In an earlier blog we looked at the right of conscientious objection - “Can doctors refuse to take a request for MAID?”. Trained to "do no harm", Canada's new assisted dying law poses both ethical and professional questions for the health care community.
In Road to Mercy, we feature two respected Canadian doctors, Louis Roy and Wendy Johnston, who each share their unique perspectives on what the law means for their practice and profession. In this article, we focus on Dr. Roy, a palliative care specialist in Quebec City.
Dr. Louis Roy is the only doctor on his palliative care team who feels comfortable to offer medical assistance in dying. In Road to Mercy, we follow Dr. Roy as he provides MAiD training for health care practitioners and helps one of his patients in her request for an assisted-death.
Trained as a family physician at Sherbrooke University, Dr. Roy has dedicated his work over the last 20 years to the development of palliative care in Quebec City and in the province of Quebec. He also co-chaired the ministerial committee for the implementation of physician-assisted dying (PAD) in 2015 with Brigitte Laflamme.
It was during his training as a family physician that Dr. Roy first became interested in palliative care. He recalls his aunt’s battle with cancer as a pivotal moment in his decision to follow the specialty. The terminal diagnosis fell hard on the Roy family; they were told there was nothing to be done. While grieving his aunt, Dr. Roy noticed how people treat death; the discomfort, the silence. “Nobody ever spoke to her about that, but she was going down and down.” In Dr. Roy’s view, palliative care is much more than pain relief. It’s comfort care, not only for the patient but for his/her family.
“We can at first think about painkillers and relieving pain but this is just a small part. It can be a big part if the pain is really important, really intense. But there’s all the other things about what’s your life? How do you want to end it? What’s important to you? Is there something you want to do before you die?”
It is this empathy and deep sense of compassion that make Dr. Roy an excellent and respected palliative care physician. It is also what made him initially oppose Bill 52 , Quebec's assisted dying law. But after a period of public discussion and personal reflection, he changed his mind.
“Physicians and all those who work in health care, we all have seen patients who were in such bad state, uncomfortable, unable to relieve their pain or their distress … and then you may feel that you’re in a dead end. You just don’t know what to do to help those patients. And then this is there, and if the patient speaks about PAD, that might be a solution for some patients.”
Quebec is home to 31 palliative care centres. However, only two, Maison René Verrier and Maison Aube-Lumière offer medical assistance in dying. In August, a palliative care home in Trois-Rivières refused to offer the service, and the patient was transferred out.
In a CBC News report, Christiane Martel, president of the Quebec Society for Palliative Care, revealed that the quantity of doctors willing to provide medical aid in dying is extremely low, "In our region, it's less than 1% of doctors".
While Dr. Roy respects doctors' rights to conscientious objection, he also believes that patients should not be denied information.
“It’s right for the patient to have all the information. Can you imagine a physician who would not believe in blood transfusion even if it can save the life of a patient. That can’t be possible. That would be medical malpractice. If you’re not comfortable you should have the objectivity and the thoroughness to call somebody else.”