Medical Assistance in Dying committee  Thank you for your question. If you don't mind, I will continue in French to make sure that I make my [Technical difficulty—Editor] more clearly. With regard to palliative care, obviously, we have come a long way, as there was initially no training. Initiatives were organized locally all over.

Medical Assistance in Dying committee  Thank you, Senator Mégie. Yes, a lot of thought has been put into that. On that note, I would say that the problem of information about access to palliative care goes back a long way. It also comes from the fear of talking about death, of talking about topics that are not easy.

Medical Assistance in Dying committee  I will express my personal opinion, which is not necessarily that of the Collège des médecins du Québec. The implementation of such a measure is going to pose some challenges. The application of a prospective measure should, in my opinion, be reserved for contentious, less clear or specific cases.

Medical Assistance in Dying committee  The problem is that, in the Quebec bill, the notion of disability is not recognized as a possibility for requesting medical assistance in dying. In French, a distinction seems to be made between an individual who suffers from a progressive disease and a person who has a physical disability.

Medical Assistance in Dying committee  Yes, exactly.

Medical Assistance in Dying committee  Yes.

Medical Assistance in Dying committee  That's a great question. I agree with you, the resource situation means that there is already some difficulty in accessing mental health care. The difficulty that stands out is making sure an independent assessment is obtained. Since the therapist may have been meeting with a patient for several years, the therapeutic relationship could be tinged with certain elements.

Medical Assistance in Dying committee  I am not an expert on the whole issue of access to mental health care, but I believe that, if something is to be implemented, the system needs to be able to take the necessary steps to allow access and accessibility.

Medical Assistance in Dying committee  Thank you for that question, Mr. Arseneault. In this case, I will put on my clinician hat. That stage of my career ended when I joined the Collège des médecins du Québec, but I still had a long career as a clinician. I have also worked extensively in palliative care, participated in the implementation of medical assistance in dying, and administered medical assistance in dying to many patients myself.

Medical Assistance in Dying committee  In my experience, most people who directly request medical assistance in dying have already come a long way and are at a stage where palliative care is not the outcome they envision. This can particularly affect people who have a neurodegenerative disease and who see themselves declining.

Medical Assistance in Dying committee  Perfect, thank you. I'm here to present the position of the Collège des médecins du Québec, where I've been working for a year and a half as an inspector in the Professional Inspection Division. In light of the progress being made in granting access to medical assistance in dying and developments over the past few years, the Collège struck a working committee made up of clinicians.

Medical Assistance in Dying committee  Hello?

Medical Assistance in Dying committee  I'll check. The headset should be selected.

Medical Assistance in Dying committee  Is that better now?

Medical Assistance in Dying committee  Okay, thank you.