{"id":4603,"date":"2019-11-08T18:21:17","date_gmt":"2019-11-08T18:21:17","guid":{"rendered":"https:\/\/tvndy.ca\/?p=4603"},"modified":"2019-11-08T18:21:17","modified_gmt":"2019-11-08T18:21:17","slug":"webcast-archive-fourth-report-from-quebecs-commission-on-end-of-life-care","status":"publish","type":"post","link":"https:\/\/tvndy.ca\/en\/2019\/11\/webcast-archive-fourth-report-from-quebecs-commission-on-end-of-life-care\/","title":{"rendered":"Webcast archive: Fourth report from Qu\u00e9bec\u2019s Commission on End-of-Life Care"},"content":{"rendered":"<p><iframe loading=\"lazy\" width=\"1180\" height=\"664\" src=\"https:\/\/www.youtube.com\/embed\/v-91Jxfbo8A?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen><\/iframe><\/p>\n<p>In this episode of\u00a0<em>Euthanasia &amp; Disability<\/em>, Amy Hasbrouck, Taylor Hyatt, &amp; Christian Debray discuss:<\/p>\n<ul>\n<li>Fourth report from Qu\u00e9bec\u2019s Commission on End-of-Life Care<\/li>\n<li>Man says a psychologist encouraged him to euthanize his wife<\/li>\n<\/ul>\n<p>Please note that this text is only a script and that our webcast contains additional commentary.<\/p>\n<p><strong>FOURTH REPORT FROM QU\u00c9BEC\u2019S COMMISSION ON END-OF-LIFE CARE<\/strong><\/p>\n<ul style=\"font-weight: 400;\">\n<li>On October 2, Qu\u00e9bec\u2019s Commission on end-of-life care released its fourth\u00a0<a href=\"https:\/\/drive.google.com\/file\/d\/1V1T4g_t1wxPR13xONOWBr3K_Ibjfxl2u\/view?usp=sharing\">report<\/a>\u00a0for the period April 1, 2018 to March 31, 2019.\u00a0 The Commission reported a substantial increase in the number of euthanasia over the previous years:\n<ul>\n<li>1,331 euthanasia were performed this year.\u00a0 Added to the 1,630* for the 28 months from December 10, 2015 to March 31, 2018, this brings the total to 2,909 euthanasia in Qu\u00e9bec since the program began.\u00a0 We\u2019ll talk in a few minutes about why those numbers don\u2019t add up.<\/li>\n<li>Continuous palliative sedation (CPS) was performed on 1,243 people during the reporting period.\u00a0 Added to the 1,704 CPS performed during the 28 months from December 10, 2015 to March 31, 2018, this brings the total to 2,947.<\/li>\n<li>Euthanasia and CPS each account for 1.9% of deaths in Qu\u00e9bec during the reporting period, for a total of nearly 4% of all deaths in the province.<\/li>\n<li>*As explained in footnote 19 on page 27, 1,630 euthanasia deaths is a corrected total from the Commission\u2019s summary report issued last spring.\u00a0 Apparently \u201ctwo MAiD reported by an institution as having been administered were not administered.\u201d<\/li>\n<\/ul>\n<\/li>\n<li>The exact number of euthanasia deaths is hard to pin down from the report.\n<ul>\n<li>On pages iii, 12, 27 (footnote 19), 37 and 38, the report says \u201c1,279 people received MAiD between April 1, 2018 and March 31, 2019.\u201d\u00a0 This figure, when added to the 1,630 from previous years, gives the reported total of 2,909.<\/li>\n<li>But on page 23, the report says \u201caccording to reports from institutions, 1,937 requests for MAiD were made between April 1, 2018 and March 31, 2019; of these, 1,271 were administered and 672 were not administered.\u201d<\/li>\n<li>The 1,271 figure, added to the 60 euthanasia performed by doctors outside of institutional settings and reported by the Coll\u00e8ge des m\u00e9decins du Qu\u00e9bec (CMQ), gives a total of 1,331 euthanasia.<\/li>\n<li>Maybe you\u2019ve noticed that 1,937 minus 672 does not equal 1,271, but rather 1,265.\u00a0 The six missing people are accounted for in a note in figure 3.17 which does not show the outcome of the six euthanasia requests in region 10. The Commission explains: \u201cIn order to respect the rules of confidentiality, and because of the risk of identification related to the disclosure of a small number of individuals, the exact distribution of the euthanasia administered and not administered could not be provided.\u201d<\/li>\n<li>As for the 1,279 figure used elsewhere in the report, we don\u2019t know where it comes from, or if it includes the 60 euthanasia reported by the CMQ.