Respite Caregivers

Transcription

Respite Caregivers

LE
SPÉCIALISTE
Le magazine de la Fédération des médecins spécialistes du Québec
Vol. 14 no. 2 | June 2012
Respite
for
Caregivers
TOUT SAVOIR
SUR L’ASSURANCE
ASSOCIATION…
Voir texte p. 36
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Summary
LE SPÉCIALISTE IS PUBLISHED 4 TIMES PER YEAR BY
THE FÉDÉRATION DES MÉDECINS SPÉCIALISTES DU QUÉBEC
EDITORIAL Committee
Dr. Bernard Bissonnette
Dr. Raynald Ferland
Dr. Paul Perrotte
Maître Sylvain Bellavance
Nicole Pelletier, APR, director
Patricia Kéroack,
communications consultant
DELEGATED PUBLISHER
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RESPONSIBLE FOR
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WORD FROM THE PRESIDENT
Stop Motion M-312
9
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LEGAL DEPOSIT
2nd quarter 2012
Bibliothèque nationale du Québec
ISSN 1206-2081
REVISION
Angèle L’Heureux
7
10 IN THE NEWS
11 LEGAL ISSUES
13 HEALTH POLICIES
16 DID YOU KNOW...
19 DOSSIER
RESPITE
FOR CAREGIVERS
• Some respite today...
For life! All pharmaceutical product advertisement’s have been approved by the
Pharmaceutical Advertising Advisory Board (PAAB).
• Serious commitment,
strict criteria
• Being a Caregiver
in Quebec
• A Caregiver Speaks
The authors of signed articles are sole responsible for the opinions expressed
therein. No reproduction without previous authorization from the publisher.
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31 GREAT NAMES IN QUEBEC
MEDICINE
Dr. Jean Deslauriers, thoracic surgeon
33 IN THE WORLD OF MEDICINE
35 FINANCIÈRE DES
PROFESSIONNELS
THIS EDITION’S ADVERTISERS:
• Desjardins
• TELUS
• RBC Banque Royale
• Financière des professionnels
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• Les Entreprises Marchand
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• Conseil québécois d’agrément
• Sogemec Assurances
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20
• Launch of the Foundation 21
CCAB audits the medical specialists and residents database
(11,505 copies audited for December 2011) The FMSQ also
distributes around 1,000 copies to Researchers and
Professors of the 4 Medical Faculties in Quebec, as well as managers and leaders
of the Québec healthcare system.
The mission of the Fédération des médecins spécialistes du Québec is to defend and
promote the economic, professional, scientific and social interests of the medical
specialists who are members of its affiliated associations.The Federation des médecins
spécialistes du Québec represents the following medical specialties: Adolescent
Medicine; Anatomical Pathology; Anesthesiology; Cardiac Surgery; Cardiology (adult or
pediatric); Clinical Immunology and Allergy; Colorectal Surgery; Community Medicine;
Critical Care Medicine (adult or pediatric); Dermatology; Diagnostic Radiology; Emergency
Medicine; Endocrinology and Metabolism; Forensic Pathology; Gastroenterology;
General Pathology; General Surgery; General Surgical Oncology; Geriatric Medicine;
Gynecologic Oncology; Hematological Pathology; Hematology; Infectious Diseases;
Internal Medicine; Maternal-Fetal Medicine; Medical Biochemistry; Medical Genetics;
Medical microbiology and infectious diseases; Medical Oncology; Neonatal-Perinatal
Medicine; Nephrology; Neurology; Neuropathology; Neurosurgery; Nuclear Medicine;
Obstetrics and Gynecology; Occupational Medicine; Ophtalmology; Orthopedic Surgery;
Otolaryngology-Head and Neck Surgery; Pediaric Hematology/Oncology; Pediatric
Emergency Medicine; Pediatric General Surgery; Pediatrics; Physical Medicine and
Rehabilitation; Plastic Surgery; Psychiatry; Radiation Oncology; Respirology (adult or
pediatric); Rheumatology; Urology; Thoracic Surgery and Vascular Surgery.
FEDERATION AFFAIRS
36 SOGEMEC ASSURANCES
38 LE MOT DU PRÉSIDENT
Non à la motion M-312
39 SERVICES AUX MEMBRES
A vantages commerciaux
LE SPÉCIALISTE | VOL. 14 No. 2 | JUNE 2012 | 5
WORD FROM THE PRESIDENT
Dr. Gaétan Barrette
Stop Motion M-312
I
t is undeniable that, in recent years, the Conservative
delegation on the back benches has been multiplying their
tactics and attempts to reopen the debate on abortion, in
particular by proposing private member’s bills. Their ultimate aim?
Obtaining legal recognition for the foetus as a person, a notion
that does not exist in our current Criminal Code. They failed
each and every time. But, with a determination that approaches
ideological obsession, this same delegation has tabled four
proposed bills before the House of Commons: C-43 in 1989,
C-291 in 2006, C-484 in 2007 and C-510 in 2010. Clearly, the
principle of representation that underlies the existence of our
parliamentary system is given way to a quasi-religious doctrine
that must be imposed on the whole country.
Up until very recently, the modus operandi had always been the
same. However, a new offensive has just been launched by the
member for Kitchener Centre. A new stratagem is making its
appearance: rather than proposing a private member’s bill, he
has chosen to make a binding motion, a tactic that is pernicious
as well as heavy with consequences. In effect, adopting this
motion would then obligate Parliament by forcing the creation
of a special committee of the House that would, still according
to the member for Kitchener Centre, “be directed to review
the declaration in Subsection 223(1) of the Criminal Code of
Canada which states that a child becomes a human being only
at the moment of complete birth.” We can already see a troop
of “experts” marching in to answer four questions, each as
biased as the others, requiring, in particular, that medical proof
be provided to support the contention “that a child is or is not
a human being before the moment of complete birth.” We can
also see, with the appearance of each of these experts, their own
personal biases, whether religious or scientific.
You can imagine the collective and emotional delirium in which
we would quickly find ourselves were this motion to be adopted.
Not to mention the highly probable demagogical misdirections
that would follow. Motion M-312 has already been the subject
of a first hour of debate in the House of Commons on April
26th. A second hour is scheduled for June, at the end of which,
the motion will be submitted to a vote. Should the motion be
adopted, the whole process would be initiated.
In 2008, action was urgently needed to block proposed bill
C-484, the nth attempt to reopen the debate on abortion. It
was thanks to provincial governments, in particular the one in
Quebec, and to popular outcry that the government, then in a
minority position, was forced to pull back. Unfortunately, this
same government has a majority today.
Stephen Harper has several times declared in public that he
would oppose any attempt to create a law on abortion. Faced
with such an explosive subject and having demonstrated on
multiple occasions his propensity to completely control his
caucus, how can he let his delegation lead this repeated attack?
In our view, it is laughable that Stephen Harper should hide
behind his members’ right to table motions or propose bills, while
repeating the argument that “a party leader does not control
that”. Stephen Harper has too often demonstrated that, when
principles are at stake, he uses all of his powers to win the battle
and, as would be the case at present, ensures that his entire
delegation follows the party line. Therefore, we can only conclude
that the Prime Minister is in favour of reopening the debate by
opting for a free vote.
Stephen Harper has also said that his hands are tied by
parliamentary rules. Verily, verily, I say unto you that his hands
are tied instead by the orthodox views of the religious right who,
as we all know, is extremely active within the Conservative Party.
And what can we say about the Liberal Party and its interim
leader, Bob Rae? It looks like there was more than one student
in that same class…
Consistency and honesty require that Stephen Harper, as head of
State, impose the party line on his delegation to make sure that
this motion is rejected and, moreover, he must publicly commit
himself, for the same reasons, to blocking any further attempts
of this kind.
For the FMSQ, whether it’s proposed bill C-484 or motion
M-312, the stakes are identical: defending medical specialists,
in the professional and legal sense, because, should the Criminal
Code be modified, there is the possibility of physicians being
sued; denying women the right to receive quality care in safe
and adequate environments; denying women the right to dispose
of their bodies according to their own wishes; and, finally,
destroying the social consensus on the subject that has existed
in Quebec for the past 30 years.
Remember, the FMSQ publicly intervened in 2008 to prevent
the adoption of proposed bill C-484, which had passed second
reading by 147 votes against 132. In the end, the project was
removed due to the call of federal elections.
In line with the actions we took in 2008 against C-484, the FMSQ
fully intends to denounce this new attempt and will seek to block
motion M-312.
Yours in solidarity!
S
L
Pour votre assurance auto,
mieux vaut être à la bonne place.
Un partenariat qui vous offre des tarifs préférentiels,
ainsi que des protections et un service personnalisés.
DEMANDEZ UNE SOUMISSION
1 866 350-8282
sogemec.lapersonnelle.com
Certaines conditions s’appliquent.
La bonne combinaison.
FEDERATION AFFAIRS
Treasurer’s Annual Report
The Fédération des médecins spécialistes
du Québec held its annual meeting on
March 22, 2012. During this meeting,
Delegates accepted the recommendations
of the Finance Committee, as follows:
Raynald Ferland, MD
TREASURER
1. Approve the financial statements of the FMSQ as at
December 31, 2011, audited by the chartered accountant
firm of Raymond Chabot Grant Thornton;
2. Approve budget plans for the year 2012 as submitted by
the FMSQ;
3. Increase membership dues from $1,266 to $1,402 to
provide for the budgetary obligations of the FMSQ.
This year, the Fédération des médecins spécialistes du Québec
set up its Foundation (see the complete dossier starting on page
19). The amount of $1 million has been included in the budget and
was accepted by the Delegates’ Assembly. This sum will therefore
be paid to the Foundation during 2012.
In 2010, a special contribution of $1,000 per member (a total
of $8,511,922) was collected with regard to negotiating the
renewal of the agreement with the government. The balance of
this contribution, as at December 31, 2011, was $3,522,903.
This balance will be reimbursed to members this year by way of a
reduction in membership fees, as the Federation has always done in
the past. As a result, the amount of $380 will be applied in reduction
of membership dues for 2012 for each medical specialist who had
paid in full. Each member of the Federation will thus be called upon
to pay out $1,022 for his Federation membership in 2012.
If you have any questions regarding the budget, you may reach
me through the Federation.
About Remuneration... In 2007, after having come to a consensus
o n t h e re n e w a l o f t h e F r a m e w o r k
Agreement with the government, the
FMSQ had undertaken to review how the
negotiated budgetary envelopes were to
be distributed. This led to the FMSQ’s
committing itself to a complete review of
Bernard Bissonnette, MD
the distribution tool then in use in order to
SECRETARY
better respond to association disparities
created by previous tools. It took several years to complete the
work and associations were asked to contribute by identifying
all the situations that needed to be adjusted.
On a parallel track, work and discussions are taking place
regarding mixed remuneration in order to bring this twelve-yearold remuneration method up to date. Although it is too early to
come to a conclusion, the mixed remuneration method should
eventually be better adapted to the current needs of those
medical specialists who use it.
An extensive census of medical administrative activities has
also been undertaken so as to place a value on the contribution
of medical specialists. The very high response rate leads us
to believe that such activities represent a significant portion of
the daily practice of medical specialists. This data is presently
undergoing in-depth analysis.
The distribution tool, adopted last February, was again presented
to Delegates on April 26th. Several criteria were established to
adjust association envelopes (federation measures and business
relations, fees). The sums awarded were modulated over time to
maintain an interassociation budgetary balance.
S
L
Vendredi 9 novembre 2012
Palais des congrès de Montréal
ASSOCIATIONS PARTICIPANTES :
•
•
•
•
•
•
Association des anesthésiologistes du Québec
Association des cardiologues du Québec
Association des dermatologistes du Québec
Association des médecins hématologues et oncologues du Québec
Association des obstétriciens et gynécologues du Québec
Association des pédiatres du Québec
•
•
•
•
•
•
Association d’oto-rhino-laryngologie et de chirurgie cervico-faciale du Québec
Association des radio-oncologues du Québec
Association des pathologistes du Québec
Association des médecins psychiatres du Québec
Association des spécialistes en médecine interne du Québec
Association des spécialistes en médecine d’urgence du Québec
Avec la collaboration de l’Association des médecins omnipraticiens en périnatalité
PLUS DE DÉTAILS
SOUS PEU
IN THE NEWS
On the Political Front
Legislative Matters
Four bills proposed by the Minister of Health and Social Services
since the fall 2011 session are making their way through
the National Assembly. These include Bill Nº 36, An Act to
amend the Act respecting health services and social services
as regards joint procurement, presented on November 15,
2011; Bill Nº 53, An Act to dissolve the Société de gestion
informatique SOGIQUE, presented on February 16, 2012; Bill
Nº 55, An Act respecting the professional recognition of medical
electrophysiology technologists, presented on February 23rd;
and Bill Nº 59, An Act respecting the sharing of certain health
information (QHR), presented on February 29th.
