Death of Andrée Simard at St. Mary’s Hospital Center | “The condemnation of the hospital is inappropriate”

(Quebec) “The condemnation of St. Mary’s Hospital for the treatment reserved for the widow of former Prime Minister Robert Bourassa is “inappropriate”, retort the doctors and other professionals of this establishment in a letter that The Press has obtained.

The board of governors of the hospital center supports this position, according to a written statement from its president, Donald M. Bastien.

The hospital has come under fire after a report by The Press on the last moments of Andrée Simard, who died after three days of suffering and distress1. The widow of Robert Bourassa was deprived of continuous sedation, palliative care normally provided for patients at the end of life. However, access to this type of care is a right guaranteed by law.

Hasty reviews

On January 20, in an outing as we rarely see, the Minister of Health, Christian Dubé, apologized to the relatives of Mme Simard, in its own name and in “that of the network”. “Healthcare professionals must work together to provide humane care,” he added.

For her part, the Minister for Health and Seniors, Sonia Bélanger, asked the CIUSSS de l’Ouest-de-l’Île-de-Montréal, to which the St. Mary’s hospital center falls, to “review the practice […] so that a situation like this never happens again”. “I will make sure that the changes are put in place and that it respects what Quebecers are entitled to” in terms of palliative care, added Belanger.

However, the Association of Physicians, Dentists and Pharmacists of St. Mary believes that the criticisms are hasty and not done in the rules of the art.

“We strongly believe that a statement needs to be made about the negative dialogue currently circulating in the media,” she wrote in a letter dated Feb. 2 and addressed “to members of the St. Mary’s community.”

“Our healthcare workers have been harshly criticized recently based on public testimony. Although we are unable to comment on the published version of events, the condemnation of the hospital, its staff and its practices by various individuals, based solely on the published articles, without qualification and without any form of independent examination, is inappropriate”, maintains the association. She does not name the “various individuals” she speaks of.

The association recalls that “health care providers are bound by a code of ethics which maintains the strict confidentiality of a medical file”.

The association insists: “the public silence of health care workers is a professional obligation and not an admission of guilt”.

“To suggest that we are opposed to adequate palliative care is inaccurate and damaging to the trust of our patient population and the community we serve,” the association adds. According to her, this care is “readily accessible” at St. Mary’s Hospital Center and “the relief of suffering” is “of paramount importance”.

Andrée Simard’s daughter, Michelle Bourassa, nevertheless testified to the “horror” experienced by the family at this hospital in a letter published in The Press2.

Compliant with guidelines

Sick, Andrée Simard had been admitted to the emergency room, where she was to contract COVID-19. After a stint in intensive care, she was sent to the medical sector, where her condition deteriorated very quickly. When she was in the worst possible condition, despite repeated requests from her family and the wishes expressed by the main person concerned, the medical team did not administer the “continuous sedation” provided for accompanying patients at the end of life. According to the explanations of the CIUSSS, as Mme Simard had COVID-19, she could not be transferred to the palliative care unit, so as not to expose vulnerable patients to the virus. This unit was close to the oncology department, which constituted a risk. Until now, “continuous sedation was offered only on the palliative care unit”, in accordance with the directives of the pharmacy department, explained the CIUSSS.

The Association of Physicians, Dentists and Pharmacists of St. Mary’s invites patients and families “to bring their concerns through formal channels to the Complaints Commissioner, which would automatically trigger a formal investigation.”

“We can all learn from constructive feedback […], she argues. “We wholeheartedly believe in the value of these processes as they are in everyone’s best interest.”

Michelle Bourassa told The Press do not want ” [s] “embark on a complaints process”. Above all, she wanted to “wave a flag so that we know what is going on”.

The association deplores the fact that patients “could now fear not receiving the quality of services to which they are legitimately entitled”. She assures that the hospital’s professionals remain “firmly committed to providing the best care possible in an atmosphere of respect and compassion”.

In an email that includes this letter as an attachment, St. Mary’s Board of Governors Chairman Donald M. Bastien endorses the association. “We, the governors of the hospital, support and approve” his message, he wrote.

The association did not respond to a message from The Press Tuesday. A request for an interview with the CIUSSS to obtain an explanation and to speak to Mr. Bastien went unheeded.

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