Lack of palliative care pushing Quebecers toward medically assisted death, College of Physicians says

Categories: Policy.

A lack of palliative care services in parts of Quebec may be forcing patients to choose medical aid in dying as a way to end their lives with dignity, says Quebec’s College of Physicians.

In a letter sent to Quebec Health Minister Gaétan Barrette this week, the group said Quebec is suffering from a lack of specialized, palliative care doctors and uneven levels of service are being offered across the province.

“Patients, failing to benefit from such care, could have had no other choice but to ask for medical aid in dying to end their days in dignity,” the letter reads.

The college said patients requesting medical aid in dying are getting priority access to available resources, “to the detriment of other patients” at the end of their lives.

“Palliative care cannot be limited to access to medical aid in dying,” its letter reads.

The group’s president, Dr. Charles Bernard, said fewer physicians and medical professionals have chosen to specialize in palliative care over the last two years.

“We are getting worried,” Bernard told CBC News.

“If we don’t recruit and if we don’t give a little help, in a few years from now, we will have a real problem.”

In 2016, the first year after Quebec’s medical aid in dying law took effect, a total of 461 patients were granted doctor-assisted death.
More access to home-based care, ministry says

In a written response to Radio-Canada, the health minister’s office said it wanted to “qualify the college’s presumptions.”

The province’s palliative care plan, launched in 2015, has led to an increase in the number of people accessing services at home, it said.

Barrette’s office did not comment any further on the college’s letter.

Radio-Canada reported 24,000 people accessed palliative care at home in 2017-2018, compared to 22,000 in 2014-2015.

However, the Quebec Society for Palliative Care said the province’s plan has resulted in uneven access to support.

“In some places, there are improvements. Sometimes, it’s stagnant. And, in some places, it’s deteriorating,” the group’s president, Dr. Christiane Martel, told Radio-Canada.

Martel agreed with the college’s letter, saying deficiencies in the system can lead patients to opt for medical aid in dying.

“When our patient tells us, ‘because I don’t have enough help at home, because I’m stuck at a hospital, I’m going to request medical aid in dying,’ doctors are uncomfortable,” she said. Read more…