“That means that the balance of Canadians have little to no access,” he said, noting that research on palliative care services is spotty.

Even within cities like Toronto or Montreal, access can vary. While Canada does a good job in dealing with acute health care issues, it is less prepared to deal with chronic conditions, chronic pain and mental health problems, Comartin said.

The report recommends the creation of a Palliative Care Secretariat to conduct research and facilitate the collaboration of those involved in palliative care and health officials at all levels of government, Comartin said.

Canadians must engage in more planning for their own personal need for palliative care later in life, he said. Doctors need more training in pain management and efforts must be made to reduce the need for extended long-term care, which is far more expensive than home or hospice care, he said.

The report outlines the palliative care philosophy as “person-centred, family focused and community based.”

“It recognizes that the psycho-social and spiritual dimensions have profound impact upon health and well-being, and that a variety of specific conditions may be operating on different levels in the chronically ill or dying person’s life,” the report says.

Canadian Medical Association president Dr. John Haggie told the news conference questions of assisted suicide and euthanasia reflect “the failure of access to adequate palliative care across the country.”  Speaking as someone who recently lost his wife, and as a physician serving a part of Newfoundland with no patient-centred palliative care system, he described the problem as “urgent.”

The Canadian Conference of Catholic Bishops welcomed the report. In a Nov. 17 news release, conference president Archbishop Richard Smith said the bishops are “pleased” that MPs have held “extensive consultations” and “published this report out of their personal concern to see established in our country a national system of compassionate and effective care for some of our most vulnerable citizens.”

“The bishops of Canada share that concern,” Smith said. “The inherent beauty and dignity of human life from its beginning until its natural end summons us to attend to this need without delay.”

The report was released as a court challenge to legalize euthanasia and assisted suicide winds its way through the Supreme Court of British Columbia.

Smith described palliative and compassionate care as “an essential priority” that “responds to all dimensions of their humanity, including the spiritual.”

“As follow-up to this report by the Parliamentary Committee, the Catholic bishops of Canada will carefully monitor how our national, provincial and municipal institutions implement these important recommendations on palliative care,” Smith said.

The Catholic Health Alliance of Canada (CHAC) also applauded the recommendations, describing them as “an important step toward improving palliative end-of-life care in Canada.”

"There are many challenges and areas that require improvement: the need for equitable access and stable funding, support for family caregivers and the pressing need to address the great confusion that exists regarding palliative care — its goals and effectiveness," said Dr. Nuala Kenney, CHAC ethics and health policy advisor, in a Nov. 17 news release. "The recommendations put forward by the committee, if implemented, would represent important steps forward in addressing those challenges."

The committee was set up a year and a half ago in the wake of the defeat of Bloc Quebecois MP Francine Lalonde’s euthanasia and assisted suicide private member’s bill. It involved 55 MPs and 24 hearings across the country involving hundreds of people.

But palliative care was only one of the urgent problems addressed by the committee.

Suicide is almost always preventable, said committee co-chair Conservative MP Harold Albrecht, but active prevention programs depend on where one lives in Canada. 

“These deaths do not ease the pain,” he said. “They just transfer the pain to others.”

Ten Canadians die a day by suicide, almost 4,000 a year, the report says. It calls for a national suicide prevention strategy.

Canada also needs a national elder abuse prevention strategy, perhaps a campaign like those in previous decades that raised awareness of spousal or child abuse, said Liberal MP and committee co-chair Frank Valerioti. Some estimates say as many as 20 per cent of elderly people are being abused in some form over their lifetime. As Canada’s population ages, the problem could become worse, he said. 

Though abuse is often not reported, Valerioti echoed the report, which says any senior could become a victim, and perpetrators could be “family members, friends, neighbours, caregivers or persons’ paid to carry out work for them.”

Comartin said national strategies for suicide prevention and combating elder abuse will be easier to tackle than palliative care.  

“We can’t do everything overnight,” he said.  

But the report provides a framework with recommendations that can be implemented in steps, he said.

The creation of a national palliative care system requires “some will” from national, provincial and territorial leaders, said Haggie, who said Canadians have stated clearly “this is what they wanted us to do.”