Press Releases

March 25, 2011

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

Region releases two reports on end-of-Life decision-making process

The Winnipeg Health Region today released two reports that examine how achieving consensus between patients (their families and representatives) and health care providers over end-of-life issues can be better supported.

"End-of-life decisions are personal and difficult," Dr. Brock Wright, WRHA Senior Vice President and Chair of the Regional Working Group, said. "But the vast majority are resolved through consensus. 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."

Mr. Marc Labossiere, Vice Chair of the WRHA Board of Directors said both reports are the result of months of work on the part of all members. "Everyone involved was very thoughtful, forthcoming and diligent throughout. I'd like to acknowledge and thank them for their hard work."

Recommendations from the reports focus on education and improved communication to clarify patient and family wishes as early as possible, including:

  • Publicly promoting and offering educational sessions about Health Care Directives and Advance Care Planning to identify patients' or their representatives' wishes about end-of- life care as early as possible;
  • Increasing and improving communications between health care providers, patients, their families and representatives throughout the care process;
  • Increasing access to mediation and ethics support services for patients, families and staff to help resolve disagreements in a timely, supportive and respectful manner; and
  • Improving other processes involving the care of and communications surrounding patients (and families) potentially facing end-of-life decisions.

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

"We have already developed a staff and public education plan about what supports are already available. Information is also being made available on the region's website and is featured in the latest issue of Wave magazine.

Both reports are available here. The report produced by the Working Group chaired by Dr. Wright recognizes the College of Physicians and Surgeons of Manitoba's Statement on the topic is binding on all Manitoba physicians, but that broader WRHA policies and procedures that do not conflict with the College Statement, can be established that apply to all WRHA staff, including physicians. (The CPSM's statement is available on the College's website.)

Both reports raise the issue of whether there should be a legislated or internal review process to resolve end-of-life care issues between patients, families and health providers as an alternative to, or intervening step before, pursuing legal action through the justice system.

Minister of Health Theresa Oswald said she considered the suggestion, but thought it more appropriate for the region to put in place the support and resources to avoid disagreements between patients, their families and health professionals.

"Decisions about end of life care are sensitive, personal and best left to patients, their families and their doctors. We believe efforts should be directed to the resources and education that can support those decisions and prevent or resolve disputes between patients, families and health care teams rather than creating an additional legislated panel for patients or families to navigate in what would already be an extremely difficult situation," Minister Oswald said. "Patients' wishes about end-of-life-care should be identified as early as possible, and initiatives currently being implemented by the WRHA will help to clarify and honour those wishes."

Dr. Wright said that discussions are ongoing with care providers and other stakeholders about whether or not the idea of an internal review process should be pursued. "Giving patients and families access to ethics services, second opinions, mediation, and doing everything possible to ensure open and transparent communication should go a long way to establishing a trusting environment in which consensus can be achieved," he said.

Ms. 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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