Adopted on May 15th, Bill Nº 55 hasn’t made any waves,
since the official opposition is in agreement with the suggested
amendments: to integrate medical electrophysiology
technologists into the Ordre des technologues en imagerie
médicale et en radio-oncologie du Québec, to reserve their
professional designation, to add a field of activity and to
establish which activities are restricted to those practicing this
profession. The FMSQ had asked the associations directly
affected by this legislative amendment for their comments and
observations in order to be ready to intervene if needed.
Adopted by division on May 15th, Bill Nº 53 eliminates
SOGIQUE, a not-for-profit organization incorporated in 1986
whose mission was to supply various information technology
services to the health and social services network. It should
be noted that this bill will result in the transfer of all SOGIQUE
employees, representing 300 FTE (full-time equivalent), to the
MSSS, which will bring the Department’s total staffing level
to 985 FTE. Originally in agreement with the Bill in principle,
the official opposition voted against its adoption, reproaching
the Minister for not having presented any studies to justify
his decision.
The large, complex and very technical Bill Nº 59, which aims to
set up the operational architecture of the future Quebec Health
Record (QHR) is made up of 177 sections. It was subjected to
a round of individual consultations and public audiences at the
beginning of May 2012 with the aim of consulting some twenty
organizations interested in the QHR, including the FMSQ who
appeared before the Committee on May 9th. Its brief is available
on the Federation’s portal. At the time of writing (with deadlines
pending), the bill had not yet been referred to the Committee
on Health and Social Services for in-depth analysis. Considering
the number of sections the bill contains, its final adoption before
the end of the current session remains uncertain.
The fate of Bill Nº 36 also remains uncertain, since it has just
passed the proposal stage.
Please note that, if general elections are called, all bills not
adopted by that time and still on the Order Paper of the National
Assembly will automatically be repealed.
Dying with Dignity
Created on December 4, 2009 by unanimous vote in the
National Assembly, the Select Committee on Dying with Dignity
published its long-awaited report this past March 22nd. With 24
unanimous recommendations, the report was well received by both
the media and the public. It should be noted that the FMSQ had, in
some sense, launched this public debate by revealing the results
of its opinion poll on euthanasia on October 13, 2009.
S
L
LA FMSQ BIEN PRÉSENTE
SUR INTERNET
SUIVEZ-NOUS ÉGALEMENT SUR
fmsq.org
Espace sécurisé pour les membres
LE 7e TOURNOI DE GOLF DES FÉDÉRATIONS MÉDICALES
facebook.com/laFMSQ
@FMSQ et @DrBarretteFMSQ
MERCI À NOS COMMANDITAIRES
AU PROFIT DE LA FONDATION DU PROGRAMME
D’AIDE AUX MÉDECINS DU QUÉBEC
Lundi 23 juillet 2012
Club de golf Le Mirage à Terrebonne
Inscrivez-vous sans tarder !
Votre participation au Tournoi de golf des fédérations médicales
du Québec (500 $ pour une participation individuelle, 2 000 $
pour un quatuor) inclut l’accès au terrain de pratique, un droit de
jeu au club de golf Le Mirage en formule Vegas (meilleure balle),
une voiturette, le brunch, le lunch, le cocktail ainsi que le souper.
Informations et formulaires d’inscription disponibles sur le site Internet de votre fédération :
www.fmsq.org www.fmoq.org www.fmrq.qc.ca www.fmeq.qc.ca
10 | LE SPÉCIALISTE | VOL. 14 No. 2 | JUNE 2012
• Association des optométristes
du Québec
• Association canadienne de
protection médicale
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et gestion du patrimoine inc.
• Desjardins Sécurité financière
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de groupe auto et habitation
LEGAL ISSUES
By Maître Sylvain Bellavance
DIRECTOR, LEGAL AFFAIRS AND NEGOTIATION
Physicians Certified in More than One Specialty
Do You Know the Rules?
With the Delegates’ Assembly having come to a consensus regarding the distribution of
monetary gains obtained during the last negotiations, each association affiliated with the
FMSQ is now undertaking the work of implementing their own fee increases.
Since these increases vary according to specialty, it is important
to remember the rules, provided for in the Agreement, that
determine the specialty in which a medical specialist is classified
for billing purposes. This is all the more important at present
since the Collège des médecins du Québec has recognized 19
new specialties, which can have an influence on how physicians
are classified.
Current Rules
The Agreement provides for various services that can only be
claimed by physicians classified in certain disciplines. This is the
case for fees relating to visits, laboratory tests as well as certain
diagnostic or therapeutic procedures. Insofar as applying the
Agreement is concerned, each medical specialist is classified
according to the Régie de l’assurance maladie du Québec
(RAMQ) in only one discipline known as the specialty category.
For several years now, the rules established by the Agreement
stipulate that the physician who qualifies as a specialist in
more than one discipline is classified according to the most
recent certificate.
Physicians may however request a change of category to
that of a former discipline if it can be shown that the former
discipline represents their main area of activity. In such a case,
the Federation and the department of health and social services
(MSSS) study physicians’ requests and decide whether to grant
the change of category or not.
Since 1994, special rules have been in force for internal
medicine, geriatrics and rheumatology. Thus, effective March
13, 1994, physicians, who have been classified in internal
medicine, geriatrics or rheumatology and who obtained a new
certificate after this date, cannot ask to be reclassified into their
previous discipline. In the same vein, physicians with more than
one certificate and classified on March 13, 1994, in a discipline
other than internal medicine, geriatrics, or rheumatology cannot,
after this date, request a change of classification into internal
medicine, geriatrics or rheumatology.
These various classification rules aim, in particular, to avoid
allowing physicians, with a certificate in more than one discipline,
to change their specialty category in line with fee increases or
modifications to billing rules that are adopted from time to time
in a given discipline.
(continued on the following page)
AVeZ-VoUs renoUVeLÉ Votre cotisAtion?
n
OUI
nous vous
en remercions.
n
NON
L’inscription en L ig ne
il est encore temps de le faire.
Vous avez jusqu’au 30 juin, 17 h, pour effectuer
votre renouvellement et votre paiement.
sécuritaire,
rapide et facile
www.cmq.org
Bon à sAVoir
noUVeAU mode de pAiement en Ligne
Une fois votre renouvellement en ligne complété, vous aurez
maintenant accès à deux modes de paiement : par carte de crédit,
ou par chèque. Si vous choisissez de payer par chèque, les mêmes
règles s’appliquent que pour tout paiement par carte de crédit :
votre chèque, accompagné du formulaire approprié, doit être reçu
au Collège au plus tard le 30 juin, à 17 h.*
RenSeignementS
514 933-4087 ou 1 888 633-3246
* Une pénalité de 250 $ sera exigée pour tout défaut de paiement dans les délais.
LEGAL ISSUES (SUITE)
New Specialties Recognized by the Collège
On November 25, 2010, the Collège
recognized 19 new medical specialties. As
a result, more than 500 certificates were
delivered during 2011 in these new specialties.
As a result, the number of medical specialists
having more than one specialty has increased
and this has forced the Federation to come
to an agreement with the MSSS concerning
the rules establishing the specialty category of
these physicians.
To start with, letter of agreement number
181 has been adopted, which establishes
that, until permanent rules can be adopted,
physicians with a specialist’s certificate in one
of these new specialties will continue to be
classified in their previous specialty category.
Secondly, work has begun to establish
classification rules for each of these new
medical specialties. Letter of agreement
number 191 was the result of numerous
discussions: it sets out the specialty category
for physicians who obtained a specialist’s
certificate in one of the new medical
specialties (see table on the right). These new
rules should come into force in the fall and
you will be so advised by an Infolettre from
the RAMQ.
Newly Recognized
Medical Specialty
Specialty Category
Colorectal Surgery
General Surgery
General Surgical Oncology
General Surgery
Pediatric General Surgery
General Surgery
Thoracic Surgery
General Surgery
Vascular Surgery
According to the last certificate obtained before that
of vascular surgery, and this, until the adoption of
rules specific to this specialty.
Pediatric Hematology/Oncology
Hematology-Oncology
Infectious Diseases (Adult)
Medical Microbiology and Infectious Diseases
Infectious Diseases (Pediatric)
Pediatrics
Adolescent Medicine
Pediatrics
Critical Care Medicine (Adult)
of critical care medicine.
Critical Care Medicine (Pediatric)
of critical care medicine.
Pediatric Emergency Medicine
Pediatrics
Occupational Medicine
Community Health
Maternal-Fetal Medicine
Obstetrics and Gynecology
Neonatal-Perinatal Medicine
Pediatrics
Neuropathology
Pathology
Gynecologic Oncology
Obstetrics and Gynecology
General Pathology
Pathology
Hematological Pathology
Pathology
Forensic Pathology
Pathology
New Rules for Pediatrics and Internal Medicine Along with the issuance of certificates in the 19 new medical
specialties, the Collège des médecins du Québec also
allowed physicians who so desired to apply for a certificate
in a specialty in which they already qualified and for which
they had not previously submitted a certificate request. For
example, a pediatrician, who had subsequently undertaken a
gastroenterology certification and who had only received this
latter certificate, can now ask for a certificate in the former
specialty of pediatrics.
resulted in renouncing the spirit of the Agreement since it must
be understood that, although the last certificate to be issued was
for pediatrics, this was in fact a qualification that predated that
of gastroenterology. As a result, a new rule was included in the
Agreement, which provided for physicians to remain classified
in their previous over-specialty, if they had obtained a specialist’s
certificate in internal medicine or pediatrics after November 25,
2010 and if they already held a certificate for an over-specialty
in internal medicine or pediatrics. However, this rule does not
negate the possibility that physicians holding
more than one certificate could ask for a change
THESE VARIOUS CLASSIFICATION RULES AIM, IN PARTICULAR, of specialty category to another discipline in
TO AVOID ALLOWING PHYSICIANS, WITH A CERTIFICATE IN which they are qualified specialists, if they
MORE THAN ONE DISCIPLINE, TO CHANGE THEIR SPECIALTY establish that the latter represents their principal
area of activity.
CATEGORY IN LINE WITH FEE INCREASES...
The granting of these certificates by the Collège resulted
in some classification errors at the RAMQ, where the text of
the Agreement was applied to the letter, thus classifying the
physician according to the last certificate issued. However, this
I hope this information will help you understand the overall
provisions regarding this subject that are included in
the Agreement.
S
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HEALTH POLICIES
By Jean-Bernard Trudeau, MD, Assistant Secretary, Collège des médecins du Québec
and Gilles Hudon, MD, Director, Health Policies and Professional Development, FMSQ
Collective Prescriptions
The adoption in 2003 of a bill entitled An Act to amend the
Professional Code and other legislative provisions as regards the
health sector resulted in a major transformation of the professional
system in Quebec insofar as physical health care delivery is
concerned. Historically following repeated legal transformations
of the health care system, the evolution of various medical and
professional practices remained laborious in spite of our constantly
evolving knowledge and the development of new skills. The Act
sets the stage so that physicians and other professionals can fully
deploy their skills within an evolving interdisciplinary framework.
Nine years later, the full potential of the Act is far from having been
reached! Everything leads us to believe that physicians in several
specialties do not benefit fully from all the advantages within
their reach for an efficient use of their time and skills. A better
understanding and the application of legislative modifications
would allow physicians to save substantial amounts of time within
the various health care processes by optimizing their cooperation
with the professionals around them, while still improving the
quality and safety of the care they deliver. A lack of knowledge
of the modifications resulting from the Act has several negative
consequences: loss of time for the physician, frustration for other
professionals in the efficient deployment of their skills, unwarranted
delays and possible harm for the patient who does not have
access to all available expertise at the proper time.
Restricted Activities
Previously, “delegated acts” were defined in law in precise and
restrictive terms; this notion of delegated acts has now been
abandoned in favour of “reserved activities”. These are in fact a
series of interventions, described in general terms, that allow for
the evolution of practices within the various professions involved,
i.e. dieticians, occupational therapists, nurses, nursing assistants,
respiratory therapists, physicians, speech-language pathologists
and audiologists, pharmacists, physiotherapists, medical imaging
technologists and radiation oncology technologist, without taking
into account other professionals who do not have a professional
corporation and whose activities are subject to authorization by the
Collège des médecins du Québec (CMQ).
