Tag: Quebec

Hearings on Quebec Bill 52: Federation of Quebec Medical Specialists

Dr. Gaétan Barrette

Tuesday 17 September 2013 – Vol. 43 N° 34

Note: The following translation is the product of a first run through “Google translate.”  In most cases it is sufficient to identify statements of interest, but more careful translation is required to properly understand the text.

Original Text

Caution: machine assisted translation
(Suspension de la séance à 12 h 27)
16 h (version non révisée)
16 h (version non révisée)
(Reprise à 16 h 7)
Le Président (M. Bergman) : Alors, s’il vous plaît, la commission reprend ses travaux. Je demande à toutes les personnes dans la salle de bien vouloir éteindre la sonnerie de leur téléphone cellulaire. The Chairman (Mr. Bergman): So please, the Committee resumed. I ask everyone in the room to please turn off their cell phones ringing.
Nous allons poursuivre sans plus tarder les consultations particulières et les auditions publiques sur le projet de loi n° 52, Loi concernant les soins de fin de vie. We will continue without further delay special consultations and public hearings on Bill 52, An Act respecting the end-of-life.
Alors, je souhaite la bienvenue à la Fédération des médecins spécialistes du Québec. Bienvenue, Dr Barrette. Je vous demanderais tout d’abord de vous présenter et de présenter les personnes qui vous accompagnent. Vous avez 15 minutes pour votre présentation, suivi d’un échange avec les membres de la commission. So I welcome the Federation of Medical Specialists of Quebec. Welcome, Dr. Barrette. I would ask you first to introduce and present the people with you. You have 15 minutes for your presentation, followed by a discussion with the members of the commission.
Alors, le micro est à vous, Dr Barrette. So the microphone is yours, Dr. Barrette.
M. Barrette (Gaétan) : Merci, M. le Président, Mme la ministre, Mmes et MM. les membres de la commission parlementaire. Je suis accompagné aujourd’hui… Dre Diane Francoeur, qui est gynécologue à l’Hôpital Sainte-Justine de Montréal et de Mme Nicole Pelletier, qui est directrice des Affaires publiques et communications à la fédération. Alors, d’abord, je tiens à vous remercier évidemment pour nous donner l’opportunité de pouvoir venir faire quelques commentaires sur le projet de loi n° 52, qui est clairement l’aboutissement d’un très long travail et qui est un document qui est extrêmement bien fait, à notre lecture. Et si vous me permettez, avant de passer à mes commentaires, je vous raconterai ceci. Mr. Barrette (Gaetan): Thank you, Mr. President, Madam Minister, and Ms MM. members of the parliamentary committee. With me today … Dr. Diane Francoeur, who is a gynecologist at Sainte-Justine Hospital in Montreal and Nicole Pelletier, who is Director of Public Affairs and Communications for the federation. So, first, I want to thank you of course to give us the opportunity to come and make some comments on Bill No. 52, which is clearly the result of extensive work and is a document which is extremely well done, in our reading. And if I may, before moving on to my comments, I will tell you this.

Full Translation

Hearings on Quebec Bill 52: Federation of General Practitioners

Dr. Louis Godin, Dr. Marc-André Asselin

Legal Services Federation

Pierre Belzile

Tuesday 17 September 2013 – Vol. 43 N° 34

Note: The following translation is the product of a first run through “Google translate.”  In most cases it is sufficient to identify statements of interest, but more careful translation is required to properly understand the text.

