“People have a right to the care that they need,” Fraser told The Catholic Register.
Fraser is parliamentary assistant to Health Minister Eric Hoskins with special responsibility for modernizing and expanding Ontario’s palliative care capabilities. He spent 2015 travelling the province, holding 16 consultations to assess the situation and find out what should be done. His March report on palliative and end-of-life care committed the Ontario government to spending $75 million over three years on a program that will add 200 hospice beds in 20 new hospices. That should nearly double the current hospice capacity.
The plan also commits the government to promoting advance care planning, educating family doctors and nurses in palliative care and better co-ordination among existing institutions and organizations when it comes to end-of-life care.
The new energy on end-of-life options has plenty to do with the Supreme Court’s decision to legalize assisted suicide.
“Because of the Supreme Court decision, there’s an imperative to improve palliative care,” Fraser said. “That’s been the focus of my work. It’s going to continue to be the focus of what my work is.”
Fraser’s father died of cancer just over two years ago. At first the family took care of him, but as death approached Fraser’s father was able to move to a hospice for the last three weeks of his life. But his politician son is painfully aware that not all of us have access to a smooth transition into professional care focused on providing a good death.
“It has to improve, there’s no question about that,” Fraser said.
In 2008 6,927 people died in Ontario hospitals, 73 per cent of those who were admitted with a palliative diagnosis. That last hospital visit averaged 13.5 days and the direct cost was $77.6 million. The average age of the dying patients was 72.8 years and more than half of them had two or more admissions prior to dying in hospital.
Dying in hospital attached to machinery is most certainly not what most people want, but it is what many get.
On that score, Fraser wants people to get their heads out of the sand and face the fact that they’re going to die. If they can do that, the next step is to engage in advance-care planning.
“Couldn’t we be just a little more ready for it?” he asks.
As a Catholic whose mother worked a lifetime in nursing, Fraser is one legislator who understands why people worry when death is put on the table as just one more health-care option.
“I can understand why people are concerned,” he said. “Because the train is moving — the train feels like it’s moving pretty fast.”
But he’s equally convinced that there will be a way to protect the conscience rights of individual health care professionals, nurses and doctors, as well as Catholic hospitals, nursing homes and other institutions.
“We have to, I think, recognize and understand that institutions are made up of people,” he said.
If Fraser is confident that religious health care can be protected, it’s based on his faith in ordinary people — whether religious communities or other groups — to band together and fashion the kind of end-of-life care they want.
“The Supreme Court decision is what it is,” he said. “One of the things that will come out of that is how we care for each other at the end of our lives. I think it’s brought a focus to that that we need to pay attention to. There’s an imperative because of that… We need to get back together as communities — whether it’s a religious community, a local community or a service organization — and say this is really important to us.”
The 20 new hospices inaugurated over the next three years won’t be part of some master plan drawn up in a hive of cubicles at the Ministry of Health. Rather the provincial government will make money available to support the work of local initiatives, Fraser said.
A March Angus Reid Institute survey of 1,517 Canadians found 68 per cent of us are opposed to forcing religiously affiliated hospitals into providing physician-assisted death and only 36 per cent in favour of forcing doctors to refer patients for euthanasia. A vast majority, 88 per cent, want people who ask for assisted suicide to have to wait long enough to reconsider the request.
If people really don’t believe assisted suicide is some sort of formula for an ideal, clean, clinical death, then it’s going to be up to them to create the alternatives.
“We all have a responsibility to each other. How we care for each other at the end of our lives is as important as at the beginning of our lives,” said Fraser. “Community support actually engages people in the process of taking care of each other.”