The terrible story of Andrée Simard, widow of former Prime Minister Robert Bourassa, who died in pain and distress, bears witness to the lack of access to palliative medical care. The small palliative teams in place are no longer enough to help all the end-of-life patients who are suffering.
Currently, 5% of Quebecers choose medical assistance in dying, the highest rate in the West. The remaining 95% also deserve not to suffer: it is time to take care of them humanely, to relieve their suffering wherever they are: in the hospital, but also at home.
We know that the vast majority of end-of-life patients are relieved when they have access to experienced palliative care. In addition, the administration of palliative sedation, which Ms.me Simard possibly needed, is a complex treatment that requires teamwork with specialized medical and nursing expertise.
Unfortunately, for four years, palliative care settings have been fighting to have enough positions for doctors and nurses who are experts in palliative care, often in vain. While the Quebec population is aging very quickly and the number of end-of-life patients is increasing exponentially, these communities are fighting with civil servants in Quebec for the right to recruit the required professionals.
Worse still, medical students specializing in palliative care must struggle to obtain a full-time position in their field, when the needs are immense everywhere; at home, in hospitals and in palliative care units. What a waste of expertise!
A priority
If the medical and nursing staff in palliative care in our hospitals were sufficient and proportional to the needs of all suffering patients, these professionals could not only ensure palliative emergencies in their dedicated unit, but also those of patients in other hospital units. Enabling all Quebecers to die with dignity and without suffering should be a priority, as stipulated in the Quebec law concerning end-of-life care. However, barely 10% of end-of-life patients at home in Quebec have access to teams of expert physicians in palliative care who are accessible at all times.
The tragic end of Andrée Simard reveals a widespread tragedy in Quebec: many Quebecers do not have access to expert palliative medical and nursing care 24 hours a day. Faced with these shortages, especially at home, the silence of the College of Physicians is surprising. , he who publicly denounces the very few palliative teams that do not yet offer medical assistance in dying.
Our decision-makers have made medical assistance in dying their priority, with success. Why don’t they do the same for other patients? It’s time to stop denigrating medical palliative care. Let’s stop saying that palliative care “is simple”, “without the need for doctors” or that “any doctor without experience can provide this care”. Let’s stop saying that “there is no need to set up expert medical teams 24 hours a day” when our emergency rooms are overflowing with these patients.
We judge a society by the way it treats its dying: we can do much better collectively.