Nine in 10 Canadians want palliative care once they understand its life-affirming role in managing serious illness

We all have our time someday. What most of us tend to worry about is the circumstances—will we suffer? For how long?

One of the chief ways our medical system works to alleviate the suffering of those who are dying is through palliative care. Earlier in May, new polling was released by the Angus Reid Institute, in partnership with Cardus and the Palliative Institute, which reveals how Canadians understand palliative care and whether they want to see it improved.

Despite the fact that everyone dies, and despite the fact that something like 180,000 Canadians and their families interact with some form of end-of-life care in a year, I keep confronting the perception that palliative care is a niche issue, not one of broad interest. But this reaction only underscores the poll’s findings: namely that many Canadians continue to misunderstand what palliative care is and isn’t. On a more positive note, however, when Canadians do understand it, palliative care is, in fact, identified as a priority issue.

Sixty-four per cent of Canadians misunderstood palliative care as only comfort care for those at the end of life. A smaller proportion—one in 20 Canadians—misunderstands palliative care to be the same as “medical assistance in dying,” even though palliative care—by definition—intends neither to hasten nor prolong death, as opposed to MAiD, in which the provider directly and intentionally ends the patient’s life.

Instead, palliative care is appropriate for any stage of serious illness and should be provided as soon as possible at or after diagnosis of a serious illness. It can be provided alongside curative and life-prolonging treatments. It is holistic care to help people live well with illness, improving quality of life through pain management and symptom management, but also through providing emotional, psychosocial and spiritual supports for a person, their family and their caregivers.

Misunderstandings of palliative care, such as it being only comfort care, only in the final days of life, or only after ceasing other treatments, can mean that:

• Patients are not referred early enough by their care teams and/or patients and families may resist an early referral, and thus do not fully benefit from the support palliative care could provide throughout their illness;
• Policymakers inadequately resource, innovate and invest in palliative care due to a lack of realization of how many Canadians would benefit from receiving it—and how early integration of palliative care can actually improve overall health-care system functioning.

The poll itself reflects this gap. After testing Canadians’ knowledge and then providing a comprehensive definition of what palliative care is, the poll went on to explore Canadians’ experiences with and views on palliative care, including concerns from a majority of respondents about access or availability issues, and the fact that three in 10 lacked confidence that they could access palliative care if they needed it.

Forty-five per cent identified improvements to palliative care as a high or highest priority, with an additional 42 per cent ascribing a medium priority to such improvements. Nine in 10 Canadians believe universal access to funded high-quality care should be a right, something that is not currently the case in Canadian law.

No, this is not a niche issue. Most of us will face serious illness. All of us will lose someone we love, and amid their illness, we will want them to have the best care possible. And with an aging population, the time to have these discussions is now.

Palliative care is, in the end, everyone’s issue. The question now is whether policymakers will treat it that way.

Rebecca Vachon is the Director of the Health Program at Cardus. A policy expert with a PhD from the University of Ottawa, she is dedicated to researching and advancing health policy that upholds human dignity. Her academic background includes expertise in federal morality policy and public administration.