the big issues: palliative care perspective monica branigan, md, mhsc chair, canadian society of...
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Access to high quality palliative careTRANSCRIPT
![Page 1: The Big Issues: Palliative Care Perspective MONICA BRANIGAN, MD, MHSC CHAIR, CANADIAN SOCIETY OF PALLIATIVE CARE PHYSICIANS WORKING GROUP ON HASTENED DEATH](https://reader034.vdocuments.site/reader034/viewer/2022051301/5a4d1ada7f8b9ab05997447f/html5/thumbnails/1.jpg)
The Big Issues:Palliative Care Perspective
MONICA BRANIGAN, MD, MHSCCHAIR, CANADIAN SOCIETY OF PALLIATIVE CARE PHYSICIANS WORKING GROUP ON HASTENED DEATH
![Page 2: The Big Issues: Palliative Care Perspective MONICA BRANIGAN, MD, MHSC CHAIR, CANADIAN SOCIETY OF PALLIATIVE CARE PHYSICIANS WORKING GROUP ON HASTENED DEATH](https://reader034.vdocuments.site/reader034/viewer/2022051301/5a4d1ada7f8b9ab05997447f/html5/thumbnails/2.jpg)
Top three issues1. Access to high quality palliative care #1 priority
2. Balancing patient access and physician conscience
3. Balance autonomy and harm reduction
![Page 3: The Big Issues: Palliative Care Perspective MONICA BRANIGAN, MD, MHSC CHAIR, CANADIAN SOCIETY OF PALLIATIVE CARE PHYSICIANS WORKING GROUP ON HASTENED DEATH](https://reader034.vdocuments.site/reader034/viewer/2022051301/5a4d1ada7f8b9ab05997447f/html5/thumbnails/3.jpg)
Access to high quality palliative care
![Page 4: The Big Issues: Palliative Care Perspective MONICA BRANIGAN, MD, MHSC CHAIR, CANADIAN SOCIETY OF PALLIATIVE CARE PHYSICIANS WORKING GROUP ON HASTENED DEATH](https://reader034.vdocuments.site/reader034/viewer/2022051301/5a4d1ada7f8b9ab05997447f/html5/thumbnails/4.jpg)
Access to palliative care The issue of true choice Physician hastened death is distinct from palliative care Equitable access to resources
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My recommendations Right of access to palliative care National Palliative Care/End of Life Strategy Separate parallel provincial service with multiple access points to provide
◦ Information◦ Counselling◦ Referral/access to willing provider list◦ Initial monitoring and documentation
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Balancing patient access and physician conscience
![Page 7: The Big Issues: Palliative Care Perspective MONICA BRANIGAN, MD, MHSC CHAIR, CANADIAN SOCIETY OF PALLIATIVE CARE PHYSICIANS WORKING GROUP ON HASTENED DEATH](https://reader034.vdocuments.site/reader034/viewer/2022051301/5a4d1ada7f8b9ab05997447f/html5/thumbnails/7.jpg)
Effective referral or effective access?
Moral distress with duty to refer Alternatives:
◦ Duty to inform: ◦ separate parallel system◦ “patient advocate”◦ designated member of the institution
◦ Team duty rather than duty of individual MD
![Page 8: The Big Issues: Palliative Care Perspective MONICA BRANIGAN, MD, MHSC CHAIR, CANADIAN SOCIETY OF PALLIATIVE CARE PHYSICIANS WORKING GROUP ON HASTENED DEATH](https://reader034.vdocuments.site/reader034/viewer/2022051301/5a4d1ada7f8b9ab05997447f/html5/thumbnails/8.jpg)
My recommendations Clear policy from Colleges about responsibilities of all health care providers with examples
Concept of effective access
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Balancing autonomy with harm reduction
![Page 10: The Big Issues: Palliative Care Perspective MONICA BRANIGAN, MD, MHSC CHAIR, CANADIAN SOCIETY OF PALLIATIVE CARE PHYSICIANS WORKING GROUP ON HASTENED DEATH](https://reader034.vdocuments.site/reader034/viewer/2022051301/5a4d1ada7f8b9ab05997447f/html5/thumbnails/10.jpg)
Potential harms and recommendations
Preventing possible premature death◦ Proportionate waiting times◦ Access to appropriate consultations◦ Education at all levels◦ Monitoring access to and quality of palliative care
Potential harm to palliative care◦ Separate, parallel service◦ Shared responsibility of the whole profession
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Potential harm to families◦ Attempt to include◦ Provide grief counselling
Potential harm to other HCP◦ Need equal protection under the law
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Consider graduated implementation◦ Start with physician hastened patient administered death◦ Then physician hastened physician administered◦ Then mental health suffering
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CSPCP Submission to the Federal Panel
http://www.cspcp.ca/wp-content/uploads/2014/10/CSPCP-Federal-Panel-Submission-Oct-22-2015-FINAL.pdf