Thank you very much. I want to thank everyone for coming today and giving us their time on a very complex issue.
I'm a family physician, or I used to be family physician, for very many years, and I find that what I'm hearing today is people suggesting that it is one thing or the other, that you either seek MAID or you seek palliative care, and I don't think that's true.
I really do, in terms of my own experience with patients, feel that palliative care has a place. A lot of people wish for palliative care, and then after that, they may get to a point where they decide that whatever is going on with their lives is unbearable and that they want to access MAID.
You have questioned Ms. Hoffman's and Health Canada's report that 82.8% of people who accessed MAID had palliative care given to them. I think the "either/or” concerns me a little bit, the idea that there is one silver bullet that if accessed by everyone would enable them to get better.
I think Dr. Naud said it extremely well. I almost got up and applauded when he said that assessing or giving a patient MAID or palliative care, or whatever else you may do to give them support, is about the patient. It's not about whether the physician believes that their decision is the most important decision for the patient; it's about knowing and assessing your patient and knowing when your patient has come to the point where they can trust you to tell you, “You know what? This has been working well. I am feeling very good about myself, but I really don't want to do it any more. I've just had it, with my years, etc.” I think it's really important for us to start talking about the things that happen if a patient who is in palliative care says, “I would like to have access to MAID.” What is it that you would say to that patient, Dr. Herx?
I know that Dr. Naud talks about the patient and the patient's limits, the patient's tolerance. It is, at the end of the day, about the patient. I think the issue of advance directives is something I'd like to get into, but I don't think I'm going to have time.
How do you make a decision in the best interest of your patient, Dr. Naud, when your patient is going through the end of life, when they're going through pain and so on? How do you make those decisions on an individual case-by-case basis?