1. Medical Aid in Dying – Developing a Framework Theresa Mudge Hospice Palliative Care Ontario October 27, 2015

2. Hospice Palliative Care Ontario is an association that represents both organizations and individuals providing hospice palliative care across the province. HPCO’s work includes informing policy, advocating for funding, and promoting awareness, education, knowledge transfer and best practices in the pursuit of quality hospice palliative care in Ontario. Hospices and Physician Assisted Death

3. The hospice movement in Ontario is just 36 years old. The first in-patient hospice opened in 1988 Seven existed in 2004 Today there are 39. Hospices include: 70 in-home volunteer led programs caring for people in their own residences; and 39 residential hospices with 284 in-patient beds. Hospices and Physician Assisted Death

4. However, the Supreme Court has ruled, so…. Where will PAD take place? What protections will be offered for conscientious objectors? While the court ruling protects physicians, what about the rest of the health care team? What about institutional conscientious objection? Should facilities be required to facilitate PAD? Hospices and Physician Assisted Death

5. The WHO definition of palliative care: Palliative care is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual. Palliative care: provides relief from pain and other distressing symptoms; affirms life and regards dying as a normal process; intends neither to hasten or postpone death; offers a support system to help patients live as actively as possible until death. Full WHO definition available at: www.who.int Hospices and Physician Assisted Death

6. Quality hospice palliative care 1. Why do people seek care in a hospice? 2. Capacity within hospices 3. Religious affiliations 4. Funding impact 5. Local choice Hospices and Physician Assisted Death

7. Yes, we need to prepare for PAD but let’s not lose focus on: Better access to palliative care An integrated palliative approach to care PAD must not be the option solely because quality hospice palliative care was not available or offered Hospices and Physician Assisted Death

8. Theresa Mudge HPCO Board Member, and Executive Director ARCH Hospice 229 Fourth Line West Sault Ste. Marie ON P6A 0B5 MudgeT@archhospice.ca Contact: