“That doesn’t make any sense, that story! » Dr. Mauril Gaudreault admits to being startled when he learned the circumstances of Stéphanie Lavoie’s death. “Lyme disease: exhausted and at the end of resources, a 30-year-old young woman resorts to medical assistance in dying,” TVA Nouvelles told us on May 21.
The president of the College of Physicians of Quebec is right, this story is insane1.
Stéphanie Lavoie was sentenced to eight years of medical wandering before resorting to medical assistance in dying (MAID). During all these years, she encountered closed doors: doctors did not believe in her illness – the chronic form of Lyme disease, the existence of which is not scientifically proven.
The doctors didn’t believe Stéphanie Lavoie, but when the time came for her to ask for the final injection, there were at least two who believed her. It sends shivers down your spine.
Of course, this does not mean that the doctor who administered MAID to the young woman committed a fault, nor did the one who gave a second opinion, as required by law. Stéphanie Lavoie was nothing more than skin and bones. Affected by malnutrition, her organs were on the verge of failure.
The problem is not the AMM, nor the professionals involved. It was the health system that failed this young woman.
“Coming to such a conclusion at 30 years old, with no possibility of improvement… I think the system missed it,” admits Dr. Gaudreault. He assumes that the College of Physicians will be called upon to look into the matter, as it has done for 21 cases related to MAID that have been reported to it over the past four years.
Among these 21 reports, the Office of the Syndic identified problems in 7 files, for which non-disciplinary measures were taken.
Until now, however, no report has been considered serious enough for a complaint to be filed before the College’s Disciplinary Council, which allows its president to conclude that there are “no abuses » regarding the administration of MAID in Quebec.
Popular: there is no other word. Quebec is the world champion in medical assistance in dying. Nearly 6,000 people used it in 2023. AMM now accounts for 7% of deaths recorded in the province. That’s twice as much as in Ontario – and ten times more than in Oregon, where the practice has existed longer.
Dr. Gaudreault cannot provide a sociological explanation for this Quebec craze. However, he is delighted with the way in which the AMM was implemented. “I find it extraordinary, the way Quebec society has organized itself in relation to this. It is the only place in the world where there is a commission on end-of-life care. It is the only place in the world where a professional order ensures that everything is done in order. »
The beacons exist, so they are solid, and that’s good.
But I repeat: the problem is not the AMM, it is the system which is failing everywhere.
On the terrace of a café on Peel Street in downtown Montreal, I confide in Dr. Gaudreault that another recent case deeply troubled me: that of Normand Meunier, who entered the emergency room at Saint-Jérôme hospital to treat a respiratory virus in January, without realizing that… it would kill him.
The 66-year-old quadriplegic was confined to a stretcher for four days, Radio-Canada reported2. His wife complained and asked for an alternating pressure mattress, but she was ignored. As a result, Normand Meunier developed a terribly painful pressure sore.
So painful that on March 29, he requested MAID to end his suffering.
I would like to believe, once again, that the doctor who administered the MAID committed no fault, that the prognosis was poor and that everything was done according to the rules of the art and with the deepest respect for the patient’s wishes.
In other words, did Normand Meunier really have a choice?
I am not the only one asking this question. On Wednesday, the day after my meeting with Dr. Gaudreault, representatives of the three opposition parties called for an independent investigation into the death of Normand Meunier. “Medical assistance in dying was decided in these places,” recalled solidarity MP Vincent Marissal, at a press briefing at the National Assembly. “It was never a substitute because there is no care in Quebec. That was never the idea. We said it, we said it again. Me, honestly, today, I am ashamed. »
Shortly after this press briefing, the Minister of Health Christian Dubé called the widow of Normand Meunier to confirm his intention to launch an independent investigation.
About three weeks ago, Mauril Gaudreault had a first meeting with Geneviève Biron, appointed head of Santé Québec, the new agency which will oversee all of the health network’s activities. They discussed, among other things, a subject dear to the president of the College: the social responsibility of the medical community.
We must, for example, ensure a fair distribution of doctors in all regions of Quebec – even if it means forcing their hand a little, he believes. “I call it an attack on the freedom of installation and practice. »
That said, we must stop hoping that every Quebecer has the right to “their” family doctor. This is a thing of the past, as several experts consulted by La Presse pointed out last Sunday3. Dr. Gaudreault shares this observation.
“Two years ago, in parliamentary committee, we were among the first to say it,” he recalls. I told parliamentarians that we had to stop aiming for every Quebecer to have access to a family doctor. Rather, we had to ensure that every Quebecer has access to a health professional, depending on their situation. »
The future requires the establishment of interdisciplinary teams, believes Dr. Gaudreault. A nurse or social worker can respond very well to a patient’s needs, sometimes even better than a doctor, who patients do not have to contact for the slightest ailment. To do this, we must allow other health professionals to make diagnoses.
It’s coming, predicts Dr. Gaudreault. And if all goes well, it will help to partially plug the gaps in the health network. “In 10 years, if we change the practice organization model, we may realize that we have enough family doctors…”