(LifeSiteNews) – I’ve had an encouraging email from Marie Curie, the United Kingdom’s largest palliative care charity. It seems that over 53,500 people have signed their petition to the British government “to fix end of life care,” and it has been delivered to the new prime minister.
“Every single person who is dying or bereaved deserves the best possible support, right to the end,” Marie Curie declares. “No one should be left to face the current crisis in end-of-life care. It’s time for change.”
Here in Scotland, good palliative care, inspired by the pioneering work of Dame Cicely Saunders, is still available. Sadly, relatively few people receive it. This strikes me as unfair. We are always told the two certainties of life are death and taxes, and we do pay a lot of taxes in Scotland. Shouldn’t those taxes go toward ensuring that everyone dies a natural death as comfortably as possible, spending their last days on earth with loved ones or, at very least, in friendship with kindly carers?
Access to palliative care in the UK
I asked someone from a British palliative care charity about the problem, and she told me that funding is indeed “often central to (the) discussion when it comes to barriers in delivering care.” In her view, palliative care hospices are simply not being fairly funded as partners in the public healthcare system.
“Many people don’t realize that as an independent hospice, two-thirds of our vital income come from public generosity and funding,” she wrote.
Another issue that prevents people from accessing palliative care is a misconception — among healthcare providers and social workers as well as patients — of what palliative care can be.
It’s not just for people who are “on a clinical ward, in a bed, at the end of life,” I was told. It’s also for people who are receiving treatment in their homes, and the support can be wide-ranging: helping a couple to get married, landscaping the patient’s garden, and teaching art, music, and other classes, both at a hospice and in the community, are examples.
“Hospice care can be what you make it or what you need it to be,” my correspondent wrote. “So, circling back, to answer your question, I think some of it comes down to dispelling myths, encouraging more open and honest conversation around death and dying, and ensuring health and social care providers across the board know about referral processes and have a single point of contact so that the process is aligned and efficient.”
Active euthanasia is still illegal in the United Kingdom, thank God. I feel almost cheerful about palliative care in Scotland, having witnessed the last days of a dear friend after she came home from hospital “to die,” as she bluntly put it. Lying on a couch in her ornate sitting-room, roses blooming outside her windows, Angela held a two-week salon. Friends and family dropped by to share memories, cats crept in and out, her husband administered her pain meds by day, and a palliative care nurse took over at night. Not to romanticize Angela’s passing — she posted to social media a fervent hope to die in her sleep — but it was at home, and she lived as well as she could to the end.
Access to palliative care in Canada
It’s with a sense of dread that I turn to the situation in Canada. Canadians frightened of being bumped off by their medical providers can now obtain “Do Not Euthanize” cards from the beleaguered, pro-life Delta Hospice Society.
“Why do so few people get palliative care?” responded its president, Angelina Ireland. “It has mostly to do with access, and today there is only access to death and not to life (in Canada).”
She added that palliative care has historically been delivered only by family caregivers and independent organizations like Delta Hospice Society. Although tens of billions of provincial tax dollars are allocated to public healthcare, palliative care organizations have been “locked out.”
“Palliative Care was never mainstreamed, respected, funded, and encouraged like other healthcare options,” Ireland wrote. “It is no wonder only 30% of Canadians ever had access to it.”
Ireland was hopeful in 2017 when Bill C-277 resulted in a pledge of $6 billion over five years to strengthen the medical discipline in Canada. However, she says there followed an “epic failure,” and a “time limit” was placed on the funding.
“From three to six months before death, people are categorized as ‘palliative,’” Ireland wrote. “They can qualify for some meagre benefits and then are thrown into a system that is becoming more and more predatory. The question has become ‘When?” not “If?” a person who is palliative will be euthanized.”
“Every palliative care (ward) is expected to offer euthanasia now, and euthanasia has become the ‘King’ of all procedures,” she continued.
Organizations that will not bow to King MAiD can expect to be dragged through the courts, and that includes “the last bastion,” Catholic healthcare.
“Catholic healthcare is the only place left protecting the pure and original 50-year-medical discipline of Palliative Care,” Ireland stated.
There popped into my mind a scene from R.H. Benson’s Lord of the World: a Catholic priest searching for believers among the suffering victims of an air-train disaster just before the “ministers of euthanasia” arrive. The heroine of the book is nonplused by the priest, but “her heart leapt in relief” when she saw the MAiD team, so appalled is she by lingering deaths. Later, we learn that her husband loathes Christianity as “this hateful thing that had so long restrained the euthanasia movement with all its splendid mercy.” Set in the 21st century, the novel was published in 1907.
A question of trust
Apparently, you can’t even pay for private pro-life palliative care in Canada; Ireland says it simply isn’t allowed. Well, Canadians know where to go when we can’t get the treatment we want, or when we have more money than patience or time: south of the Border. I’m hoping to hear next from American experts about access to palliative care in the United States. Sadly, what I’ve come across so far are anguished accusations from people who believe that their loved ones were poorly treated in U.S. hospices, deliberately overmedicated and/or dehydrated to death.
And this strikes me as the greatest barrier of all to good palliative care: a growing public distrust in healthcare professionals. Not only do we need funding for palliative care, more palliative caregivers, and more understanding of what palliative care can be, we need more medical professionals to show that we can trust them. Spending sufficient time with patients and their worried relations to discuss and explain treatment plans would be a good start. Fighting for the right of palliative carers to assist patients without killing them would be nice, too.
That said, there’s something we all should do, and that is to prepare for our own inevitable deaths: not only spiritually, which should go without saying, but practically. And that deserves an article of its own.