The Triggering Prescription
Several reserved activities are subject to a single condition in order
to be authorized: the physician’s prescription, whether individual
or collective. By collective prescription, the law has granted
physicians an important role in the independent use of the skills
of various health care and social service professionals. In addition,
collective prescriptions increase the level of cooperation with and
between different professionals and allow quality to be attained
at a lower cost.
The Collective Prescription and Levels
of Responsibility
Any physician, wherever he or she practices, can write collective
prescriptions. But too many physicians erroneously believe that
they remain responsible for the activities of other health care
professionals as a result of their prescription. This is not the case.
The physician’s responsibility is limited to writing a prescription that
meets the requirements of the Regulation respecting the standards
relating to prescriptions made by a physician and whose content
corresponds to current medical practice standards whether the
prescription covers, for example, additional tests or medication. To
be considered complete, the collective prescription must specify
the clinical situation triggering the prescription, possible contraindications, as well as the professional or professionals concerned
(nurses, pharmacists, respiratory therapists, etc.). For increased
efficiency, the professionals concerned can prepare a draft
collective prescription to be submitted to the signing physician
so that the latter can evaluate its compliance.
The various professionals who are called on to execute collective
prescriptions are solely responsible for the acts they perform:
they are subject to a code of ethics and to rules regarding their
record keeping, rules that are the responsibility of their respective
professional corporations and not by the CMQ. Thus, the
professional who executes a collective prescription is responsible
for deciding to use it as well as for the act or procedure itself,
within the framework of practicing those activities that are reserved
to the professional in question. The end result is the recognition
of greater independence for the various health care professionals
along with the responsibility attached to this independence.
Collective prescriptions encourage an interdisciplinary deployment
and allow setting up health care teams that some believed only
possible with the creation of specialized nurse practitioners;
and this is already possible today, within our current practice
environments, in hospital centres and in our offices.
With the modernization of fields of practice and with the
arrival of activities reserved to various professions, the law has
eliminated the concept of monitoring. A professional can thus
practice a reserved activity wherever chosen, without having
a physician nearby, which explains the interest in using these
collective prescriptions.
To find out which activities are reserved to which professionals, as
provided for in the law, and to better measure all the possibilities
for specialists to increase their efficiency through the use of
collective prescriptions, we invite you to visit the CMQ website.
Collective prescriptions will be the subject of a presentation
during the FMSQ’s 5th Interdisciplinary Education Day (IED), on
November 9, 2012, at the Palais des congrès in Montreal.
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RÉFLEXION SUR MA PRATIQUE :
Le profil individuel et confidentiel
de prescription d’IMS
S
avez-vous qu’il existe un outil de formation professionnelle permettant au médecin d’établir une
comparaison entre sa pratique de prescription de médicaments et celle des pairs de sa province et du Canada ?
Le site Web sécurisé d’IMS permet aux médecins intéressés de préparer, pour leur analyse personnelle, leur
profil individuel et confidentiel de prescription.
Le profil de prescription individuel en ligne est strictement confidentiel et élaboré uniquement par le
médecin qui a demandé et obtenu un code d’accès
personnel au site Web sécurisé. Le profil en ligne
fournit une estimation des activités de prescription
et, à titre comparatif, de celles d’un groupe de pairs,
aux échelons provincial et national pour une période
de douze mois.
Écrans fictifs pour fins d’illustration seulement
Cette information est uniquement rendue disponible aux médecins.
Sécuritaire : Ces informations professionnelles
sont accessibles gratuitement à la seule condition
que les critères rigoureux de sécurité soient
respectés. Le médecin génère lui-même son profil
en ligne et peut l’imprimer s’il le désire; lui seul
peut générer son profil et lui seul peut décider
d’en imprimer une version papier. IMS ne divulgue
à aucune tierce partie le nom des médecins qui
ont demandé leur profil individuel et confidentiel
de prescription. De plus, IMS ne détient et ne
conserve aucune copie électronique ou papier
des documents créés sur le site Web sécurisé.
Flexible : Une fois les trois éléments de
sécurité et d’accès en main, le médecin peut
accéder rapidement et en tout temps à cet outil
d’autogestion. Le site sécurisé offre aux médecins
la flexibilité de choisir une catégorie ou famille
de produits, pour laquelle il désire approfondir
l’analyse. Compte tenu des intérêts et pratiques
variés, l’outil permet au médecin de comparer
ses habitudes de prescription à celles de pairs
de spécialités différentes de la sienne.
Informatif : Le profil individuel et confidentiel
de prescription en ligne offre trois différentes vues
à l’utilisateur :
• Comparaison par géographie : offre au médecin
une comparaison avec ses pairs, omnipraticiens
ou spécialistes, aux niveaux provincial et national.
• Comparaison par spécialité : offre la possibilité
au médecin de modifier le groupe de pairs avec
lequel il désire être comparé, selon ses intérêts.
• Profil récapitulatif : présente un tableau statique
en format PDF des principales catégories de
médicaments prescrits par un médecin.
Une mise à jour des données est effectuée aux trois
mois, il s’avère donc important pour l’utilisateur de
sauvegarder l’information qui l’intéresse puisqu’elle
sera mise à jour régulièrement.
Le profil est un outil de réflexion parmi d’autres, qui
aident le médecin à dresser un portrait de sa pratique.
Selon le Docteur Robert L. Thivierge, MD FRCPC,
Direction DPC, Faculté de Médecine de l’Université de Montréal et membre du Département de Pédiatrie de l’Hôpital Ste-Justine : « Dans le contexte
actuel d’autogestion du développement professionnel continu comme le prônent nos autorités et associations professionnelles, le profil-en-ligne d’IMS
constitue un outil personnel privilégié qui me permet de mieux connaitre ma pratique clinique et de
gérer moi-même ma propre formation continue. »
Tous les médecins peuvent compléter un formulaire
de demande d’accès en se référant au site :
http://imshealth.com/Reflexionsurmapratique
Un site de langue anglaise est aussi disponible au :
http://imshealth.com/Mypracticeinsights
16720, route Transcanadienne
Kirkland (Québec) H9H 5M3
Tél : 1-888-400-4672
DID YOU KNOW...
Prizes and Awards
ASCPEQ Prize
Canadian Nutrition Society Award
he 2012 Prix Hommage given out by the
T
Association des spécialistes en chirurgie
plastique et esthétique du Québec has been
awarded to Dr. Roger Paul Delorme. This prize
aims at highlighting the overall career of a plastic
surgeon and his or her contribution to advancing
his or her medical specialty.
APQ Prize
r. Robert L. Thivierge, a pediatrician at the
D
Sainte-Justine University Hospital Centre, has
received the 2012 Prix Letondal from the
Association des pédiatres du Québec in
recognition of the exceptional quality of his work
and for his out-of-the-ordinary involvement with
all aspects of the profession.
RCPSC Award
r. Peter J. McLeod, an internist and former
D
director of the McGill Centre for Medical
Education, has received the 2012 Duncan
Graham Award from the Royal College of
Physicians and Surgeons of Canada to highlight
his remarkable life-long contribution to medical
education. Dr. McLeod continues to teach while
maintaining a research program.
2011 AFMC Award
uring the 2012 Canadian Conference on
D
Medical Education, the Association of Faculties
of Medicine of Canada presented the AFMC –
May Cohen Gender Equity Award to Dr. Saleem
Idris Razack, a pediatrician at the Montreal
Children’s Hospital. This award highlights the
recipient’s efforts to improve the gender equity
context in university medicine in Canada.
Prix Hippocrate
rs. Isabelle Tremblay, a pharmacist
M
and Dr. Sylvain Gagnon, a Chicoutimi
obstetrician and gynecologist, have
had their cooperation rewarded with
the Prix Hippocrate given out by the
magazine Le Patient. This prize aims
at recognizing interdisciplinarity
between physicians and pharmacists
in the exercise of a professional activity
in the spirit of Bill 90 for the benefit
of patients.
The Canadian Nutrition Society has presented
its prestigious Khush Jeejeebhoy Award to
Dr. L. John Hoffer, an internist at the Jewish
General Hospital in Montreal, in recognition of
his exemplary contribution to the clinical
application of research results in the field
of nutrition.
The Canadian Pædiatric Society Award
r. Francine Ducharme, a pediatrician and the
D
assistant director of clinical research at the
Sainte-Justine University Hospital Centre, and
her team have received the 2012 Career in
Research Award from the Canadian Pædiatric
Society. Given out every two years, this award
highlights the career of a noteworthy and
accomplished researcher who is interested by
an aspect of pediatric research.
Société Francophone du Diabète Prize
r. Pavel Hamet, an endocrinologist at the
D
CHUM and holder of the Canadian Research
Chair in predictive genomics, has received the
Société Francophone du Diabète’s Roger Assan
Prize. This prize highlights his significant
contribution to advancing our understanding
of diabetes.
Ordre national de la Légion d’honneur
r. Michel Chrétien, an endocrinologist, has
D
been promoted Officier of the Ordre national de
la Légion d’honneur. He had received the title
of Chevalier in 2004 to highlight his work on the
development of new approaches for the
treatment and prevention of serious illnesses,
specifically for cancer, AIDS and Alzheimer’s
disease, work he performed at the same time
as he developed close links with several
research institutes in France, including the
Pasteur Institute.
National Assembly’s Medal
Dr. René Blais, an emergency medicine specialist
at the Quebec Poison Control Centre, was
awarded a medal by the National Assembly to
highlight his work with various health care partners
in order to update protocols in the case of mass
toxic incidents or wanton acts.
DID YOU KNOW... (SUITE)
Prizes and Awards (suite)
IMS Brogan Awards
The winners of the 2011 IMS Brogan awards were revealed
recently. These awards are given to physicians, pharmacists and
students in recognition of their contribution to the education of
their peers. Three medical specialists are among the winners
this year:
r. Francine M. Ducharme, a pediatrician at
D
the Sainte-Justine University Hospital Centre,
for her article “Written action plan in pediatric
emergency room improves asthma
prescribing, adherence, and control”.
Quite a Scene Around Organ
Donations
The staff at Montreal’s Sacré-Coeur hospital were treated
to quite a scene! In fact, Dr. Pierre Marsolais and Dr. Marc
Giasson, both internists-intensivists and Dr. Jean-François
Giguère, a neurosurgeon, wrote a screenplay to teach good
practices for organ and tissue donations and to destroy the
myths that still exist in the minds of clinical practitioners.
In addition, the three medical specialists took part in a
dramatic scene opposite Dr. Pierre Meilleur, played by
James Hyndman, for the television series Trauma.
r. Fadi Massoud (ex æquo), a geriatrician
D
at the CHUM Notre-Dame Hospital, for his
article “Switching cholinesterase inhibitors in
older adults with dementia”.
r. Christopher Labos (ex æquo), an internist
D
at the Montreal General Hospital, for his article
“Risk of bleeding associated with combined
use of selective serotonin reuptake inhibitors
and antiplatelet therapy following acute
myocardial infarction”.
Annual CMQ Awards
Photo : Danielle Giguère
he Collège des médecins du Québec
T
presented its 2012 Award of Excellence to
Dr. Louise Provencher, an oncological
surgeon at the Hôpital du Saint-Sacrement, to
highlight her commitment to women stricken
with breast cancer. This award is given to a
physician whose accomplishments have made
a difference in the life of patients, healthcare
professionals or students and who stands out
thanks to an outstanding contribution to the
development of the profession.
Photo : Danielle Giguère
r. Raynald Simard, an internist and
D
hematologist-oncologist at the Chicoutimi
CSSS, for his part, received the 2012
Humanitarian Award. This award is given to
members who, through social commitment,
embody the values of humanism that are
extolled by the Collège and whose actions
contribute to the well-being and
development of their patients, their
community or charitable organizations.
Opio en Provence,
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licence par LoyaltyOne, Inc. et Transat Distribution Canada Inc. Titulaire d’un permis du Québec.
