The process of dying can be scary. Many of us think about dying in a vague way, hoping it will happen at home after a brief illness, without pain, surrounded by loving friends and family. In fact, most Canadians don’t die that way. Too many of us die in hospital, tethered to machines, tagged to receive CPR even if we don’t want it.
Fear causes us to avoid planning for health care at the end of life, and that can result in all sorts of problems. Planning in advance confronts those fears and increases our chances of a good death down the road.
That's why End of Life Planning Canada, a charity dedicated to helping Canadians navigate the end-of-life experience with confidence and dignity, developed a Patient Rights Booklet in 2016. It outlines what rights and options you have when planning for end of life. Medical assistance in dying (MAID), palliative care, voluntary stopping of eating and drinking (VSED) and proper pain management are among the issues that are discussed. (Note: The booklet was published a few months before the passage of Canada's assisted dying law in June 2016. You can learn more about the law, including its eligibility requirements, here.)
All Canadians are guaranteed protections under the Charter of Rights and Freedoms. The Charter provides for freedom of religion, of thought, of expression, of the press and of peaceful assembly. The question of a right to access MAID has thrust patient autonomy under law into the spotlight as it relates to claims that such restrictions violated sections 7 (the right to “life, liberty, and security of the person”) and 15(1) of the Canadian Charter of Rights and Freedoms (equality).
Another issue of consideration relates to a patient charter of rights. At this time no federal framework for patient rights exists. Individual provinces have led their own initiatives regarding rights and entitlements to health care including: Alberta, New Brunswick, Nova Scotia, Ontario and Quebec.
Planning ahead makes us think about our deep-seated values and the things that make our life worth living. It encourages us to imagine illnesses that could happen to us and figure out what treatments we would want, which we would refuse, and why? Planning causes us to think about our rights and preferences as individuals in a huge and complicated health care system, and to write our wishes down so that others will know what we want if we can’t speak because we are too sick.
Planning ahead makes the process of dying less scary.
This booklet is for you.
— Patient Rights Booklet and summary used with permission on End of Life Planning Canada.