Bioethics Blogs

Debunking the Myth About Access to Palliative Care

Jocelyn Downie and Georgia Lloyd-Smith dispute the oft-repeated claim that current rates of access to palliative care in Canada are between 16%-30%.

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Assisted death is the subject of conversation in the media, in public meetings, and around kitchen tables across Canada. Often these conversations include discussions about access to palliative care with some people claiming that assisted dying should not be allowed until access to palliative care is improved. So, what is the evidence on access to palliative care in Canada?

A recent press release from the Canadian Medical Association on its National Dialogue on End-of-Life Care tour stated that “fewer than 30% of the Canadians who will die in 2014 will have access to palliative care.” The Senate of Canada Report “Raising the Bar: A Roadmap for the Future of Palliative Care in Canada” stated that “[i]n 2008, a best estimate suggested that somewhere between 16-30% had some level of access, depending on location.”  The 2011 report of the Royal Society of Canada Expert Panel on End of Life Decision-Making claimed that “As many as 70% of Canadians lack access [to palliative care].” In 2012, Justice Smith in Carter v. Canada concluded that “high quality palliative care is far from universally available in Canada” and quoted a Crown expert: “Unfortunately only 16-30% of Canadians receive palliative care as part of their life-threatening illness.” A 2014 comparative study of Canada, England, Germany, and the United States stated that “the hospice palliative care utilization rate was 16%-30% of all deaths.”

Ward_in_the_Hospital_in_Arles

Vincent van Gogh, Ward in the Hospital in Arles (1889)

That only 16-30% of Canadians have access to palliative care (or, its derivative, 70% are without access to palliative care) seems to be an accepted fact.  But is this, in fact, true?

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.