DID YOU KNOW... (SUITE)
New Releases
Adolescentes anorexiques
(Anorexic Teenage Girls)
Questions d’éthique
(Ethical Questions)
r. Jean Wilkins, a pediatrician and specialist in
D
adolescent medicine at the Sainte-Justine
University Hospital Centre, has published
Adolescentes anorexiques : plaidoyer pour une
approche clinique humaine through the Presses
de l’Université de Montréal. Dr. Wilkins is the
founder of a specialized clinic dealing with eating
disorders and has been working with anorexic
teenage girls for more than 35 years. He is known
for his participative clinical approach, which is the
opposite of the conventional coercive treatment.
r. Michel Carrier, a cardiac surgeon, in
D
collaboration with Danielle Laudy, a research and
clinical ethicist, both working at the Montreal
Heart Institute, have published Questions
d’éthique via Éditions du CHU Sainte-Justine. The
authors deal with the ethics, confidentiality
and responsibilities surrounding research activities
and clinical trials for the development of
medical treatments.
Révolutionner les soins de santé : c’est possible !
(Revolutionizing Health Care: It’s Possible!)
r. Robert Ouellet, a radiologist, and Dr. Alban
D
Perrier, have collaborated with Jacques Beaulieu,
a biologist and scientific communicator, in writing
Révolutionner les soins de santé : c’est possible !
published by Éditions Trois-Pistoles. The authors
declare that action is urgently required: we need
to stop accepting the unacceptable and take
action. They show how other countries have
succeeded in changing their health care system
while adapting it to their needs.
Bébés illimités - La procréation assistée... et ses petits
(Babies Unlimited - Assisted Procreation... and its Kids)
nder the direction of Dr. Jean-François Chicoine,
U
a pediatrician, this journalistic essay written by
Dominique Forget and published by
Québec‑Amérique deals with the various forms
of assisted procreation: ovarian stimulation,
artificial insemination, in vitro fertilization, etc. In
addition to clarifying the subject through
numerous statistics and detailing applicable
regulations, this work presents the various points
of view of physicians who have taken part in
debates on the subject of assisted procreation.
Le cancer de la prostate
(Prostate Cancer)
3e ÉDITION
e cancer de La prostate
Le cancer de La prostate
YMPTÔMES - DIAGNOSTIC - TRAITEMENTS - RÉADAPTATION
Vous avez un cancer de la prostate. » Ces quelques mots,
n voudrait ne jamais avoir à les entendre. Pourtant, au Canada, un
omme sur sept risque de développer un cancer de la prostate.
s’agit du cancer le plus fréquemment diagnostiqué chez les
ommes et son incidence a augmenté de 30 % depuis 1988. Bien
u’il frappe le plus souvent après l’âge de 70 ans, il arrive qu’il
uche des hommes dans la quarantaine ou dans la cinquantaine.
À l’instar d’autres types de cancers, cette maladie affecte non
eulement le patient, mais aussi sa compagne et sa famille. Au
moment du diagnostic, bien des interrogations demandent à être
ssipées. Ce livre, qui est devenu au fil des ans et des éditions
uccessives un ouvrage de référence, fournit des explications
mples, concises et pratiques pour aider à mieux comprendre
maladie. Il représente une formidable source d’information sur
prévention et les causes du cancer de la prostate, sur le diagnostic
récoce, ainsi que sur les options de traitement qui s’offrent aux
atients, leurs effets secondaires et les complications auxquelles
les sont associées.
Le cancer
de La prostate
Docteur Fred Saad
Docteur Michael McCormack
d r Fred saad
Chef du service d’urologie,
Directeur de l’uro-oncologie,
Centre hospitalier de l’Université de Montréal (CHUM)
Professeur titulaire de chirurgie, Université de Montréal
d r Michael Mccormack
Urologue,
Centre hospitalier de l’Université de Montréal (CHUM)
Professeur agrégé de clinique au département de chirurgie,
Université de Montréal
ISBN 978-2-923830-03-2
CDN.LEU.12.02.01F
50097688
DID YOU KNOW
LE SPÉCIALISTE
IS ALSO AVAILABLE
IN ENGLISH ?
Dr. Fred Saad and Dr. Michael McCormack, both
urologists with the University of Montreal Hospital
Centre, have published Le cancer de la prostate.
The third edition of this best seller has been
completely revised and updated. Prostate cancer
touches 1 man in 7 and its incidence has grown
by 30% over the past 25 years. This book is a
complete source of information on prevention,
causes, diagnosis and available treatment options.
Read your copy directly at fmsq.org
Erratum
In the March issue’s cover story, on page 20, in the table entitled Detailed statistics on medical specialty membership, the lines for
radiology and radio-oncology were inverted for the year 2002. These lines should have read as follows:
Detailed statistics on medical specialty membership
2002
2012
Increase
Total MD
Women MD
% Women
Total MD
Women MD
% Women
Radiology
489
145
30%
565
202
36%
6%
Radio-oncology
56
23
41%
112
56
50%
9%
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DOSSIER
Respite for Caregivers
What do the Fédération des médecins spécialistes du
Québec and the hundreds of thousands of caregivers
in Quebec have in common? All of them recognize each
caregiver’s need for respite.
Physicians in all medical specialties, whether they are
surgical, medical, imaging or laboratory, treat patients
whose pathology or disability require that they receive
continuous care or services without necessarily having to
be in a long-term care facility. The caregiver thus becomes
an indispensable partner of the care receiver and the
support provided is not only extensive, but given every
day. Who exactly are these caregivers? They are most
often someone close, like a spouse, a parent, a friend, or
a neighbour.
Since disability is independent of age, the care receiver
can be a child affected by a physical handicap or
a serious intellectual deficiency that necessitates
continuous care; an adult stricken with a pathology
or a serious and prolonged deficit affecting his or her
mental or physical functions and whose effects are such
that the person’s ability to perform the normal tasks of
daily life is significantly reduced; or, finally, an elderly
person, considered autonomous, but needing support or
home care.
The FMSQ has listened to the artist Chloé Sainte-Marie’s
message concerning caregivers, the people who give so
much of themselves they end up totally forgetting their
own needs and only looking after their sick loved one.
Who looks after them when the burden is so heavy it
wears them out? Who worries about their distress? How
do we give them the respite they are so badly lacking?
Le Spécialiste, to mark the launching of the FMSQ
Foundation, tackles the subject of caregivers and the
respite they need. Paralleling the health network, their
world is one in which the Federation has decided to
get involved.
S
L
By Nicole Pelletier, APR
Director, Public Affairs and Communications
Some respite today... For life!
In Quebec (as elsewhere, probably), social needs are great and constantly increasing. But,
while we were almost ignorant of their existence, some needs quickly became acute… as
if they had flown under the radar for too long. We are all acquainted with one crying need...
that of caregivers, those who volunteer to take care of people close to them.
Who better than a physician, of any and all
specialties, can give witness to the ravages that ill
health can cause in the life of a stricken person, a
couple, or a family? Unfortunately, not all illnesses
can be cured; but, thanks to caregivers, patients can
count on the availability, attention and provision of the
care they need in their homes.
THE FMSQ WISHES TO
ACKNOWLEDGE THE
FACT THAT CAREGIVERS
ARE, IN SOME SENSE,
AN EXTENSION OF THE
HEALTH SYSTEM’S
PROFESSIONAL
RESOURCES AND THAT,
WITHOUT THEM, AN
IMPORTANT SLICE
OF SOCIETY WOULD
BE COMPLETELY
DEPRIVED, EVEN TO
THE POINT OF DESPAIR.
WHO BETTER THAN A PHYSICIAN, OF ANY AND ALL
SPECIALTIES, CAN GIVE WITNESS TO THE RAVAGES
THAT ILL HEALTH CAN CAUSE IN THE LIFE OF A
STRICKEN PERSON, A COUPLE, OR A FAMILY?
It is on this “hidden dedication” that
the FMSQ wanted to shine a light
by creating a foundation that would
contribute to the implementation,
maintenance or improvement of
respite resources for caregivers
in Quebec. And, since respite is
not just for the elderly, the FMSQ
Foundation will support respite
initiatives that address the needs
of various groups, whether they
are children or adults. The FMSQ
wishes to acknowledge the fact
that caregivers are, in some sense,
an extension of the health system’s
professional resources and that,
without them, an important slice
of society would be completely
deprived, even to the point
of despair.
To make a real difference “in the field” for respite organizations,
a substantial annual aid
budget had to exist,
from the very start.
DÉCOUVREZ
COMMENT
Delegates therefore decided that the Federation would make
VOS ASSURANCES
a donation to its Foundation
of $1 million per year drawn from
its regular operating POURRAIENT
budget.
ÉVOLUER
AU MÊME
Armed with these decisions,
the RYTHME
necessary formalities to
create the Foundation
were
undertaken.
The Fondation
QUE VOTRE STYLE
DE VIEde la
Fédération des médecins
spécialistes
du
Québec
thus came
ET VOS BESOINS.
to be and was recognized as a charitable organization under
the Income Tax Act. This status would allow the Foundation
to benefit from the advantages devolving to this type of
organization, including the possibility of receiving voluntary
donations from members and non-members of the FMSQ and
the fact that contributions would be eligible for tax credits for
charitable purposes.POUR EN SAVOIR PLUS :
1 800 361-5303
In order to ensure operating expenses are kept as low as
514
350-5070
/ 418 990-3946
possible, the FMSQ
will
make needed
human resources
and logistics available to its Foundation. FMSQ directorates
provide
support
Parwill
courriel
ou Internet
: and expertise
The implementation of the Foundation
as needed, in particular Legal Affairs
[email protected]
is the culmination of a full year during
and Administrative Services, while the
www.sogemec.qc.ca
DE LA FÉDÉRATION
w h i c h w e e x p l o re d , e v a l u a t e d ,
Public Affairs and Communications
DES MÉDECINS SPÉCIALISTES DU QUÉBEC
designed and prepared the project.
directorate will coordinate activities
The Delegates’ Assembly, representing
associated with the Foundation.
the medical associations affiliated
In addition, contributions will be
with the FMSQ and as its highest decision-making body,
entrusted to the Professionals’ Financial under a policy of
unanimously voted for the creation of the FMSQ Foundation
safe investments.
whose aim would be of financially supporting various respite
The Foundation’s creation by the FMSQ is the material
initiatives in Quebec. As there are many charities, there are also
expression of the slogan “Helping Others”, especially when one
many community organizations, for the most part, counting
realizes that more than one million Quebeckers are caregivers!
on government financing even though there is evidently never
enough money.
FONDATION
SOGEMEC ASSURANCES
filiale de la
Respite for
Caregivers
Official Launch of the Foundation
From initial idea to concrete reality, close to one year went by. In fact, after its application to
regulatory authorities, federal as well as provincial, collating various details, and evaluating
the situation in Quebec, the FMSQ Foundation was finally ready to take off.
As principal source of funds, the FMSQ is the sole member of
the Foundation and its board of directors assumes the same role
for the Foundation. The first official meeting of the Foundation
was held on April 17th; during the meeting, the directors
adopted the documents, as a whole, relating to the Foundation’s
implementation (by-laws, charter, internal operating manual, etc.).
The Foundation’s activities were officially launched during a press
conference held on April 23rd last. For this occasion, Dr. Barrette
was accompanied by Mrs. Veerle Beljaars, General Manager of
The Brome-Missisquoi Caregivers Support Group (RSABM) and
by the artist Chloé Sainte-Marie, spokesperson for the Group
and representative of caregivers in Quebec, who in addition was
herself caregiver for her spouse, the filmmaker Gilles Carle.
A First Donation
The Brome-Missisquoi Caregivers Support Group is the first
respite organization to receive a financial contribution from the
Foundation. In order to complete the renovations of the new
Maison Gilles-Carle, located in Cowansville, and thus be able
to welcome its first beneficiaries, the Foundation donated the
sum of $100,000. Adapted to lodging four semi-autonomous or
autonomous guests, this respite home offers care receivers the
possibility of staying for a short period, between 2 and 14 days.
Maison Gilles-Carle finally sees the light
of day!
The official inauguration of Maison Gilles-Carle took
place on Wednesday, May 16th in Cowansville. The
FMSQ was present at this event since the donation
made by its Foundation allowed the project to be
completed. The money
served, among others things,
to install an essential piece
of equipment for the type of
clients expected: an elevator.
Care receivers will find it easier
to go from their rooms on the
ground floor to the multi-use
room in the home’s basement.
From the Regroupement Soutien aux Aidants de Brome-Missisquoi: Mr. Richard
Leclerc, Director; Mrs. Sylvie Carreau, Chairman of the Board; Mrs. Veerle
Beljaars, General Manager; and Mrs. Chloé Sainte-Marie, representing Quebec’s
caregivers beside Dr. Gaétan Barrette.
