Due to ongoing confusion amongst the general public regarding Hospice Palliative Care (HPC) and Medical Assistance in Dying (MAiD), the Canadian Hospice Palliative Care Association (CHPCA) and the Canadian Society of Palliative Care Physicians (CSPCP) would like to clarify the relationship of hospice palliative care and MAiD.
Healthcare articles and the general media continue to conflate and thus misrepresent these two fundamentally different practices. MAiD is not part of hospice palliative care; it is not an “extension” of palliative care [i] nor is it one of the tools “in the palliative care basket”.[ii] National and international hospice palliative care organizations are unified in the position that MAiD is not part of the practice of hospice palliative care.
Hospice palliative care and MAiD substantially differ in multiple areas including in philosophy, intention and approach. Hospice palliative care focuses on improving quality of life and symptom management through holistic person-centered care for those living with life threatening conditions. Hospice palliative care sees dying as a normal part of life and helps people to live and die well. Hospice palliative care does not seek to hasten death or intentionally end life. In MAiD, however, the intention is to address suffering by ending life through the administration of a lethal dose of drugs at an eligible person’s request.
Less than 30% of Canadians have access to high quality hospice palliative care, yet more than 90% of all deaths in Canada would benefit from it. Despite this startling discrepancy, access to hospice palliative care is not considered a fundamental healthcare right for Canadians. In contrast, MAiD has been deemed a right through the Canada Health Act, even though deaths from MAiD account for less than 1.5% of all deaths in Canada.
We call on the federal and provincial governments to prioritize funding and improve access to hospice palliative care in Canada, and to support the implementation and action plan of the National Framework for Palliative Care in Canada. Canadians must have a right to assistance in living with hospice palliative care, and not just a right to termination of life.
Sharon Baxter, MSW
Canadian Hospice Palliative Care Association (CHPCA)
Editor’s note. This appeared here. Internal citations omitted for clarity.