Physician-Assisted Dying committee  It is one of concern, in terms of where a request of this nature would fit in the context of the continuum of care that exists in a family physician-patient relationship. We would have concerns with that. We would prefer to see this as a medical act that is part of tons of other medical acts that physicians are involved in and are considering with their patients.

Physician-Assisted Dying committee  I cannot make specific comments because I have not spoken to any family physicians who have been involved in the process. However, we do know that, since December, assisted suicide has been used in some cases. Over the next few months, we intend to carry out a somewhat more appropriate consultation through the Quebec College of Family Physicians to better understand how things are going.

Physician-Assisted Dying committee  There is no doubt that palliative care is very important and that what is currently being done in Canada in that area must be improved. However, I believe that Canadians have been very clear. Although quality palliative care is provided in Canada, Canadians want a separate right to have access to that service, where assisted suicide would be considered.

Physician-Assisted Dying committee  Good afternoon. As mentioned, my name is Francine Lemire. I am the Executive Director and Chief Executive Officer of the College of Family Physicians of Canada. I am a family physician myself. I want to thank you for inviting me. It is a privilege to be presenting to you today.

Physician-Assisted Dying committee  I'm also glad that I was here for the first part of this discussion, which has given me the flavour of the kinds of questions we may be discussing. The College of Family Physicians of Canada represents 35,000 members across Canada. We are the professional organization that is responsible for establishing the standards of training and certification for family physicians.

Health committee  We need to be able to manage the overlapping scopes of practice at the local level. This is where it works the best, and we have lots of lessons to learn from the rural environments. If you don't do it there, you die.

Health committee  That don't support that care?

Health committee  Yes.

Health committee  I've felt quite picked on in the last hour, but that's okay, I can take it.

Health committee  I will say to you what I have said elsewhere. Certainly for family medicine, in trying to increase the attraction of that discipline we have said, more or less they can do family practice, they can pursue areas of special interests, they can have flexibility in the profession. All this is true, except that now we need to deal with some of those consequences: that as a family physician, paid by society and being conferred that privilege by society, you have a responsibility to society.

Health committee  We just need to scale up some of the innovation that's already existing in this country with some of the new models of care. I think certainly some of the Ontario models of care—

Health committee  I would add to that that the training of our doctors now and in the future must focus heavily on the importance of working as part of a team. Their training must expose them to experiences that will enhance their ability to work in a team going forward. There is no doubt that the community health centre model is philosophically relevant in terms of meeting a community's needs.

Health committee  Based on what we know, we're catching up on numbers. The area in which we're failing is distribution. That's what I see as a big problem now and in the future and something that obviously needs to be addressed collectively. The collective is the way we prepare physicians and we have conversations with them about their social responsibility.

Health committee  It's multifactorial, and it relates not only to the practice of the physician but the job of his or her spouse and the other issues you've discussed. It's not an easy situation, and certainly none of us, I don't think, at this table can enforce anything with our providers. We can train them according to the best standards, we can advocate, nudge, but we certainly cannot force them.

Health committee  I won't repeat everything that was said, but I would like to point out that the College of Family Physicians of Canada has formed a partnership with physician assistants. It allows them to use our platform, which we use to ensure their skills remain up to date. We have an agreement to help foster a good relationship with them so we can gain a better understanding of what physician assistants do.