\u00a0 And if you think we\u2019re being nit-picky, just remember that euthanasia laws are supposed to impose \u201c<a href=\"https:\/\/scc-csc.lexum.com\/scc-csc\/scc-csc\/en\/item\/14637\/index.do\">stringent limits<\/a>\u201d that are \u201cscrupulously monitored and enforced.\u201d<\/li>\n<\/ul>\n<\/li>\n<li>This year, the Commission received 1,400 euthanasia reports, some of which document euthanasia performed before the reporting period. \u201cThe Commission notes that 86 forms were received more than six months after the administration of MAiD and some of them more than one year later.\u201d\u00a0 A few things to note about the Commission\u2019s process:\n<ul>\n<li>The Commission can only evaluate compliance with the law; it has no influence over other aspects of the medical practice, even if they could affect euthanasia. So, for example, if the doctor makes a mistake in diagnosis or the cause of a decline in capacity, that would probably fall outside the Commission\u2019s area of responsibility.<\/li>\n<li>Two-thirds of the commissioners must agree that a violation has occurred for a finding of non-compliance to be made. Such cases are referred to the institution\u2019s Council of Physicians, Dentists and Pharmacists (CPDP) and the Coll\u00e8ge des m\u00e9decins du Qu\u00e9bec.\u00a0 There is no remedy for the loved ones of ineligible people who are euthanized, or where safeguards are ignored.<\/li>\n<li>This year the Commission introduced a new procedure for evaluating reports, in response to the growing number of euthanasia. Declarations are examined by a sub-group including at least three commissioners; if all group members agree that the eligibility criteria were met and the safeguards complied with, the case is recommended for approval by the whole commission.\u00a0 If there is disagreement in the small group, the case is referred to the full commission for further discussion.<\/li>\n<\/ul>\n<\/li>\n<li>The commission took a first look at 1,384 reports, and needed more information or had questions on 31%, or 430 of them. The Commission found that 96% of the 1,354 cases it ruled on complied with the law, but it could not reach a decision in 41 cases (3%) because they didn\u2019t get the information they requested from the doctor.\u00a0 The commission found that 13 euthanasia (1%) did not comply with the law.\n<ul>\n<li>Four people were not eligible:\n<ul>\n<li>Three people did not have a serious and incurable illness (they all had broken hips);<\/li>\n<li>One person\u2019s medical insurance card had expired.<\/li>\n<\/ul>\n<\/li>\n<li>In nine cases, safeguards were violated.\n<ul>\n<li>The second doctor examined the person before the euthanasia request was signed in five cases.<\/li>\n<li>The doctor did not conduct the interviews to ensure that the request was informed, that the person\u2019s suffering persisted and they still wanted euthanasia.\u00a0 \u201cIn two cases, the physician who administered the MAiD met the person only on the day of the [euthanasia].\u201d<\/li>\n<li>One request form was witnessed by a non-qualified person.<\/li>\n<li>\u201cIn one case, the second doctor consulted had a family connection with the doctor who asked for the opinion.\u201d<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li>Of those who asked for MAiD, 65% received it.<\/li>\n<li>The three most common reasons euthanasia was not administered were:\n<ul>\n<li>The person was not eligible (246 people, or 37%)<\/li>\n<li>The person died before the evaluation process was completed or before MAiD could be administered (224 people, or 33%)<\/li>\n<li>The person withdrew their request (127 people, or 19%).<\/li>\n<\/ul>\n<\/li>\n<li>Forty percent of those approved were euthanized within ten days of making the request.<\/li>\n<li>The R\u00e9gie d\u2019assurance maladie du Qu\u00e9bec (RAMQ) reports that 682 doctors billed for services related to MAiD. According to the CMQ, of 23,478 doctors registered, 480 say they performed euthanasia in 2018.<\/li>\n<li>If there\u2019s a take-away message from this report, it would probably be that the number of euthanasia deaths is increasing rapidly, and procedures are still handled in a slip-shod manner.