Complete details concerning the Foundation are available
on the FMSQ website (fmsq.org/fondation).
From left to right: Mr. Arthur Fauteux, Mayor of Cowansville; Mr. Bruno
Petrucci, Director General of La Pommeraie CSSS; Dr. Gaétan Barrette;
Mrs. Hélène Sactouris, Director of Communications and Associative Affairs,
Caisse populaire Desjardins Brome-Missisquoi; Mrs. Chloé Sainte-Marie;
Mr. Daniel Bélanger, Maisons Horizon, builder of the home; and Mrs. Veerle
Beljaars, General Manager of the RSABM.
Serious commitment,
strict criteria
The FMSQ Foundation is committing itself to helping caregivers, in particular by supporting
respite initiatives. These initiatives can be associated with specific locations or with isolated
or recurring actions designed to support care receivers with the underlying aim of providing
moments of respite to their caregivers.
What the Foundation Wishes to Support
The Foundation wishes to contribute to providing respite to those
who dedicate their time, energy and love to care for someone
close who is no longer autonomous. Without periods of respite,
these caregivers also end up destroying their health, physical as
well as psychological.
Two types of respite are being considered: initiatives associated
with infrastructure projects and those linked to activities for
people.
ONLY THOSE APPLICATIONS SUBMITTED
BY A NON GOVERNMENTAL NOT-FOR-PROFIT
ORGANIZATION (NPO), RECOGNIZED AS SUCH
WITHIN THE STRICT MEANING OF THE INCOME
TAX ACT, WITH A HEAD OFFICE IN QUEBEC,
WILL BE ACCEPTED. PROJECTS WILL ALSO
NEED TO BE LOCATED ENTIRELY IN QUEBEC.
On the one hand, the FMSQ Foundation will accept applications
dealing with building, expansion, and renovation projects or with
purchasing real estate, furniture, specialized equipment and
vehicles. On the other hand, the Foundation will also consider
requests for respite services (short-term lodging, activities or
companionship), paratransit and specialized human resources.
Only those applications submitted by a non governmental notfor-profit organization (NPO), recognized as such within the strict
meaning of the Income Tax Act, with a head office in Quebec,
will be accepted. Projects will also need to be located entirely
in Quebec.
What the Foundation will not Support
To start with, the Foundation will not accept applications for
financial support for projects aimed at constituting a working
capital (except in specific circumstances), a reserve or a
contingency fund; reimbursing existing mortgages or loan
guarantees; paying insurance premiums, taxes, rent, current
administrative salaries, and current general expenses, or
purchasing equipment and office supplies; paying for promotional
activities or documents; or organizing, or participating in, a
symposium or conference. The Foundation will also refuse to
contribute to financial campaigns or to fundraising.
Allocation Procedures
Eligible entities wishing to apply for support from the Foundation
will need to complete an application form. Each request will be
analyzed and all files will then be submitted to the Foundation’s
board of directors for a final decision.
Support announcements will be made a few times during the
year, in particular during the first week of November, during the
activities surrounding Caregivers’ Week.
Respite for
Caregivers
By Patricia Kéroack
Being a Caregiver in Quebec
Why, and since when, does our health care system need the contribution of “non professional”
caregivers to dispense care to individuals whose autonomy is no longer assured? What
resources are currently available to help support the work of caregivers? What is the role
of caregivers?
We have all read or heard of hospices that used to be managed
in the past, in the majority of cases, by religious communities.
Anyone who was sick or hospitalized was taken charge of
unquestioningly: from the tubercular to the depressed, from the
physically handicapped to the “mental cases”.
Over the last 40 years, with the evolution of society and
science, major changes have been made in the organization
of the health care system. Some former methods of care
have been discredited, abolished or cast into doubt. Care and
services have been adapted to support the move towards
de-institutionalization. Hospitals have shifted to ambulatory
care and concentrated on offering shortterm specialized services. And the notion
of home support services made its
appearance as the vocation of all institutions
sheltering non autonomous persons was
being overhauled.
Even if anyone can be called upon to take care of a needy relative
or friend, at present the majority of caregivers are women and
their unrecognized status is often precarious.
Statistics regarding caregivers are incomplete. A clear portrait
of the situation is difficult to draw and attempting to account
for their work with certainty is even more difficult. When is the
spouse of an elderly person stricken with a degenerative disease
officially recognized as a caregiver? Is it when he or she applies
for the appropriate status in order to benefit from tax provisions?
Is it when the physician provides a diagnosis? Or is it when the
patient is taken charge of by the CSSS or the CLSC?
But who would take care of all those who,
in the past, were sheltered by religious
communities or by the state? Little by little,
the task fell to those who were the closest:
relatives, friends or neighbours. They are
the ones who, over the years, became the
caregivers, the people providing care from
day to day.
To help these caregivers, the health care
system planned to make available a series
of resources. The local community service
centre (CLSC) was to be the single access
point for people needing help.
The Situation of Caregivers
in Quebec
According to the Regroupement des aidants naturels du Québec
(RANQ), “caregivers” are individuals who, without compensation,
regularly care for a needy relative or friend.
“Caregivers play a front-line role in the health care network, as
much in Quebec as elsewhere in Canada: 80% of care given
at home is dispensed by caregivers. They are the pillars of
home care.”1
The RANQ currently estimates that one person in seven is a
caregiver and that the majority are women. The tasks performed
by caregivers vary according to the needs of the care receiver.
In general terms, caregivers provide a minimum of five hours
per week (mainly in aid given to the elderly). This figure varies
according to the type of support or care given. The RANQ also
estimates that one half of women, between the ages of 35 and
64, can expect to be called upon to care for an elderly parent.
The average age of care giving women is 46, while that of care
giving men is 44.
Avis d’élection
Les membres du
Collège des médecins
du Québec sont
priés de noter
qu’il y aura,
le mercredi
3 octobre 2012,
élection des administrateurs
des régions électorales suivantes :
Bas-Saint-Laurent et
Gaspésie-Îles-de-la-Madeleine
un administrateur
Chaudière-Appalaches
un administrateur
Estrie
un administrateur
Lanaudière et Laurentides
un administrateur
Mauricie-Centre-du-Québec
un administrateur
Montérégie
un administrateur
Outaouais et Abitibi-Témiscamingue
un administrateur
Québec
deux administrateurs
Saguenay-Lac-Saint-Jean,
Côte-Nord et Nord-du-Québec
un administrateur
Seuls peuvent être candidats les membres du Collège qui sont
inscrits au tableau de l’ordre au moins quarante-cinq (45) jours
avant la date fixée pour la clôture du scrutin. Seuls peuvent être
candidats dans une région donnée les membres du Collège qui
y ont leur domicile professionnel.
Les candidats doivent être proposés par un bulletin signé par
le candidat et par au moins cinq (5) membres du Collège ayant
leur domicile professionnel dans la région électorale dans
laquelle le candidat se présente.
Les bulletins de présentation doivent parvenir au secrétaire
adjoint au plus tard le jeudi 30 août 2012 à 16 h.
Seules peuvent voter les personnes qui étaient membres
du Collège quarante-cinq (45) jours avant la date fixée pour
la clôture du scrutin. La date et l’heure de clôture du scrutin
sont le mercredi 3 octobre 2012 à 16 h.
Pour obtenir des bulletins de présentation, vous pouvez
consulter le site Web du Collège des médecins du Québec
(www.cmq.org) ou vous adresser à :
Me Christian Gauvin
Secrétaire adjoint
Collège des médecins du Québec
2170, boulevard René-Lévesque Ouest
Montréal (Québec) H3H 2t8
Respite for
Caregivers
Fragile Resources
Studies have shown that psychological distress is up to 25%
higher in caregivers that in the general population. When care
receivers have physical problems, between 20% and 30% of
caregivers are depressed. This rate climbs to 40% when care
receivers suffer from severe dementia. Helping an elderly spouse
increases the risk of death by 60% for the caregiver2.
Among the causes of distress in caregivers, we include
increases in tasks, isolation, exhaustion, guilt and financial strain.
Caregivers see substantial increases in their tasks. Decisions and
responsibilities that used to devolve to care receivers are now
the burden of caregivers. If caregivers are not ready to assume
these new responsibilities, they will become an additional source
of stress that will be unavoidable. Can caregivers, on their own,
reconcile what their lives were like before, with the reality they are
faced with now?
Isolation is a fact of life for caregivers as well as for their own circle.
Caregivers, knowing their role and their responsibilities, do not
want to become a burden or a source of stress for other people.
On the other hand, knowing that caregivers have a lot to do for
their care receivers, family and friends prefer not to disturb the
caregivers and wait for a signal.
Exhaustion is a commonly encountered problem for caregivers,
but few of them recognize its effects before it’s too late. In addition
to daily occupations and responsibilities, caregivers must manage
meals, medication, health, hygiene, as well as leisure, education
and other activities for care receivers. Thus, caregivers need to
plan, foresee, decide and live for two people at the same time.
And if something goes wrong, caregivers take responsibility. It’s
generally when there is such a crisis that caregivers seek respite.
Yet, there are signs to let people know that caregivers are on the
verge of breaking down: fatigue, irritability, impatience, sadness,
anger, loss of appetite or sleeplessness, difficulty concentrating,
frequent forgetfulness, etc.
Caregivers, burdened with responsibilities, often have the
impression they aren’t up to the expectations of care receivers,
or their families. This guilt is a common denominator among
most caregivers. They feel guilty because they hadn’t done or
said something when their care receiver was still healthy, because
they’d had thoughts of placing their care receiver in a specialized
centre, because they’d taken some time to think of themselves,
because they failed in their duty or because they’d had to ask for
outside help, etc. There are many other factors that can make
caregivers feel guilty and, if they don’t request the help they need,
they get to the point where they start having emotional problems
themselves, problems that may need professional intervention.
CAREGIVERS, BURDENED WITH RESPONSIBILITIES,
OFTEN HAVE THE IMPRESSION THEY AREN’T UP
TO THE EXPECTATIONS OF CARE RECEIVERS,
OR THEIR FAMILIES. THIS GUILT IS A COMMON
DENOMINATOR AMONG MOST CAREGIVERS.
Not all caregivers have the needed financial resources to take
care of a person without having to work. If, on average, caregivers
spend some twenty hours a week with their care receiver, they
cannot hope to maintain their regular economic activities. Very
quickly, caregivers find themselves in a situation of economic
precariousness, many having had to leave their jobs or no longer
having access to the same revenues. There is no remuneration of
any kind for caregivers... not to mention the costs incurred by taking
charge of a person such as structural modifications or adaptations
to the home, the purchase of specialized equipment, etc.
Being a caregiver is not an easy task in and of itself; the multitude
of responsibilities can incapacitate a person who is not prepared
for it or who does not have adequate resources to take on
this function.
Should we say “aidant naturel” (informal caregiver) or “proche aidant” (family caregiver)?
In French, the term “proche aidant” (translated by the MSSS as “informal and family caregiver”) is used by the department
of health and social services in Quebec in its policy on support for home care entitled “Home is the option of choice”
(© MSSS, 2003 – text in French only). However, several community groups and organizations use the term “aidant
naturel” (informal caregiver) instead, thus recalling the informal link between the caregiver and the care receiver. In recent
years, the terms “aidante naturelle” or “aidant naturel” have been used for most of the research on the subject. The two
terms have convergent meanings and are now used indiscriminately. The FMSQ Foundation has chosen to use the term
“aidant naturel”, as suggested by participants active in this field. [Note from translators: In Canadian English, the single word
“caregiver” is used to encompass both informal and family caregivers.]
Informal caregiver or family caregiver, the reality is the same. The caregiver is the non professional person who takes care
of, and provides substantial support to, a disabled member of his or her extended family, whose health is fragile or who
cannot meet his or her personal needs to ensure survival. Some caregivers take care of an elderly parent or a sick spouse;
others are also parents whose role is made more difficult by the health of their child (physical or mental handicap, etc.).
Few Resources Available in Reality
Free support resources for caregivers are rare. In a context
where there are few organized resources, caregivers must
first off depend on their circle of relatives and friends, then
on professionals from the health care network, community
resources, self-help groups, etc. Caregivers may need
emotional, material, organizational or social help and would be
well advised to quickly inventory the various resources available,
if only in case of need. When caregivers are accepted by the
community service centre, they can get some services. If their
financial resources allow it, caregivers can get help in the form
of domestic help, meal preparation, companionship services,
nursing care, etc. Insofar as financial aid is concerned, there
are a few rare programs for caregivers in the form of tax credits,
targeted grants and compassionate care benefits.
