Because physicians and healthcare establishments continue to obstruct eligible requests for medical aid in dying, the Collège des médecins intends to call its members to order and challenge the government.
The Dr Mauril Gaudreault, president of the College of Physicians, recalls that if no doctor is personally required to proceed, “medical assistance in dying is a care in the same way as any other care”.
Any request must be made in accordance with the law, and patients must be properly informed, says the Dr Gaudreault.
“It’s a situation, like others, that requires us to issue a periodic reminder [aux médecins]and we are going to do it”, underlines the Dr Gaudreault.
In 2021-2022, 3,663 Quebecers received medical assistance in dying, indicates the annual report of the Commission on end-of-life care tabled in December in the National Assembly. This is proportionally higher than in Belgium or the Netherlands, where the practice has been going on for much longer than in Quebec.
In the report, it is specified that 334 Quebecers died before the end of the evaluation or before receiving it, that 74 other requests were in the process of evaluation or process, and that for 17 others, another treatment option was privileged.
According to the Dr Alain Naud, family and palliative care doctor at the CHU de Québec, these statistics say nothing about these cases where doctors receive eligible requests and “tell patients that they do not have access to them” when they are actually admissible.
A recalcitrant hospital
He also mentions the case of the Marie-Clarac hospital, in the north of Montreal, a hospital founded and directed by the Sisters of Charity of Sainte-Marie which offers rehabilitation and which is also one of the largest centers of its kind in Quebec in palliative care.
PHOTO DAVID BOILY, LA PRESSE ARCHIVES
The Mère-Anselme-Marie pavilion and its palliative care unit at the Marie-Clarac hospital, in Montreal North
On its website, this establishment indicates for its part very clearly that it does not provide medical assistance in dying. “The referred clientele is informed precisely of this practice before their admission, can we read. Management has set up a mechanism for evaluating and administering medical assistance in dying in collaboration with an external partner from a public health institution to respond to a possible request made by a user. »
The Dr Gaudreault specifies having already written to the government in 2019 about Marie-Clarac. He intends to question him again shortly.
For any questions, the CIUSSS du Nord-de-l’Île-de-Montréal directed us directly to the management of Marie-Clarac, telling us that it only had a monitoring responsibility with regard to safety and the quality of care provided.
In an interview, Sister Martine Côté, Executive Director, explains that the hospital is, like any CHSLD, a private establishment under agreement and that it receives public funds.
A patient who changes his mind and who requests medical assistance in dying, although having been informed upon admission of the policy in place, would then be transported by ambulance to another establishment and accompanied by a staff member.
This respects the user, the law and the Church, and the government is fully aware of this very transparent way of doing things.
Sister Martine Côté, Director General of Marie-Clarac Hospital
Many private hospices don’t provide physician-assisted dying either, but last year a bill nearly forced them to do so.
A position that raises questions
Does the Marie-Clarac hospital fear being attacked in court or does it consider its position legally concrete?
“That’s a good question,” replied Sister Côté. Currently, this is our position, but it may change over time depending on the context. »
The Church does not seem about to change its own, what context could then make Marie-Clarac evolve?
“We would cross the river [en temps et lieu]. If we don’t [nous] gave more funding, would we maintain our position? I can not say it. We adapt to the context and we reflect. »
It should be noted that palliative care establishments that are reluctant to administer medical assistance in dying nevertheless provide continuous sedation, which consists of putting a person at the end of life into deep sleep in order to relieve or prevent their suffering.
It is this treatment that was refused to Andrée Simard, the wife of Prime Minister Robert Bourassa, as reported in The Press friday.