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January 15, 2011, Université de Montréal
The fourth edition of the CMEQ was a resounding success, with more than 180 attendees registered and an audience made up of students from the four faculties of medicine in Québec and students in health law.
Centred around the dynamic between legal and clinical aspects, the symposium raised current issues such as end-of-life care and euthanasia. Prompted by these poignant problems that confront us with questions as much as they touch us, Professor Suzanne Philips-Nootens, Dr. Marcel Boisvert and Dr. Serge Daneault presented some very rich and thought-provoking conferences.
The information day also gave the future physicians a chance to become familiar with the concepts of risk management, users rights and medical responsibility, in order to spend less time in court and more in the hospital! In this context, Jean-Pierre Ménard, a lawyer and experienced speaker, presented his survival guide for young physicians, and Dr. Jacques Guilbert, a physician risk manager, talked about the Canadian Medical Protective Association, for which he works.
Dr. Jean-François Lajoie, President of the QMA
Louis Couturier, president of the QMA Students Group
Annie Genois, externship representative of the QMA Students Group
A professor at the Faculty of Law and senior chair of health law and governance at Université de Sherbrooke, Professor Philips-Nootens reflected on the boundaries governing end-of-life decisions from a medical standpoint. Where does life-sustaining treatment begin? When is euthanasia legitimate, and legally and morally acceptable? Ms. Philips-Nootens gave a comprehensive summary of the current situation of the law in Québec and Canada, discussing certain concepts such as the respect for human dignity and individual freedom, which were originally behind greater open-mindedness about euthanasia. Finally, she also highlighted the current status of the debate on euthanasia in Québec, after a study of the impacts of the experience in the Netherlands and Belgium.
If there is one place where the convergence of law and medicine struggles for clear expression, it is the thorny question of euthanasia and the role of physicians regarding end-of-life care. Speakers Dr. Marcel Boisvert and Dr. Serge Daneault, co-authors of the book Être ou ne plus être : débat sur l’euthanasie (To be or not to be: a debate about euthanasia), generously shared and compared their points of view. For Dr. Marcel Boisvert, it was not life that should be sacred, but rather the person. Dr. Serge Daneault emphasized that for him, without life, there was no individual, and that the person no longer had any autonomy as such. The sacred aspect of life should therefore, in his opinion, take priority over the sacred aspect of the person. While they may express themselves in different ways, both speakers pointed out that the role of physicians must be to accompany their patients in their journey through life as well as their journey towards death.
Punctuated by humour, lawyer Jean-Pierre Ménard gave the future physicians a few tips to help them spend less time in court and more in the hospital... He recalled that even though risky medical disciplines abound (gynecology, anesthesia, surgery, etc.) and physicians can make mistakes, the concept of responsibility was based on the need for the presence of a fault, damages and their relationship and causality. Besides basic tips (such as the clarity and quality of notes written on patient records), Mr. Ménard underlined the importance of communication with patients as a prerequisite for the “legal survival guide”, and the essential nature of transparency.
A physician risk manager, Dr. Jacques Guilbert presented the organization for which he works, the Canadian Medical Protective Association, and an overview of how the CMPA can assist and help future physicians. A leader in medico-legal risk management in Canada and internationally, the Association participates actively in making medical care safer in the country. Dr. Jacques Guilbert illustrated his comments with real-life stories of physicians and their patients that were sometimes odd, outrageous or troubling.