Appendix G: Questions for Discussion

////Appendix G: Questions for Discussion
Appendix G: Questions for Discussion2017-05-29T01:25:39+00:00
  1. Within the scope of LCO’s project, are there any additional affected individuals, communities, and institutions that should be taken into account?
  2. Are there any additional recent debates or legislative frameworks that LCO should be aware of?
  3. What legal rights and principles are important for shaping care and establishing professional standards in the last stages of life?
  4. Legislation governing health care, housing, employment, professions, and other areas intersects with the last stages of life – what gaps exist that would benefit from greater certainty or clarity?
  5. Should a public health approach to palliative care be integrated into Ontario’s regulatory framework, and how would it look on the ground?
  6. The LCO has identified several areas where medical assistance in dying could be clarified, including transitions in care, conscientious objection, and appeals of capacity determinations. Are there other additional issues to consider?
  7. What are your experiences as a member or supporter of a community of need going through the last stages of life?
  8. What law reforms do you believe are needed for communities with unmet needs, and how would such reforms be most effectively implemented in law?
  9. Are there any communities with unmet needs who are not identified in this paper that the LCO should consider?
  10. How can institutions, professionals and the public be better supported to obtain meaningful and legally compliant health care consent?
  11. How can practice tools achieve the goal of providing accurate, consistent and meaningful information about consent and advance care planning?
  12. There are connecting laws, principles and policies regarding decision making for life-sustaining practices such as CPR, DN, and nutrition. What are the strengths, weaknesses and gaps in Ontario’s current legal framework for decision-making authority over life-sustaining practices?
  13. Who should have authority to determine whether life-sustaining and lifesaving treatment (e.g., CPR, DNR) is offered to, or withdrawn from, a patient – the patient (or SDM) or a health care provider? Under what circumstances?
  14. Should Ontario regulate the offering of food and water to persons nearing the end of life, including the authority of SDMs to consent to withholding necessities of life?
  15. Should Ontario regulate the clarity, consistency and safety of palliative sedation therapy considering the ethical challenges, medical assistance in dying, and the need for safeguards like informed consent?
  16. Which options are preferred to better plan for and manage expected deaths at home? Would it be beneficial to have a province-wide strategy or formal regulation?
  17. How can strategies for addressing the needs of health care providers assist with mental and moral stress? How can health care practitioners be better prepared to manage disputes?
  18. Do legal professionals require specific education and guidance on matters relating to the last stages of life, and what form might this best take?
  19. What approaches are best suited to address barriers, accommodations and supports to better integrate faith, cultural and spiritual practices into care nearing the end of life?
  20. What are your experiences as a patient or caregiver transitioning between care settings in the last stages of life?
  21. Are law reform measures needed to improve access, navigational supports, and the coordination of care within the health care system?
  22. What strategies, processes, or institutions are best suited to resolving disputes in the last stages of lfie?
  23. How can legal information or education about the law be made more relevant, timely, and effective in the last stages of life?