winter 2013

g e n e r a l   c o u n c i l
End-of-life issues dominate CMA debate, an Integrated Palliative Approach to Care launched

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Issues surrounding the physician role at the end-of-life took centre stage at this year’s CMA General Council meeting in Calgary.

Issues surrounding the physician role at the end-of-life took centre stage at this year’s CMA General Council (GC) meeting in Calgary. The end-of-life issue, which garnered extensive media coverage before, during and after the meeting, was featured in two GC sessions dealing with advance care directives and palliative care.

The most contentious debates on resolutions centred on the terminology used in discussing physician involvement in such care. Many of the resolutions were proposed by delegates from Quebec, where new legislation about physician-assisted suicide and euthanasia was being considered.

A resolution urging governments to conduct large-scale public consultations regarding medical aid in dying at the end of life was narrowly defeated. However, a motion that passed easily called on the CMA to support the right of any physician to exercise conscientious objection when faced with a request for medical aid in dying. A resolution to make advance care directives legally binding was also defeated by delegates, who expressed concerns about its implementation and how it might interfere with the physician-patient relationship.

The Way Forward: An Integrated Palliative Approach to Care

The Way Forward: An Integrated Palliative Approach to Care, led by the Quality End-of-Life Care Coalition of Canada (QELCCC) and managed by the Canadian Hospice Palliative Care Association (CHPCA), is a three-year project (2012-2015) funded by the Government of Canada that will engage settings, sectors, professionals and governments in a dialogue regarding the implementation of community-integrated hospice palliative care.

As part of The Way Forward, a series of discussion documents were written to scope the current landscape about community-integrated hospice palliative care, and also identify considerations for implementing a palliative approach to care across settings.

Seven discussion documents are now complete and available online at It is hoped these discussion documents will facilitate dialogue about the palliative approach and move the project further toward achieving the objectives of The Way Forward to change the understanding and approaches to aging and chronic, life-limiting illness and dying; and to enable community-integrated hospice palliative care across settings of care.

The Way Forward National Framework: A Roadmap for the Integrated Palliative Approach to Care has also been made available online, which is at the core of The Way Forward initiative. It is the beginning of a framework that, once completed, will guide health care professionals, health systems leaders, program planners and others as they adopt an integrated palliative approach to care. It contains principles and action steps, best practices and other resources to help communities and organizations adopt the palliative approach to care across all settings.

Over the coming months, the Framework will be revised and refined based on the advice and feedback from stakeholders across the country. Add your voice to the discussion by reading the draft framework and providing your thoughts in the online comments section at



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