Editing Advance healthcare directive (section)

===Canada===
[[Health Canada]] – [[Canada]]'s federal health agency – has acknowledged the need for a greater investment in [[Palliative care|palliative]] and [[hospice]] care as the country faces a rapidly growing population of elderly and terminally ill citizens.<ref>{{cite web|url=http://www.hc-sc.gc.ca/ahc-asc/minist/speeches-discours/_2014/2014_03_06-eng.php |title=Health Canada- Minister's speeches |publisher=Health Canada.ca |date=2014-02-06 |access-date=2014-11-18 |url-status=dead |archive-url=https://web.archive.org/web/20141129081757/http://www.hc-sc.gc.ca/ahc-asc/minist/speeches-discours/_2014/2014_03_06-eng.php |archive-date=2014-11-29 }}</ref>

Canada has focused on [[advance care planning]] which involves encouraging individuals to reflect on and express their wishes for future care, including end-of-life care, before they become terminally ill or incapable of making decisions for themselves. A number of publicly funded initiatives exist to promote advance care planning and to encourage people to appoint "[[Surrogate decision-maker|substitute decision makers]]" who make medical decisions and can give or withhold consent for medical procedures according to the patient's pre-expressed wishes when the patient becomes incapable of doing so themselves<ref>{{cite web|url=http://www.chpca.net/about-us.aspx |title=Canadian Hospice Palliative Care Association |publisher= CHPCA.net |date=2014 |access-date=2014-11-18}}</ref><ref>{{cite web|url=http://www.hpcintegration.ca/about-us.aspx |title=The Way Forward |publisher= HPC integration.ca |date=2014 |access-date=2014-11-18}}</ref><ref>{{cite web|url=http://thecarenet.ca/about-us |title=The Carenet |publisher= The Carenet.ca |date=2014 |access-date=2014-11-18}}</ref><ref>{{cite web |url=http://pallium.ca/about-us/ |title=Pallium Canada |publisher=Pallium.ca |date=2014 |access-date=2014-11-18 |archive-url=https://web.archive.org/web/20141219081109/http://pallium.ca/about-us/ |archive-date=2014-12-19 |url-status=dead }}</ref>

In 2008, The Advance Care Planning in Canada: A National Framework and Implementation Project was founded.<ref>{{cite web|url=http://www.advancecareplanning.ca/about-advance-care-planning/national-framework-for-acp.aspx |title=National Framework for advance care planning |publisher=SpeakUp |date=2014 |access-date=2014-11-18 |url-status=dead |archive-url=https://web.archive.org/web/20141128195532/http://www.advancecareplanning.ca/about-advance-care-planning/national-framework-for-acp.aspx |archive-date=2014-11-28 }}</ref> The goal was to engage healthcare professionals and educate patients
about the importance of advance care planning and [[End-of-life care|end of life care]].

Polling indicates that 96% of Canadians think that having a conversation with a loved one about planning for the end of life is important. However, the same polls show that only about 13% have actually done so, or have created an advance care plan for themselves.
<ref>{{cite web|url=http://hpcintegration.ca/media/56049/TWF%20double%20survey%20infographic%201pg.pdf |title=The Way Forward: an Integrated Approach to Palliative Care |publisher= HPC integration |date=2014 |access-date=2014-11-18}}</ref>

A 2014 Ipsos Reid Survey<ref>{{cite web|url=http://hpcintegration.ca/media/55755/CHPCA_The%20Way%20Forward%20Survey_Final%20Report_August2014.pdf |title=The Way Forward- moving towards an integrated palliative approach to care: survey of GP/FPs and nurses in primary care |publisher= Ipsos Reid |date=August 2014 |access-date=2014-11-18}}</ref> reveals that only about a third of Canadian doctors and nurses working in primary care feel comfortable discussing end of life issues with their patients. End-of-life issues in Canada have recently been highlighted due to the ongoing related debate about [[Euthanasia in Canada|physician-assisted death in Canada]]. Former Federal Health Minister Rona Ambrose (July 15, 2013 to November 4, 2015) has stated: "I think the starting point for me is that we still don't have the best elderly care and palliative care yet… So let's talk about making sure we have the best end-of-life care before we start talking about assisted suicide and euthanasia."<ref>{{cite web|url=http://www.cbc.ca/news/politics/rona-ambrose-says-canada-needs-better-palliative-care-1.2764813 |title=Rona Ambrose says Canada needs better palliative care |publisher= CBC |date=2014-09-15 |access-date=2014-11-18}}</ref>