it. “. . . With 12 years of experience, I take a very different view,” he told the British Parliament in 2014 when they were considering legalizing assisted suicide. “Euthanasia is now becoming so prevalent in the Netherlands, that it is on the way to becoming a default mode of dying for cancer patients. Assisted deaths have increased by about 15 per cent every year since 2008 and the number could hit a record 6,000 this year. Campaigns for doctor-administered death to be made ever easier will not rest until a lethal pill is made available to anyone over 70 who wishes to die.” He concluded, “Some slopes truly are slippery.”

Is it any surprise that the Netherlands has only 70 palliative care beds in the country, according to a Dutch palliative care specialist? That is the result of 20 years of assisted suicide in that country. Will Canada be immune from such pressures?

The CCRL has consistently warned, as we do so now, that the pursuit of safeguards for vulnerable people have been ignored over time in other mature western jurisdictions when it comes to assisted suicide.

The risks to the highly vulnerable, namely the aged, children and those with mental health issues have increased, while the availability of palliative care options has not changed significantly.

The Need for Expansion of Palliative Care Options

Accordingly, the CCRL calls for the availability of informed options on palliative care as a treatment option for the frail elderly, the terminally ill, or others in vulnerable circumstances.

There have been ample previous studies on this subject. As part of the Thomas More Lawyers Guild, Philip Horgan was part of a team which presented to the special Senate Committee on Euthanasia and Assisted Suicide, prior to the release of its 1995 report.

More recently, in 2011, the all-party Parliamentary Committee on Palliative Care published its report, “Not to be Forgotten: Care of Vulnerable Canadians.” The League submitted a paper to the committee urging a strong commitment to a greater range of options for palliative care and better access to it.

That committee’s report came out with 14 recommendations, including the development and implementation of a national palliative and end-of-life care strategy, the development of a flexible integrated model of palliative health care delivery, able to take into account the geographic, regional and cultural diversity of Canada, strengthening of the home care delivery program for First Nations, Métis and Inuit communities, developing home delivered palliative care resources, sensitive to community, cultural, familial and spiritual needs, and the expansion of compassionate care benefit provisions and the setting up of a Canada Pension credit for family caregivers.

Previous studies and project implementation ideas were summarized and reviewed in The Way Forward (2012) of which members of the current committee were intimately involved. While the focus there was on hospice care, the report provided a helpful review of the importance of other principles, such as patient based strategies, various levels of community involvement, and the need for adaptation to the increased usage of home palliative care.

We support the submissions made by the Canadian Conference of Catholic Bishops (CCCB), and/or the Catholic Organization for Life and Family (COLF) on these important issues.

We wish to reiterate that a properly understood and effective delivery of palliative care options, rightly understood in its life affirming meaning, provides a true option for those with terminal illness or chronic conditions. Such options need to be made available for the frail elderly, the terminally ill, or others in vulnerable circumstances.

We further seek an adequately funded national palliative care initiative, whether through public facilities or private options, including hospice and home care alternatives, and that tax policies provide support for such initiatives.

We urge that a robust provision for religious and conscience rights of physicians and other healthcare workers be observed, which affirms life, such that patients or their caregivers are not forced into assisted suicide or euthanasia, through the availability of palliative care.

We seek to reinforce that if true alternatives are provided in the form of palliative care, properly funded, and made available on a patient-centred focus, the serious risks of an abuse endemic with assisted suicide of the frail, elderly or disabled persons can be partially ameliorated.

Thank you for considering our submission.

Philip Horgan, B.A., J.D., President
Christian Elia, PhD., Executive Director


About the CCRL

Catholic Civil Rights League (CCRL) (www.ccrl.ca) assists in creating conditions within which Catholic teachings can be better understood, cooperates with other organizations in defending civil rights in Canada, and opposes defamation and discrimination against Catholics on the basis of their beliefs. The CCRL was founded in 1985 as an independent lay organization with a large nationwide membership base. The CCRL is a Canadian non-profit organization entirely supported by the generosity of its members.

To donate to the CCRL, please click here.

For further information:

Christian Domenic Elia, PhD
CCRL Executive Director
416-466-8244
@CCRLtweets