The Law Commission of Ontario’s (LCO) Improving the Last Stages of Life project released two final research papers ahead of publishing its consultation paper. The LCO’s project examines how Ontario laws are shaping the quality of life of dying people and how end of life care can be improved in Ontario through a better understanding of the law by healthcare workers, patients, and substitute decision-makers. It also considers recommendations for legislative reform.

“Balancing the Interests of Patients, Substitute Decision-Makers, Family and Health Care Providers in Decision-Making Over the Withdrawal And Withholding of Life-Sustaining Treatment” provides a substantive explanation of how treatment decisions are made including the role of substitute decision-makers in providing or withholding end of life care.  In addition to public misconceptions about these types of treatment decisions, there is a lack of clarity in the medical and legal communities on how these decisions are made and who gets to make them.

“Integrating Religious and Cultural Supports into Quality Care in the Last Stages of Life in Ontario” looks at end of life care in the context of religious, spiritual and cultural practices. The paper provides a summary and review of mainstream religious practices regarding end of life issues as well as ways to improve the integration of religious and cultural practices into an institutional care setting.

Next steps for the LCO’s project are the release of a discussion paper by the end of this month. Requests for public consultation are open until September 2017.

If it hasn’t already, end of life care is an issue that will affect most people in the upcoming years. Remarkably, there is still great uncertainty with respect to how literal “life and death” decisions are made. Patients’ consent to treatment, the role of the substitute decision-makers, and advance care planning are all issues that will have to be considered and clarified (through legislation and/or case law) in the upcoming years.

Thank for reading,

Diane Vieira