Tax Credits and Compassionate Care Support
In Quebec, there is a tax credit for caregivers and a tax credit
for caregiver respite.
The tax credit for caregivers who take care of their elderly
spouses who cannot live on their own can reach $591. For those
who house an eligible person or those who live with someone
who cannot live alone, the amount can reach $1,075.
These latter two situations are included in the government of
Quebec’s 2011-2012 budget. In the budget speech, there is a
mention that with population aging, the contribution of caregivers
will gain in importance. The budget provides for an extension of
the refundable tax credit to caregivers with a spouse aged 70 or
more and suffering from a physical or mental disability as well
as to caregivers living in the same home as the care receiver.
According to the government, this increase has benefited
more than 17,000 caregivers, and itself represents more than
$11.5 million in 2011.
A tax credit for respite for a caregiver is also available. The
maximum tax credit is $1,560 per year. The credit is equal to
30% of the total expenses you paid in the year (to a maximum
of $5,200 in expenses) for specialized respite services for the
care and supervision of a person.
On the federal side, a tax credit that can reach $4,282 is
available for caregivers of dependent persons aged 18 or more.
The government of Canada also offers compassionate care
support benefits which are Employment Insurance benefits paid
to people who have to be away from work temporarily to provide
care or support to a family member who is gravely ill and who
has a significant risk of death within 26 weeks (six months). A
maximum of six weeks of compassionate care benefits may be
paid to eligible people. They can be taken by one person or
more, but cannot exceed a maximum of six weeks of benefits.
Like unemployment benefits, one must plan for a qualifying
period before receiving the initial payment.
Caregivers and the Health Care Network
In 2003, the Minister of health and social services published
the French-only document entitled Chez soi : le premier choix
(Home is the option of choice), its new home care support policy.
Clarifications to this ministerial policy were made in 2004 to go
along with and encourage the implementation of the home care
support policy.
The policy says that (unofficial translation) home care support is
not a new area (…), but a new way of responding to needs that
is more efficient, better adapted to today’s reality. From its first
pages, caregivers have a recognized status: “Caregivers need
support to fulfill their role. A series of services and measures
aimed at supporting caregivers must gradually be implemented
in each region to respond to their specific needs.”4
Respite for
Caregivers
This policy recognizes that home care services are better
adapted to today’s reality. Thus, the policy says that “home
care support is based on a variety of means...” that specifically
include “services for caregivers (respite, emergency respite,
etc.)…”5 Based on a reading of this policy, we could come
to the conclusion that respite services are already in place,
organized and integrated within the continuum of care services
offered to the population.
In November 2009, following regional consultations undertaken
by the Minister responsible for Seniors, Marguerite Blais, the
government announced the creation of a $200 million fund
(over a period of 10 years) in cooperation with the Fondation
Chagnon aimed at supporting caregivers in Quebec. The
government then promised to invest the sum of $150 million,
while the balance of $50 million would come from Sojecci II ltée,
a corporation created for this purpose by the Chagnon family.
The government states in its communications that the money is
designated to support those persons who contribute, without
compensation, to caring for relatives stricken with a serious
or persistent disability that could compromise their ability to
remain at home. The funds are supposed to support caregivers
of people 65 or older and will be administered by an Appui
régional, one of the support hubs for caregivers.
What is an Appui régional?
The regional caregiver support hubs (13 in all) are groupings
of organizations from the community, health and association
sectors as well as representatives of the caregivers in each
area. This grouping of regional stakeholders is seeing to the
development of the best possible practices in order to supply
caregivers of the elderly with diversified services adapted to
their needs (information, training, psychological support and
respite services).6 The hubs do not offer any direct respite
services.
Appui hubs are currently being organized and implemented.
The Director General of the provincial organization is Dr. Michel
Boivin, a gastro-enterologist. The regional management
positions have just been filled. Projects and activities supported
by this new parapublic structure and aimed at senior citizens
will be identified later.
The Appui for caregivers launched its Internet portal on
Monday, May 14th. This information portal lists resources as
well as general information for caregivers of the elderly. Needs
and services can differ greatly from one region to another; the
portal provides the means to supply this information as well as
report on regional news.
Respite Services
A f t e r re s e a rc h b y t h e F M S Q ’s P u b l i c A ff a i r s a n d
Communications team, a directory of resources has been
compiled in order to measure the extent of services offered to
caregivers. To do so, all available documentation was dissected,
while compiling the information acquired by contacting the
various groups dedicated to caregivers, analyzing ministerial
credits relating to the Department’s Community organization
support program (PSOC) and, occasionally, speaking with other
grant-giving entities. More than 175 organizations and respite
homes offering respite services have thus been inventoried.
After analysis, each of these has been classified according
to the type of services they offer to caregivers and to the
administrative region involved. For example:
• respite homes or dedicated respite centres
(with lodging);
• o
rganizations offering out-of-home respite
(with lodging or activities);
• o
rganizations offering in-home respite services
(such as companionship);
• o
rganizations offering both out-of-home and
in‑home respite;
• referral agencies;
• ongoing projects.
This impressive directory will be kept up to date as new data
becomes available.
A discussion with representatives of various respite organizations
allowed us to understand the hardships one meets in the field.
The lack of financial means has been identified as the major
factor hindering the completion of respite projects proposed
by the organizations. In addition, resources differ markedly
from one region to another: some regions are well-endowed
with resources, others unfortunately have nothing at all. In
a few regions, it is surprising to see a substantial number of
organizations dedicated to a particular health problem such
as Alzheimer’s disease and pervasive developmental disorder.
An overall view of the situation is difficult: even the resources
themselves seem to have only fragmented knowledge of how
services are organized in general in their territory or even... of
their own clientele!
Different Types of Respite
Respite Homes
In Quebec, there are a few homes offering a service that takes
complete charge of a care receiver in order to allow the caregiver
to recuperate. With stays normally lasting no more than a few
days, these homes also offer professional services such as
occupational therapy, supervision, professional educators, etc.
Respite Activities
Generally dispensed during the day, respite activities include
services such as vacation day camps, companionship services,
drop-in centres, emergency respite, home supervision, etc.
In drop-in centres, caregivers can leave their care receivers in
the morning and return for them in the evening. In the meantime,
care receivers are given attention as dictated by their needs. In
the case of in-home supervision, a person replaces the caregiver
for a few hours, thus allowing the caregiver to do something else
or just to run errands.
Support Services
Quite a few organizations offer support services like active
listening, coffee-meetings, meeting places, and community
information. These organizations do not provide direct respite
services, but can play the role of referral agency between
caregivers and formal resources.
References
1 www.ranq.qc.ca
4 Id. p. 6
2 w
ww.lebelage.ca/aidants_naturels_
prenez_soin_de_vous.php
5 Ibid. p. 8
6 www.aidantsdesaines.org
3 Chez soi : le premier choix, La
politique de soutien à domicile,
MSSS, 2003, p. 1
Le Québec accueille les spécialistes de la lutte contre
le cancer de plus de 100 pays, qui se réuniront pour
la première fois à Montréal à l’occasion du Congrès
mondial contre le cancer 2012 de l’UICC.
Pour plus de détails et pour s’inscrire, veuillez consulter le :
www.worldcancercongress.org
Suivez-nous sur twitter: @WCC2012
ORGANISMES
HÔTES
Du 27 au 30 août 2012
MONTRÉAL, CANADA
Respite for
Caregivers
Interviews and Text by Patricia Kéroack
A Caregiver Speaks
The FMSQ Foundation has donated an initial amount of $100,000 to the Maison Gilles-Carle,
recently built in Cowansville. This project, originally carried by the singer and artist Chloé
Sainte-Marie, became a reality under the auspices of The Brome-Missisquoi Caregivers
Support Group.
W h e n i t ’s a q u e s t i o n o f
caregivers, Chloé Sainte-Marie
knows better than most what
she is talking about, since
she took care of her spouse,
the filmmaker Gilles Carle,
throughout his illness. During
recent years, she has taken part
in all possible forums to talk
about the multitude of problems
experienced by caregivers in
Quebec and to clamour, loud
and clear, for more support and
respite services. Le Spécialiste
met with her.
“We, both of us, felt rage and anger:
Gilles, because he could see himself
going, and I, because I didn’t have
the capacity to help him come back
to what he was. And, because I
didn’t have the resources to help
myself, I was afraid I would have to
institutionalize him. So, I scraped
up my courage, awakened public
opinion, and begged everywhere
for the financial resources I needed
to keep him at home. Gilles “cost”
no less than $10,000 per month in
specialized resources over the last
10 years.
“I hammered out that Gilles was a part of our heritage and
I went to see every possible department (Health, Culture,
Revenue, Heritage, etc.) to ask for help. It was a hard
fight. But, slowly, my first battles brought me to battles
for caregivers.”
S Over the 28 years of living with your spouse, how
L
long was he ill with Parkinson’s disease?
CSM “17
years! Long years... and yet, looking back today, the
years seem short.”
S L
What was most difficult during those years?
CSM “What
Gilles and I found most difficult was to see him
gradually losing his abilities. You feel powerless before
the ravages of this illness. You are a witness to what is
happening but there is nothing you can do. Gilles used to
speak of his ‘decomposition’; that’s what he wrote and
how he described it in his song To be or not to be la vie:
L’arme sur la tempe, la tête sur l’oreiller, l’âme au plancher,
je me décompose lentement, lentement je me fuis, To be
or not to be la vie. (To be or not to be la vie. A gun to my
head. My head on the pillow. My soul to the floor. I’m
slowly decomposing. I’m slowly escaping from myself. To
be or not to be... life).
“Gilles saw himself, slowly, losing his autonomy. I mean
passively, since there is nothing active here! It started
slowly with simple things: he couldn’t tie his shoelaces
any longer, put on his socks or his shoes, bring a spoon
or fork to his mouth, until he was completely paralysed.
S Why are the financial resources needed by
L
caregivers so limited?
“I believe
CSM that the government hasn’t yet understood the
role and importance of caregivers, nor to what extent they
are a current of fresh air for our health care system. Some
individuals have understood, but they are still too few.”
S When do people know they are caregivers?
L
“You
CSM feel it clearly when you understand you have become
indispensable: when your care receivers can no longer
get up or eat on their own, when you need someone to
watch them or when they can no longer look after their
basic needs. As caregivers, you feel as if you’re caught in
a stranglehold that is getting tighter and from which you
can’t escape... as if you’re in a tunnel with no light to show
the end of it.”
L
“Even if Gilles has left us, I’m
going to carry on helping.
I firmly believe than we
become caregivers for life,
even if our own care receiver
is no longer there. Often, it’s
because we’re overwhelmed
by a feeling of guilt: we can’t
take care of everything and
when that happens, we feel it
for the rest of our lives.”
S What should be done for caregivers?
“The
CSM only escape for caregivers is to use a respite
home: a place where a care receiver can be taken
in for a short period in order for the caregiver to
recuperate. We also need to recognize the work of
caregivers in Quebec by making more resources of
all kinds available.”
L
S What do we not know about the work of
caregivers?
CSM (Chuckles)
“That it’s constant work, almost slavery. You
have to be there all the time. As well, the work you do is
always in the dark.”
L
S What are your plans for the future?
“I want
CSM to carry on with the Maisons Gilles-Carle project.
If other homes of this kind can be set up to support
caregivers, then thank God. They don’t have to carry
Gilles’ name. We just need to have more resources to
provide respite.
S When you’re a caregiver, are you allowed to fall?
L
“When
CSM you’re a caregiver, you often think you’re a superhero. You’re in the middle of the action and you can’t see
yourself going. Frequently, it’s other people who talk to you
about it and who ring the alarm bell. Unfortunately, it’s often
too late and you do fall.
“Today, two years after Gilles’ death, I’m becoming aware
that I’m falling. It’s only now that I realize that Gilles is
really gone. I’m just starting to grieve and it’s hard. I miss
Gilles terribly.”
LE SPÉCIALISTE
Médicaments d’exception non codifiés
DEMANDER UNE AUTORISATION :
UNE OPÉRATION FACILE !
Connaissez-vous les formulaires spécifiques ?
Plus de 90 médicaments ont leur propre formulaire, ce qui :
• simplifie le remplissage;
• permet d’avoir une demande complète en quelques minutes;
• fait gagner du temps au médecin, au patient et à la Régie.
