A Better Death

We strive to live a life of meaning, purpose and with a little luck the love and support of family and friends who make it all worthwhile.  We are living longer, no doubt about it, and with a growing number of elderly who may have multiple chronic medical conditions, end of life care planning is on the minds and lips of many in the medical community.

We have the means to sustain life, even when the outcome may be what most would consider a fate worse than death: to have permanent loss of function mentally and physically or to be in constant pain.  Recognizing this conflict, the Canadian Medical Association has amended it’s policy regarding assisted death, supporting doctors who follow their own conscience in deciding whether or not to provide medical aid in dying.

“There are rare occasions where patients have such a degree of suffering…that they request medical aid in dying,” states the policy on Euthanasia and Assisted Death.

End of life care over the next few decades will be increasingly important at the number of seniors grows by up to 25 per cent and the number of deaths rises by 65 per cent, according to a publication from Sunnybrook Hospital in Toronto.    Nearly 70 per cent of elderly patients reported they would prefer to focus on comfort at the end of life rather than be in a clinical setting, kept alive with machines.  Most elderly, frail patients would rather die at home and or in hospice where palliative care can make their final days as comfortable as possible.

After a thorough assessment of the pro and cons of medical intervention, aggressive treatment may not always result in a benefit for the patient if they can no longer live a life they want.  In some cases, less may be more.

A program that began in 2009 in Nova Scotia found that frail and elderly patients (with multiple chronic health issue) who had all the information about aggressive interventions wanted less done.  Risks of infection, loss of memory or mobility may give patients pause before agreeing to treatments that could in their opinion do more harm than good.  For more information about the Palliative and Therapeutic Harmonization program at the QEII Health Science Centre in Halifax, Nova Scotia visit: http://www.cdha.nshealth.ca/geriatric-medicine/palliative-therapeutic-harmonization-clinic .  To learn more about end of life law and policy in Canada, visit the Dalhousie University Health Law Institute at: http://eol.law.dal.ca/ .