This article has been peer reviewed. Abstract Canada faces a significant and growing burden of terminal illness. There are major unresolved economic, ethical and social issues related to care at the end of life. The authors propose a conjoint initiative by the Royal College of Physicians and Surgeons of Canada and the College of Family Physicians of Canada to develop specialized training programs in palliative medicine as a critical step in addressing this crisis.
Palliative care is at an important crossroads in Canada.
The field has grown in importance and public support since the introduction of palliative care programs at St. Boniface Hospital, Winnipeg, and the Royal Victoria Hospital, Montreal, in 1974 75. 2 Palliative care measures were accorded a high priority by citizens in the state of Oregon when they were asked to rank health services in anticipation of decreases in health care funding in the early 1990s. The report of the Special Senate Committee suggested that palliative care would likely be given a similar priority by Canadians. Despite this apparent high degree of public support, there has been a disappointing response from the medical profession in terms of developing palliative care services and the discipline of palliative medicine. 4 Very little palliative medicine is taught to undergraduates in Canadian medical schools.