Physician-Assisted Dying committee  We had quite a stark presentation the other day about the last year of life of someone with dementia. It's probably in all our minds. We were asked to think about how we would feel with a family who had dementia, or even ourselves, and would we want to ensure that we wouldn't have to endure this terribly stark picture of the last year of life with the privilege of being able to say in advance with an advance directive while we were still competent that we wouldn't want to and that in fact, someone might end their life far earlier while they were still competent if they didn't have the assurance that they'd be able to provide an advance directive.

Physician-Assisted Dying committee  What kind of information could you see being collected under this approach, in terms of monitoring oversight and then having a feedback loop into the legislative process?

Physician-Assisted Dying committee  We have heard that nurse practitioners and other medical professionals could be involved in actually administering the process, the death for the patient. Could you see that as well?

Physician-Assisted Dying committee  Thank you, Chair. Ms. Ng, I'd like to ask you a little more about the point you made about a review after a death. We have heard, for example, that the review is very important. Data collection and oversight could then lead to a review of the legislation in an ongoing way to update or change it over time.

Physician-Assisted Dying committee  I'll still defer my time to Senator Joyal.

Physician-Assisted Dying committee  Thank you, Chair. I will defer my time to Senator Joyal, if I may.

Physician-Assisted Dying committee  Thank you very much for your testimony. I will start with Dr. Grant. When Peter Hogg appeared before the committee at the end of January, he proposed that federal legislation should be drafted to provide a fairly extensive framework for physician-assisted dying in Canada, with the provision that this federal legislation would not apply to provinces or territories that have enacted substantially similar physician-assisted dying regimes.

Physician-Assisted Dying committee  In fact, you said when you began your presentation that what was fundamentally medical and clinical should be the right of the colleges, so I ask you about the process and procedures with which we have been somewhat preoccupied; process and procedures meaning the steps that should be involved in making a request for physician-assisted dying, and the steps that should be involved in the physician providing physician-assisted dying.

Physician-Assisted Dying committee  Thank you. Dr. Lafontaine, thank you very much for your presentation to us this evening. It was extremely revealing and important for us to listen to. I would like to ask you a rather pragmatic question, if I might. It has to do with some testimony we've heard before this committee about how regulated health professionals, including registered nurses or physician assistants, should be able to provide physician-assisted dying under the direction of a physician or a nurse practitioner.

Physician-Assisted Dying committee  Thank you. I appreciate that, because that's exactly the reason for the question. It's the point you just made, which is that we need to think about the patient. It needs to be patient-centred, so we need to ensure access when a physician decides he can't do it. If I might ask Professor Ells—

Physician-Assisted Dying committee  Thank you very much for your testimony today. Ms. Baxter, if I might ask, you mentioned that there are 600 hospices across the country.

Physician-Assisted Dying committee  Thank you. That's very helpful. With that in mind, thinking specifically now about Bill 52 in Quebec, I'm wondering if there is anything you could share with us in terms of how the hospices are reacting to Bill 52, and if there is something we might learn from that right now.

Physician-Assisted Dying committee  That actually leads me to my next question, to which Professor Ells and Ms. Baxter and perhaps even Dr. Smith might respond, and that has to do with the referral process itself and the transfer that everybody has talked about. I'd like to have some explanation of how you see that working.

Physician-Assisted Dying committee  You talked about the conflicts in terminology and the misunderstandings about the terminology, about definitions and things like that. I know that I've often heard the confusion about what palliative care does, compared to physician-assisted dying. From the point of view of Canadians, there is a good deal of confusion.

Physician-Assisted Dying committee  Thank you, Chair. Thank you very much for your testimony. If I might, I will say to Mr. Miller and Ms. Masotti that likely every single one of us around this table would agree with you that palliative care is a pretty important aspect of health care in this country, and that there is a continuum in end-of-life care that includes palliative care as well as physician-assisted dying now that the Supreme Court has made this ruling.