Sinai Health Bioethics Grand Rounds | Virtual
Join us for a virtual fireside chat on "Living and Dying on the Streets: The Ethics of Delivering Palliative Care for Equity-Deserving Populations" with esteemed palliative care physician, Dr. Naheed Dosani.
Speaker
Naheed Dosani, MSC, MD, CCFP(PC), FCFP, BSc
Palliative Care Physician, St. Michael's Hospital, Unity Health Toronto
Founder and Lead, Palliative Education And Care for the Homeless (PEACH), Inner City Health Associates
Medical Director/Health Equity Lead, Kensington Hospice/Kensington Health
Health Equity Advisor, Canadian Partnership Against Cancer
Assistant Professor, Department of Family and Community Medicine, University of Toronto
Abstract
People experiencing homelessness and other forms of structural vulnerability are often excluded from palliative and end-of-life care systems designed around stable housing, caregiver support and predictable access to services.
In this Bioethics Grand Rounds fireside chat, Dr. Naheed Dosani will draw on his clinical, advocacy and research experience to explore what equitable palliative care requires in practice. The conversation will examine ethical tensions in delivering care on the streets and in shelters, including harm reduction, trust, autonomy, medical assistance in dying, health literacy, and the limits of individual resilience when systems create avoidable barriers.
Dr. Dosani will also reflect on moral injury and compassion fatigue among clinicians and teams working within inequitable systems. Grounded in patient experience and the work of the PEACH program, the session will invite participants to consider how health organizations can redesign care around dignity, relationships and justice so that people who are unhoused or precariously housed are not excluded from compassionate care at the end of life.
By the end of this session, participants will be able to:
- Describe how homelessness, poverty, racism, trauma, substance use and other structural conditions shape access to palliative and end-of-life care.
- Identify ethical tensions that arise when conventional palliative care systems are designed around assumptions of stable housing, caregiver support and reliable access to services.
- Apply equity-oriented, trauma-informed and harm-reduction principles to ethical decision-making and care planning with people experiencing homelessness or housing insecurity.
- Reflect on moral injury and compassion fatigue in clinicians and teams, and identify individual and system-level responses that support sustainable, compassionate practice.