Original Text

Caution: machine assisted translation
11 h 30 (version non révisée)
11 h 30 (version non révisée)
(Reprise à 11 h 30)
Le Président (M. Bergman) : À l’ordre, s’il vous plaît! Alors, je souhaite la bienvenue à la Fédération des médecins omnipraticiens du Québec. Dr Godin, bienvenue. Je vous demande de vous présenter, présenter les membres, votre collègue, et vous avez 15 minutes pour faire votre présentation, suivie d’un échange avec les membres de la commission. The Chairman (Mr. Bergman): Order, please! So I welcome the Federation of General Practitioners of Quebec. Dr. Godin, welcome. I ask you to introduce yourself, introduce the members, your colleague, and you have 15 minutes to make your presentation, followed by a discussion with the members of the commission.
M. Godin (Louis) : D’accord. Mr. Godin (Louis): Okay.
Le Président (M. Bergman) : Alors, ce micro, c’est à vous. The Chairman (Mr. Bergman): So, this microphone is yours.
M. Godin (Louis) : Merci, M. le Président. D’abord, je vous remercie de nous donner l’opportunité de s’adresser à vous. Je voudrais saluer Mme la ministre ainsi que les représentants de la première et deuxième opposition. Je suis le Dr Louis Godin, président de la Fédération des médecins omnipraticiens du Québec. Je suis accompagné, à ma droite, du Dr Marc-André Asselin, premier vice-président de la fédération et président de l’Association des médecins omnipraticiens de Montréal, ainsi que de Me Pierre Belzile, qui est le chef des services juridiques à la fédération. Mr. Godin (Louis): Thank you, Mr. President. First, thank you for giving us the opportunity to address you. I welcome the Foreign Minister and the representatives of the first and second opposition. I’m Dr. Louis Godin, president of the Federation of General Practitioners of Quebec. With me, on my right, Dr. Marc-André Asselin, Senior Vice President of the Federation and President of the Association of general practitioners in Montreal, as well as Pierre Belzile, who is the Head of Legal Services federation.
Je dois vous dire d’entrée de jeu que ce projet de loi là revêt un caractère particulier et essentiel pour la fédération et les médecins de famille qu’elle représente parce que, comme vous le savez sans doute, les médecins de famille sont probablement les médecins au Québec qui sont les plus interpellés par les soins en fin de vie, que ce soient les soins palliatifs ou tout autre service qui peut être donné à nos patients. Donc, les médecins de famille sont vraiment au coeur de ce projet de loi là et de cette situation-là. I must say from the outset that this bill there is special and essential for the federation and the family physicians it is because, as you know, family physicians are likely physicians in Quebec who are most challenged by the end of life care, whether palliative care or other services that can be given to our patients. So, family physicians are really the heart of this bill there and that situation.

Full Translation

Hearings on Quebec Bill 52: College of Physicians

Dr. Charles Bernard, Dr. Yves Robert, Dr. Michelle Marchand

Tuesday 17 September 2013 – Vol. 43 N° 34

Note: The following translation is the product of a first run through “Google translate.”  In most cases it is sufficient to identify statements of interest, but more careful translation is required to properly understand the text.

Original Text

Caution: machine assisted translation
M. Bernard (Charles) : Merci, M. le Président. Alors, M. le Président, Mme la ministre, Mmes, MM. les parlementaires, alors le Collège des médecins du Québec vous remercie de lui permettre de vous présenter ses réflexions sur le projet de loi n° 52 concernant les soins de fin de vie, et j’ajouterais que nous sommes honorés d’être les premiers à auditionner devant cette commission en cette journée de rentrée parlementaire, alors on vous en remercie. Thank you, Mr. President. So, Mr. President, Madam Minister, Mrs, Mr. parliamentarians, while the College of Physicians of Quebec thank you for allowing him to present his thoughts on Bill No. 52 on the end-of-life, and I would add that we are honored to be the first to audition before the Committee on this day parliamentary session, so we thank you.
Alors, ce projet de loi constitue, à nos yeux, un jalon très important dans la réflexion sur les soins de vie, et, à notre avis, il devrait être adopté. Amorcée en mai 2006 à l’occasion de notre assemblée générale annuelle, cette réflexion s’est transformée en un vaste débat public, à l’issu duquel la Commission spéciale sur la question de mourir dans la dignité a remis sont rapport en mars 2012. D’entrée de jeu, vous nous permettrez de souligner le travail exceptionnel effectué sur ce sujet extrêmement complexe et sensible par tous les parlementaires, et en particulier le vôtre, Mme la ministre, vous avez fait preuve d’un respect, d’une qualité d’écoute, d’une rigueur et d’une compréhension des enjeux d’une rare qualité, et nous vous en remercions sincèrement, cela mérite d’être souligné. So this bill is, in our view, a very important milestone in thinking about life care, and, in our opinion, should be adopted. Began in May 2006 at our annual general meeting, the discussion turned into a broad public debate, the end of which the Special Committee on Dying with Dignity are handed over in March 2012. From the outset, please allow us to recognize the outstanding work done on this topic extremely complex and sensitive by all parliamentarians, particularly yours, Madam Minister, you have demonstrated compliance, quality listening, rigor and an understanding of the challenges of a rare quality, and we sincerely thank you, it deserves to be highlighted.

