A report with the title ” Analysis of palliative care in Canada » was published by the Canadian Cancer Society (CCS) to take stock of the situation in the country. Although this care is essential, it shows that Canada does not have high-quality palliative care.

An observation made by an international study on the topic “ Quality of death and the end of life », published in 2022 [1]which puts the country in 22nd place out of 81.

“3.97 palliative beds per 100,000 inhabitants”

This is the first time these data have been available since 2017, when the results were released by the Canadian Palliative Care Association.

To prepare its report, the SCC conducted a survey in all provinces and territories, as well as four federal ministries [2] and thirteen community organizations [3]. Quebec and Manitoba are the only two provinces not participating.

Canada does not have a standard or target for the number of palliative care beds the country should have. According to the Canadian Cancer Society, “ best practices from different administrations »[4] suggest that there should be at least 7 palliative care beds per 100,000 inhabitants.

According to the report, the country does not have enough beds compared to the need. In fact, as of May 31, 2022, Canada only had 3.97 palliative care beds per 100,000 people. The number of beds in most provinces is below the threshold of 7 palliative care beds. Only British Columbia and the Yukon exceed this threshold.

“Access to quality palliative care is limited and unequal”

The report highlights that access to quality palliative care is particularly difficult for populations who “ undersupplied “, such as rural and remote communities, First Nations, Inuit and Métis, and people experiencing homelessness.

“ It is disheartening to see how limited and unequal access to quality palliative care is for many people in Canada, even though they need and deserve such care. » laments Andrea Seale, executive director of the Canadian Cancer Society. “ Every person with a life-limiting illness has the right to comfort, dignity and the opportunity to choose, and that is exactly what palliative care provides. ” she adds. ” It's a service that all Canadians are entitled to, but not everyone gets it » also denounces Daniel Nowoselski from the Canadian Cancer Society.

“Misperceptions of palliative care”

In addition to the insufficient number of palliative care beds, the report reveals other gaps, such as the need to provide palliative care in locations other than hospitals, including hospices, retirement homes or at home, to ensure continuity of care. The lack of training of health professionals in palliative care was also highlighted, as well as a lack of knowledge of palliative care among patients, families and health professionals.

It is still common for palliative care and its benefits to be misperceived. Most patients, families and physicians combine palliative care and “ Task “. In addition, there are significant social hurdles to talking about the end of life and death.

“Awareness campaign”

At the end of 2023, the Canadian Federal Minister of Health should take stock of the progress made since the implementation of the 2018 Palliative Care Framework and the 2019 Action Plan before Parliament. This is not yet known, but perhaps this will allow to complete the inventory carried out by the SCC and better understand the situation in order to develop it further?

In order to address the shortcomings identified, the report proposes, first of all, the establishment of an awareness-raising campaign aimed at the general public and health professionals, but also the development of training courses for a larger number of health professionals. “ More needs to be done to ensure that people are aware of the information and support available to them and that healthcare professionals have the resources necessary to provide palliative and end-of-life care for people with life-limiting illnesses, such as cancer » emphasizes Andrea Seale.

While the use of euthanasia continues to rise in Canada, the country lacks adequate palliative care. It does not provide its residents with all the necessary resources to adequately deal with suffering and support them at the end of their lives. However, Canada was a pioneer in palliative care a few years ago. Has euthanasia replaced palliative care, causing it to decline since its legalization?

[1] The studyproduced by Duke-NUS Medical Schoolwas identified using 13 indicators and then a questionnaire was sent to palliative care specialists in each country.

[2] Health Canada, Correctional Service Canada, National Defence, Indigenous Service Canada and Veterans Affairs Canada

[3] These include members of the Coalition for Quality End-of-Life Care Canada and various provincial palliative care associations

[4] Including practices established by the Auditor General of Ontario