\u00a0 We still wouldn\u2019t get on an airplane with a 1% chance of crashing, and a 3% uncertainty factor.<\/li>\n<\/ul>\n<p><strong>MAN SAYS A PSYCHOLOGIST ENCOURAGED HIM TO EUTHANIZE HIS WIFE<\/strong><\/p>\n<ul style=\"font-weight: 400;\">\n<li>On November 2,\u00a0<a href=\"https:\/\/montreal.ctvnews.ca\/mobile\/couple-alleges-psychologist-tried-to-talk-husband-into-killing-terminally-ill-wife-1.4667916\">CTV News<\/a>\u00a0ran a story about a psychologist who reportedly advised a Montreal man to kill his wife, who has a terminal illness.<\/li>\n<li>Serge Simard sought professional help after his wife, Miranda Edwards, was diagnosed with cancer. Ms. Edwards was \u201cdetermined to fight it,\u201d saying \u201cI want to live, I want every medical intervention possible \u2026 I will do every treatment [possible] to stay alive.\u201d<\/li>\n<li>Mr. Simard says the psychologist \u201ctold him to overdose his wife with morphine she had been prescribed for her pain.\u201d After hearing this, Mr. Simard recorded the rest of the session on his phone. The recording captured the words: \u201cAt one point, it will be a dose too much and she just won\u2019t wake up. It\u2019s the best thing that could happen, really. She won\u2019t be suffering anymore. She\u2019ll be in a better place.\u201d The psychologist\u2019s identity cannot be revealed since the person has not been charged with a crime.<\/li>\n<li>Mr. Simard is \u201chorrified\u201d by the professional\u2019s reaction. Yet he made a distinction between MAID and the action he was counseled to take. \u201cThat\u2019s not assisted suicide, that\u2019s murder. I will not murder my wife. If Miranda voices any [wish about wanting to die], I will respect her wishes. Miranda has never voiced that she wanted to pass away.\u201d<\/li>\n<li>Mr. Simard and Ms. Edwards filed a professional complaint against the psychologist, but were notified that the person had retired. If the psychologist begins to practice again, an investigation may be opened. So far, police in Montreal and Gatineau have refused to act. The couple is \u201cdisappointed\u201d by the response they have received; they may consider bringing a civil action.<\/li>\n<\/ul>\n   ","protected":false},"excerpt":{"rendered":"<div class=\"entry-summary\">\n<div class=\"entry-summary\">\nThis week, we go over another report from the Quebec commission, and discuss a disturbing act from a Montreal health care professional.\n<\/div>\n<div class=\"link-more\"><a href=\"https:\/\/tvndy.ca\/en\/2019\/11\/webcast-archive-fourth-report-from-quebecs-commission-on-end-of-life-care\/\" class=\"more-link\">Continue reading<span class=\"screen-reader-text\"> &ldquo;Webcast archive: Fourth report from Qu\u00e9bec\u2019s Commission on End-of-Life Care&rdquo;<\/span>&hellip;<\/a><\/div>\n<\/div>\n<div class=\"link-more\"><a href=\"https:\/\/tvndy.ca\/en\/2019\/11\/webcast-archive-fourth-report-from-quebecs-commission-on-end-of-life-care\/\" class=\"more-link\">Continue reading<span class=\"screen-reader-text\"> &ldquo;Webcast archive: Fourth report from Qu\u00e9bec\u2019s Commission on End-of-Life Care&rdquo;<\/span>&hellip;<\/a><\/div>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[92],"tags":[455,121,53,422,96,641,608,118],"class_list":["post-4603","post","type-post","status-publish","format-standard","hentry","category-webcast-archive","tag-commission-de-soins-de-fin-de-vie","tag-euthanasia-disability","tag-quebec-en","tag-report","tag-safeguards","tag-serge-simard","tag-statistics-en","tag-webcast","entry"],"_links":{"self":[{"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/posts\/4603","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/comments?post=4603"}],"version-history":[{"count":3,"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/posts\/4603\/revisions"}],"predecessor-version":[{"id":4606,"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/posts\/4603\/revisions\/4606"}],"wp:attachment":[{"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/media?parent=4603"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/categories?post=4603"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/tags?post=4603"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}