Getting Around the Impasse - The Collège des médecins du Québec Reveals Its
Reflections on End-of-Life Care

MONTREAL , Nov. 3 /CNW Telbec/ - Subsequent to an intensive three-year period of reflection, the Collège des médecins du Québec (CMQ) is revealing its perspective and conclusions today regarding end-of-life care and euthanasia. Although numerous consultations were conducted during this period of deliberation, the Collège does not pretend to possess any simple answers to a highly complex question that is of concern to every individual and to society as a whole.

The CMQ embraces the point of view of the patient who is confronting imminent and inevitable death. In such a situation, the patient looks to their physician and generally requests that they be able to die without undue suffering and with dignity. Neither surveys, nor attorneys, nor politicians can properly advise the physician and the patient facing this situation. In the majority of cases, the patient and their doctor find the appropriate analgesia that respects the ethical obligation of physicians not to preserve life at any cost, but rather, when the death of a patient appears to be inevitable, to act so that it occurs with dignity and to ensure that the patient obtains the appropriate support and relief.

"However, there are exceptional situations," underlines Dr. Yves Lamontagne , President and Chief Executive Officer of the Collège des médecins du Québec. "where agony and suffering persists and where physicians are asked to act in certain ways that could be interpreted as being prohibited by the Criminal Code. We are of the opinion that many of these actions constitute appropriate medical care."

"Limiting the question of end-of-life care to Are you for or against euthanasia? is the wrong approach and will inevitably lead to the wrong answers and an impasse," adds Dr. Yves Robert , Secretary of the Collège. In fact, according to the CMQ, the existing legislative status quo does not reflect the clinical reality of patients and their doctors and restricts the development of appropriate end-of-life care.

"We have to get beyond the logic of current legislation," continues Dr. Lamontagne . "We need to move toward an appropriate care logic and adapt the legislative framework accordingly so that it allows us to reassure patients, physicians and society that the care provided at the end of an individual's life will be as appropriate as possible."

Such legislation must not be aimed at identifying all possible scenarios and offering protocols for each. Instead, it should define the process for arriving at a decision whereby the patient, their family, and the physician all have their word to say and can obtain the assistance needed to jointly make a decision that is satisfactory to each party concerned.

"We believe that a new sensitivity is clearly evident among doctors and the public that is increasingly pluralistic," indicates Dr. Robert . "The new tendency is to acknowledge that there do exist certain exceptional situations where euthanasia could be considered by the patient and their physician to be an ultimate and necessary step in assuring the patient receives appropriate and quality care to the very end."

In view of these reflections, the Collège is calling upon key players, including the Ordre des infirmières et infirmiers du Québec and the Barreau du Québec, to join in the process it has initiated.

"I encourage these parties to review the report produced by the Collège's Clinical Ethics Group and the discussion paper it gave rise to," concludes Dr. Lamontagne . "Both of these documents are available on our Web site and will serve to outline the process and thinking that led the CMQ to arrive at its conclusions. I then invite all the principal players to work with us to develop concrete proposals that can help lead us out of the current impasse. Of course, these proposals must be fuelled by the overriding commitment to offering the most appropriate care possible to each and every individual whose life has reached its end stage."

The Collège des médecins is the professional order of Québec physicians. Its mission is to promote quality medicine to protect and contribute to improving the health of the province's population.

For further information: Ms. Leslie Labranche, Public Relations Coordinator, Collège des médecins du Québec, Media Line: [phone], Cellular: [phone]