Full Translation

Letter: If society wants to legalize euthanasia, physicians should not be the ones to carry it out  

The Gazette

J. Donald Boudreau, MD

Physicians who refuse to be co-opted into assisting patients  accelerate their death are not, as Dr. Dave Lambert seems to imply,  medical dinosaurs. And by rejecting his option, we are most certainly  not trying to save or prolong lives “at all costs,” that is, we are  not vitalists. One can simultaneously reject both vitalism and euthanasia. . . [Full text]

 

Redefining the practice of medicine – Part 3

Winks and nods and euthanasia in Quebec

Re:  Bill 52: An Act respecting end-of-life care (June, 2013)

Sean Murphy*

Part 3: Working in the MAD matrix

Abstract

“Medical aid in dying” in Bill 52 (An Act respecting end-of-life care) will be transformed into euthanasia using the structures and powers established by other Quebec statutes governing the delivery of health care. These laws have established a multi-layered and overlapping bureaucracy. If Bill 52 passes, health care providers and others who want no part of euthanasia will find their working environments increasingly controlled by a MAD matrix functioning within this system.

The Minister for Social Services and Youth Protection may issue “policy directions” about euthanasia. Health care in every region in Quebec is delivered under the direction of a regional health and social service agency. In addition, local health and social services networks have been established. These will be expected to provide or facilitate euthanasia.

Almost all local community service centres, hospital centres or residential and long-term care centres will be required to offer euthanasia, as will rehabilitation centres, which serve developmentally disabled patients. Palliative care hospices and hospitals are not required to do so. Physicians associated with private health care facilities must not provide euthanasia unless authorized by a local health authority.

Policies, standards, codes of ethics, protocols, guidelines, directives, etc. can be used to normalize euthanasia, and disciplinary and complaints procedures can be used to force participation in it. Local complaints commissioners, the Health and Social Services Ombudsman and syndics (investigators) for professional orders could create considerable difficulty for objecting physicians.

Under Quebec’s Professional Code, the Physicians’ Alliance for Total Refusal of Euthanasia, the Euthanasia Prevention Coalition and other groups that oppose euthanasia might face substantial fines if they persist in encouraging or advising physicians not to participate in the procedure.

Physicians may refuse to provide euthanasia if the patient is legally ineligible, and for other reasons, including conscientious objection. Section 30 of the bill should be amended to avoid unnecessary conflict with objecting physicians. Section 44, the provision specific to conscientious objection, is inadequate. Further, patients may lodge complaints against physicians who refuse to provide or facilitate euthanasia with institutions and the regulatory authority, regardless of the reasons for refusal.

Despite the promise of immunity, some Quebec physicians may be unwilling to provide euthanasia while the criminal law stands, even if they do not object to the procedure. Similar reluctance might arise in regional health agencies, councils of physicians or other entities responsible for issuing MAD guidelines. Some might deliberately and obstinately interpret “medical aid in dying” to exclude killing patients, on the ground that the Act does not explicitly require or permit euthanasia, and the criminal law precludes such an interpretation.

Finally, objecting physicians might be able to appeal to the Public Protector, who is empowered to intervene “whenever he has reasonable cause to believe that a person or group of persons has suffered or may very likely suffer prejudice as the result of an act or omission of a public body.” [Full commentary]