NEWS

Region to enhance approaches
to end-of-life care

Measures will facilitate discussions between families
& health-care providers

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Withholding/Withdrawing Life-Sustaining Treatment / WRHA Board Working Group Report

Report of the WRHA working group on withholding and withdrawing life-sustaining treatment

Arlene Wilgosh on the importance of advance care planning

Wave: Making Plans

Press Release: Access to end-of-life supports and resources to increase for patients, families and professionals

National Advance Care Planning Day

Winnipeg Health Region
Published Friday March 25, 2011

The Winnipeg Health Region is implementing a wide-ranging plan to better support consensus-building among those involved in developing end-of-life treatment options for seriously ill patients. 

The measures, announced today, flow from the recommendations of two Winnipeg Health Region working groups - one consisting of Board members, the other made up of staff members - that spent several months looking at issues surrounding end-of-life care.

The key recommendations from the two groups include:
  • Reducing the possibility of conflict by publicly promoting and offering educational sessions about Health Care Directives and Advance Care Planning;
  • Increasing and improving communications between health care providers, patients, their families and representatives;
  • Increasing access to mediation and ethic support services; and
  • Improving other processes involving the care of and communications surrounding patients (and families) potentially facing end-of-life decisions.

Dr. Brock Wright, Region Vice President and chair of the staff working group, said the reports reflect the Region's desire to find ways to help ensure health-care providers can work with family members and loved ones to ensure patients receive appropriate care.   

In the vast majority of cases, Wright explained, health-care providers, family members and loved ones work together to arrive at appropriate decisions concerning treatment for those who are nearing the end of life and may not be able to speak for themselves.

However, there are rare occasions when relatives or loved ones may wish to have certain treatments performed on a patient to prolong life. Differences of opinion can arise if health-care providers believe the treatment in question would cause more harm than good.

"End-of-life decisions are always personal and difficult," Wright said. "What we're trying to do here is put in place the necessary supports so that everything possible is done to facilitate agreement between families and care providers in the very small number of more complex and contentious situations."

Marc Labossiere, Vice Chair of the Region's Board, said the reports represent the best efforts of all involved to address a complex issue. "Everyone involved was very thoughtful, forthcoming and diligent throughout," said Labossiere. "I'd like to acknowledge and thank them for their hard work."

Lori Lamont, Vice President and Chief Nursing Officer for the Region, said work has already begun on the implementation of the reports' recommendations.

One of the most important things a person can to ensure they have a voice in their care is to create a Health Care Directive. A key part of the advance care planning process, a Health Care
Directive is a legal document which can guide the health-care team when a patient is unable to offer instructions.

"We have already developed a staff and public education plan about what supports are already available." Links to information about the advance care planning process and Health Care Directives can be found in the "Read More" box on this page.

The report produced by Wright's working group recognizes that the College of Physicians and Surgeons of Manitoba (CPSM) statement on the topic is binding on all Manitoba physicians, but that broader Region policies and procedures, that do not conflict with the College statement, can be established that apply to all Region staff, including physicians.

Both reports also raise the issue of whether there should a legislated review process to resolve such differences of opinion about care options. Health Minister Theresa Oswald said she considered the suggestion, but thought it more appropriate for the Region to put in place supports and resources needed to build consensus.

Lamont said the Region's decision to focus its efforts on education and increasing public awareness is the best approach. "Achieving consensus is our goal and that can only be accomplished by working together."

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