Ils sont toujours à jour
dans le site Internet.
Vous trouverez ces formulaires à la rubrique
« Médicaments d’exception et Patient d’exception »
dans la section « Professionnels » au
www.ramq.gouv.qc.ca
GREAT NAMES IN QUEBEC MEDICINE
By Patricia Kéroack
Quebec-Changchun
As a young student at the Collège Notre-Dame-de-l’Assomption,
Jean Deslauriers discovered in himself a passion for science.
At that time, those who continued their studies were destined
to become priests, lawyers, teachers or... physicians. With his
medical diploma from Laval University, he pursued a specialization
in thoracic surgery at the University of Toronto before returning to
Laval Hospital where a position awaited him once his fellowship
was completed. He worked there during his entire career, except
for the year he spent in China on sabbatical.
For a number of years, in addition to his clinical duties,
Dr. Deslauriers, an expert in airway surgery, has been busy
training future medical specialists. In particular, he took part in
the restructuring of thoracic surgery post-doctoral training and in
the writing of several specialized books, including the renowned
“Pearson’s Thoracic and Esophageal Surgery”, which is considered
the reference in the field. “Mastering the various scientific methods
is essential in my view and I concentrate on turning my fellows
into experts on the subject. We implicate them in projects, they
publish and become better doctors,” says Dr. Deslauriers. Today,
Dr. Deslauriers’ activities are known beyond Quebec’s borders;
residents and clinical fellows come from everywhere to learn from
him and he is often solicited from abroad to give conferences,
workshops and other postdoctoral courses.
But where does this international reputation come from? In 1986,
a Chinese researcher working at the CHUL asked Dr. Deslauriers
to take her husband, who was a thoracic surgeon in China, as
a research assistant. Dr. Deslauriers accepted, but had to find
the needed financial resources. This assistant, thrilled by his
experience, then worked on developing an exchange program
between Laval University and China. The project, with a grant from
CIDA, lasted from 1988 to 2000 and Dr. Deslauriers travelled there
a few times to give conferences, for visits, etc.
In 2008, Jilin University invited him to spend a year in China as
an international advisor. Along with his wife, a nurse specialized
in oncological research, he spent a full year in Changchun, an
industrial city of 7 million inhabitants (as populous as the province
of Quebec), in the heart of the People’s Republic of China, founded
by Mao in 1949.
Industrialization, pollution and cigarettes result in a high prevalence
of breathing disorders in China. Dr. Deslauriers developed a
respiratory disease centre with a structured program of teaching
and research. Today, anti-smoking campaigns have borne fruit,
but cancer is still very present. “Despite all the criticism of the
regime, Mao had created a free, universal health care system
and the life expectancy of Chinese citizens rose from 40 to more
than 70 years. In China, the health care system is a model of
efficiency. The hospital in Changchun has six operating theatres
just for thoracic surgery. In Quebec, the Laval University Institute
of Cardiology and Pulmonology has only one per day. In China,
operating theatres are delivered as complete, pre-assembled kits
and are operational as soon as they are delivered. Here? It’s very
different,” says Dr. Deslauriers.
If Dr. Deslauriers’ expertise was important for the development of
thoracic surgery in China, he remains convinced that Quebec can
also benefit from it. He thus presented a review of how thoracic
surgery is done to the MSSS with a proposal, among others, that
some hospitals become centres of excellence. “Thoracic surgery
would be concentrated in a few centres throughout Quebec.
This way, we could be more efficient, patients would benefit from
better treatments even if these services were dispensed far from
their homes.” Dr. Deslauriers is of the opinion that regionalizing
highly specialized services would substantially reduce the costs
of health care; patients would have faster access and a dedicated
team of specialists. According to him, studies have proven that
such methods have reduced complications and surgical mortality,
increased long-term survival, reduced waiting lists, and involved
lower costs for the system. “Rather than equipping a secondary
centre with all the needed devices for a few surgeries, budgets
could be concentrated and centres of expertise properly equipped
with cutting-edge tools.”
Dr. Jean Deslauriers
Thoracic Surgeon
Today, Dr. Deslauriers still carries on his activities outside Quebec.
On occasion, he returns to China for specific missions. Laval
University has since set up exchange programs with the best
universities in China (Beijing, Shanghai, etc.) and Dr. Deslauriers
often accompanies university mission members. At the age of 67,
Dr. Deslauriers would like to see others taking up the challenge:
he no longer wishes to carry on full tilt, seven days a week, as he
used to. Proud of his accomplishments, he also sees everything
that remains to be done.
Dr. Deslauriers reminds us that lung cancer, which is highly
prevalent here, kills twice as many women as breast cancer and
close to 4.5 times as many men as prostate cancer. “One day, a
molecule or a treatment will be found and we will defeat it. In the
past, we operated for tuberculosis; when streptomycin became
available, everything changed.” Even though he is convinced that
cancer will be beaten one day, no one can predict when or how.
Molecule, vaccine, treatment, everything is possible. Dr. Deslauriers
likes to say that science has seen some real advances in recent
years and that this is not the end. Laval University presented him
with the 2010 Teaching Career Award and, on November 3, 2011,
he was appointed Member of the Order of Canada.
S
L
IN THE WORLD OF MEDICINE
By Lorraine LeGrand-Westfall, MD
DIRECTOR, REGIONAL AFFAIRS, CMPA
Medico-Legal Risks
What Medical Specialists Want to Know
Soins aux patients
Rapports médicaux Gestion pour de lda es Protection pratique tiers et dpes roblèmes renseignements intrahospitaliers
personnels, confidentialité et consentement
Soins ppatients
Rapports médicaux édicaux Gestion d
dProtection a Protection ptiers
ratique tiers e12%
t roblèmes dpes renseignements intrahospitaliers
Soins aaux ux Rapports 20%
m
Gestion pp
our dour e e lda les pes ratique t depes rroblèmes enseignements intrahospitaliers
38%
17%
38%
20%
17%
12%
38%
20%
17%
12%
Soins aux patients
Rapports médicaux Gestion pour de lda es Protection pratique tiers et dpes roblèmes renseignements intrahospitaliers
38%
20%
17%
12%
Quebec medical specialists
regularly
getpour inProtection touch
withintrahospitaliers
thepersonnels, Canadian
Medical Protective
Soins aux patients
Rapports médicaux Gestion de lda es pratique tiers et dpes roblèmes renseignements confidentialité et consentement
38%
17%
12%
Association (CMPA) for advice
on20% various
medico-legal
questions resulting from the
practice of medicine. They turn to the CMPA because they recognize the reliability of the
information it provides to physicians.
The Association can, indeed,
lend its assistance in the case of
civil legal actions or complaints
lodged with the Collège des
médecins du Québec, but this
is not the limit of its assistance.
The CMPA can provide advice
on, among other subjects, the
medico-legal aspect, including
hospital privileges; billing audits;
coroners’ inquests; human rights
complaints; and, in certain cases,
general contracts associated with
the practice of medicine.
Over recent years, the CMPA
has received an unprecedented
number of calls from members
regarding medico-legal questions.
The illustration lists the various
types of calls received by
the CMPA from specialists in
Quebec. These specialists also
wanted more information on the
obligations and professional duties
deriving from an established
doctor-patient relationship,
Soins
aux
patients
Soins aux patients
on the assistance provided
Soins aux
Soins
auxpatients
patients
P
atient aux
caremédicaux
38%
b y t h e C M PA , o n re l a t i o n s
Soins
patients pour des tiers
Rapports
Rapports médicaux pour des tiers
Rapports
médicaux
pour
des tiers
between colleagues (including
M
edical reports
for third
parties
Rapports
médicaux
pour
des tiers 20%
At the CMPA, medical officers are
Rapportsdemédicaux
pour
des tiers intrahospitaliers misconduct and defamation) as
Gestion
la pratique
et problèmes
M
anagingde
a practice
– in-hospital
issues
17%
Gestion
de
pratique
et problèmes
intrahospitaliers
Gestion
lalapratique
et problèmes
intrahospitaliers
the ones who listen to members
well as on questions concerning
Gestion
de
la
pratique
et
problèmes
intrahospitaliers
P
rotectingde
personal
information
–
and who provide answers on
12%
Gestion
la pratique
et problèmes
intrahospitaliers
Protection
des
renseignements
personnels,
confidentialité
new therapies.
Protection des
renseignements
personnels,
confidentialité
confidentiality
– consent
Protection
des
renseignements
personnels,
confidentialité
medico-legal questions. Everyone
et
consentement
et
consentement
Protection
desrenseignements
renseignements
personnels,
confidentialité
et
consentement
knows that medical and health
The advice most in demand
Protection
des
personnels,
confidentialité
et consentement
consentement
et
care is extremely complicated
concerns patient care. Questions
today and evolves rapidly; that is
deal with the medical treatment,
why medical specialists look for reliable medico-legal advice
the patient, the family or other healthcare professionals, as
and information that is readily available. For example, advice on
well as with other subjects such as establishing diagnoses
questions involving a more rigorous examination of the issues
and medication.
relating to protecting personal information and confidentiality
Here are a few concrete examples of calls received from
in regulatory organizations (Colleges), privacy protection
medical specialists:
committees and human rights tribunals. In fact, such advice
has become essential to physicians so that they can manage
• A physician wanted advice because he had administered the
their medico-legal risk in these areas.
wrong dose of epinephrine to a patient;
When a member of the CMPA gets in touch with the
• A nother physician called because he had perforated
association concerning a medico-legal question, he is put in
a patient’s eyeball during a procedure to repair a
touch with a medical officer. CMPA medical officers benefit from
detached retina.
extensive clinical and medico-legal experience: many of them
have even practiced in Quebec in several specialties. Moreover,
In these types of situations, the CMPA medical officers have
they have access to information that is specific to Quebec
the knowledge and experience needed to guide members
(pertinent laws, requirements of the Collège) that allows them
towards the best line of conduct to adopt. They can also
to offer practical advice members can count on. When the
review strategies and supply concrete suggestions to reduce
situation requires it, they can also call upon the services of
the medico-legal risks.
lawyers to help the member.
Calls received by the CMPA from
Quebec medical specialists
IN THE WORLD OF MEDICINE (SUITE)
Providing medical reports to third parties
In second place, specialists get in touch with the CMPA for
advice on providing medical reports to third parties. More than
72% of these calls involve summonses to appear, witness
subpoenas, search warrants, court orders and questions
involving expertise. Specialists also ask questions on their
duty to issue warnings (when a third party is at risk), to report
cases of assault and battery, to report infectious diseases and
to confirm a patient’s capacity to drive.
• Physicians who had treated a man for back pain received
a summons to appear before the Commission des
lésions professionnelles;
• A plastic surgeon who performed an operation to correct a
patient’s breasts received a summons to appear from the
patient’s lawyer.
The CMPA can provide advice and points of view on medical
reports addressed to third parties and review the steps and
activities normally associated with summonses to appear.
The association can also provide information on important
considerations regarding the protection of personal information
and respecting the confidentiality which physicians should take
into account when providing medical reports to third parties.
Medical officers are well informed on these questions and on
the changes that result from them. They can ensure that the
complexities of care and of a practice are well understood
by members.
Protecting personal information, respecting
confidentiality and consent
In fourth place, specialists contact the CMPA to obtain advice
on protecting personal information, respecting confidentiality
and consent. Physicians as well as patients seem to worry
more every day about issues of protecting personal information
and of confidentiality. In addition, physicians are well aware of
the fact they must use concrete measures to respect the law on
the protection of personal information in a complex environment
of care that is in constant evolution.
Today, colleges, committees on the protection of privacy and
human rights tribunals, all of whom have within their mandate
the duty of protecting the public from attacks on privacy, are
attentively studying issues of protection of personal information
and confidentiality.
In third place, specialists call upon the CMPA regarding
the management of a practice and in-hospital issues. Their
questions mainly allude to hospital privileges, administrative
issues, medical files, changes within the practice, office
management, shared responsibility and billing problems.
The CMPA can advise members on consent as well as on the
threats and protections associated with personal information.
It can also offer strategies and suggestions to allow physicians
to respect their obligations insofar as protecting personal
information is concerned without compromising the provision of
health care. The association has also published information on
various aspects of these subjects on its website (cmpa-acpm.
ca). They can be accessed by initiating a search on one of
the following keywords: protecting privacy, protecting personal
information, confidentiality and consent.
The following represent concrete examples of calls received:
Physicians can count on the CMPA
• An ORL surgeon noticed that significant undesirable changes
had been made to his hospital privileges while his colleagues
had seen theirs improved;
Since 1901, the CMPA has been protecting the professional
integrity of physicians and has inestimably contributed to the
Canadian health care system. Members can count on the
CMPA for judicious advice from physician to physician, medicolegal assistance and specialized legal services, a discretionary
protection and training regarding the management of risks.
That is why the CMPA strongly encourages medical specialists
in Quebec, as well as members from the entire country, to
communicate with the association when they are faced with
medico-legal problems resulting from medical acts. Advice
is confidential and exempt of all judgment. To obtain help,
members need only call the association at 1-800-267-6522 or
submit a request for medico-legal assistance by email via its
website at cmpa-acpm.ca.
Managing a practice and in-hospital issues
• A psychiatrist asked for advice concerning her obligation to
provide the hospital with 60-days advance notice in case
of resignation;
• A pediatrician wanted information on the requirement for him
to be physically at the hospital while on-call.
As the working environment becomes more complex for
physicians, members communicate more often with the CMPA
to obtain advice on privileges and other contractual provisions
affecting how their practice is managed. The association keeps
itself informed of changes and new additions to provisions
affecting a professional practice that could have an effect on
its members. Questions regarding medical files have become
another subject of interest, as the Collège des médecins du
Québec has proposed modifications to the rules regarding their
conservation (increasing the period from 5 to 10 years).
S
L
FINANCIÈRE DES PROFESSIONNELS
By Mathieu Huot, M. Fisc., Fin. Pl.
TAX EXPERT AND FINANCIAL PLANNER
Why Should You Have a Family Trust?
The family trust is a tool designed to allow splitting of investment revenues between
beneficiaries who are generally the children or grand-children of the person setting it up.
The family trust allows a person to reduce income tax on
investment revenues by transferring these revenues to
designated beneficiaries. These investment revenues can
be used to pay for expenses that directly profit beneficiaries
(tuition fees, vacation camps, etc.). Depending on the child’s
financial situation, he or she normally has little or no tax to
pay on investment revenues transferred from the family trust.
In comparison, if the revenues had been earned by
the parent, depending on his or her tax rate, the taxes
paid on these revenues would have no doubt been
much higher.
A trust involves three actors: the settlor, the trustee and
the beneficiary or beneficiaries. The settlor is the person
who, from the legal standpoint, creates the trust by
donating an asset that does not generate revenues, a
coin for example. This settlor must however have ties
of affection with the beneficiaries. The trustee is the
parent or one of the grand-parents who owns the sum
of money and who wishes to transfer it into the trust.
He or she is also the person who will decide on the
different types of investments in which the trust will invest
and on the manner of distributing the funds between
beneficiaries. Insofar as the beneficiaries are concerned,
they are the ones with whom it is interesting to split the
investment revenues.
The advantage of setting up a family trust has never been as
interesting as it is at present. Why? To start with, please note
that the minimum interest rate on loans fixed by the government
is historically lower, i.e. 1%. The sum of money lent to the
trust at this rate will eliminate any possibility of reattributing this
revenue to the author of the transfer.
Advantage of a family trust
Invesment
Séries2
Tax bill
Séries3
$160,000
$140,000
$120,000
$100,000
$80,000
$60,000
$40,000
$20,000
$0
In order to set up this trust, the parent or one of the grandparents must transfer the sum of money held in his or her
name in the form of a loan to the trust. There are in fact several
provisions in the Income Tax Act preventing an individual from
transferring investment revenues to his or her spouse or minor
children who are dependents. By transferring the sum in the
form of a loan at the prescribed rate, rather than as a gift or
a loan at a rate lower than that prescribed, application of the
law’s provisions is avoided.
Let us not forget that, since the sum has been transferred
in the form of a loan, it is possible for the trustee to demand
payment of the loan at any time thereby recovering the money
from the trust.
1 2 3 4 5 6 7 8 9 1011121314151617181920
Years
After 20 years, an investment of $100,000 with a hypothetical
capital gain of 6% will be worth $302,560. If your marginal tax
rate is 48.22%, your tax bill would be $48,837. In this example,
it is this latter amount that could be saved. In addition, the
tax bill could be even higher if the returns were in the form of
interest. Therefore, the higher the amount invested, the more
productive the return and the longer the investment lasts, the
greater will be the tax savings.
In order to set up this trust, a trust deed as well as a loan
agreement will need to be written. The Professionals’ Financial
has all the tools and resources needed to help you set up your
family trust.
If you want to take part in your children’s or grand-children’s
future while taking advantage of an important tax saving, the
family trust should meet your needs to perfection. Discuss it
with your Financial Solutions Advisor.
SOGEMEC ASSURANCES
By Yves Martel, MBA
FINANCIAL SECURITY ADVISOR
The FMSQ’s association group insurance
Much more than a simple group plan!
The FMSQ’s association group insurance is often compared to
an employer’s group insu rance plan. Making such a comparison
shows how little the FMSQ’s plan is understood. Here are the
four main characteristics that differentiate the two types of plans.
NEW MEDICAL SPECIALIST
EXCLUSIVE OFFER
As a new medical specialist, the
FMSQ through its subsidiary,
Sogemec Assurances, is offering
you the opportunity to sign up
for its life, disability, and office
expense insurance plans, without
medical proof. You must however
sign up within 90 days after the
end of your residency.
Amounts without medical proof*
Less than 35 years of age
$3,000 Disability insurance
$3,000 Office expense insurance
$100,000 Life insurance
Flexibility
Group insurance is one of
the benefit plans offered to
employees of a corporation. It
must satisfy two main objectives:
offer employees protection in
case of illness or accident and
include a benefit that builds
loyalty. The plan is more or less
extensive according to the needs
of employees and is based on
the company’s financial means.
Signing up is compulsory
for employees.
The FMSQ’s association group
insurance is set apart by its
* For those aged 35 and over, please get
flexibility. It came into being
in touch with our advisors for amounts
because of the FMSQ’s desire
eligible without proof.
to increase its service offer to
members, mainly to protect
them by offering a made-to-measure product distributed by
people whose sole objective was the welfare of members. It is
available to members of the FMSQ as well as their immediate
families, but is subject to certain restrictions.
Several types are offered such as: life, illness, disability, dental
care, general office expenses, residential, severe illnesses,
automobile, drug, and commercial insurance. These types of
insurance are optional, with the choice of coverage and its
amount varying according to the specific needs of each member.
Quality of Disability Insurance
For a self-employed worker such as a medical specialist,
insurance protection against the loss of revenues is the
foundation of a good financial plan. In fact, you can draw the very
best plan and follow it to a T, and still, from one day to the next,
you can suffer a disability that lays waste to all your efforts. This
is the reason the FMSQ created a made-to-measure disability
insurance for you.
Here are the characteristics of the FMSQ’s plan that you cannot
find in an employer’s group insurance plan and that are, for the
most part, exclusive to the FMSQ:
Payment
of benefits until the age of 70 in the case of
total disability;
Coverage
of partial disability in the case of HIV, hepatitis B
or any other serious infectious disease;
Coverage,
without exclusions, of trips abroad and
physicians undertaking a fellowship;
Addition
of an option to protect future revenues;
Opportunity
for all beneficiaries to take advantage of
improvements to the plan as they are made;
Fixed
benefits indexed at 5%;
Automatic
Higher
indexation of coverage up to the age of 54;
underwriting capacity than the competition.
Grouping allows associations to negotiate specific clauses for
their members with insurers. The strength of the group has
allowed the inclusion of a conversion privilege in the contract
that guarantees you will not find yourself without protection
should the group cease to exist. It is not very probable that
this conversion privilege will need to be exercised. In fact, the
thousands of medical specialists in Quebec who are members of
the group are preferential clients for the insurer, whose interests
would not include losing them.
Grouping also gives access to the power of the group should
a disagreement arise with the insurer when disability strikes.
The FMSQ’s association group insurance provides for setting
up a committee of experts made up of the insurer’s medical
expert and one (or two) medical experts selected by the FMSQ
to review the file and to formulate the appropriate opinions
and recommendations.
A Unique Product
The association group insurance is a unique product that has
the advantage of offering you the best aspects of an employer’s
group insurance plan and of an individual insurance that is
offered by industry brokers.
The FMSQ plan was created for you specifically. Perhaps you
are wondering why industry brokers do not recommend it to
you? The reason is simple: it’s because they cannot distribute
this unique product.
SOGEMEC ASSURANCES
By Gilles Robert, MD
PRESIDENT
Growth Continues
I am pleased to inform you that 2011 was, once again,
a very good year for Sogemec Assurances. As you are no
doubt aware, the insurance industry is a very competitive
one. The challenge we faced in 2011 was two-fold: Sogemec
Assurances needed to continue growing while still maintaining
a top-of-the-line service to its members.
In the case of general insurance, we successfully met
the challenge. Our sales are constantly growing and the
success of the plan is outstanding. To date, we have 8,977
contracts in effect with a retention rate of 99%! This rate of
client satisfaction is undeniably the highest in the industry: it
indicates that 99% of our clients renew their insurance with
us. By the way, I must mention that the month of April 2012
marks the 10th anniversary of our agreement with The Personal
[Insurance Company].
its extended line of services, those
of a financial planner, specialized
in insurance and estate planning.
This strategic investment will be of
benefit to current and future clients.
The two main sectors of the
organization (general and group
insurance) have thus produced
similar results; in other words, some
800 new sales each.
With sales figures of $40 million,
Sogemec Assurances continues
to be capable of providing you with
excellent service and to look out for
your interests.
The group insurance sector (life, disability), with its 3,200
I would like to take this opportunity
contracts, is also in fine fettle. In addition, to respond to
t o t h a n k y o u m o s t s i n c e re l y
requests from our clients wanting more detailed advice on their
for having made of Sogemec
estate planning and on the role of insurance for physicians
Assurances
4575_SOGA_annonce_FMSQ_2012_montgolfiere_7x4.5(8)_Layout
2:25 PMsuch
Pagea1success.
who
decide to incorporate, Sogemec Assurances has added to 1 4/2/12
POUR TOUS VOS
BESOINS D’ASSURANCES
NOMINATION NOTICE
I would also like to
announce the
nomination of
Dr. Michèle Drouin to
the post of Director
of Sogemec Assurances.
The Board of Directors of
Sogemec Assurances for
the year 2012-2013 is made
up of Dr. Gilles Robert,
President; Dr. François Nepveu,
Vice‑President; Mr. Paul-André
Malo, Treasurer; Me Maurice
Piette, Secretary as well as the
following directors: Mrs. Esther
Gadoua (also a member of
the Executive Committee),
Dr. Gaétan Barrette, Mr. Claude
Lamonde, Dr. Jean Simard and
Dr. Michèle Drouin.
Grâce au
SERVICE PRÉFÉRENCE
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filiale de la
LE MOT DU PRÉSIDENT
Dr Gaétan Barrette
Non à la motion M-312
I
l est indéniable que, depuis des années, la députation
conservatrice d’arrière-ban multiplie stratégies et tentatives
visant à rouvrir le débat sur l’avortement, notamment par la
présentation de projets de loi privés. L’objectif ultime ? Octroyer
une personnalité juridique au fœtus, une notion inexistante dans
le Code criminel actuel. Chaque fois, un échec, mais, avec une
détermination qui frise l’obsession idéologique, cette même
députation aura déposé quatre projets de loi devant la Chambre
des communes : C-43 en 1989, C-291 en 2006, C-484 en 2007
et C-510 en 2010. Clairement, le principe de représentation qui
sous-tend l’existence de notre vie parlementaire a fait place à une
doctrine quasi religieuse à être imposée au peuple entier.
Jusqu’à tout récemment, le modus operandi avait toujours été
le même. Voilà qu’une nouvelle offensive vient d’être lancée
par le député de Kitchener-Centre. Un nouveau stratagème est
employé : plutôt que de recourir à la présentation d’un projet de
loi privé, il a choisi de présenter une motion exécutoire. La tactique
est pernicieuse et tout aussi lourde de conséquences. En effet,
l’adoption de cette motion lierait alors le Parlement en forçant
la création d’un comité spécial de la Chambre des communes
qui serait, toujours selon le député de Kitchener-Centre, “ chargé
d’examiner la déclaration figurant au paragraphe 223(1) du Code
criminel selon laquelle un enfant devient un être humain lorsqu’il
est complètement sorti du sein de sa mère ”. On voit déjà défiler
la batterie “ d’experts ” appelés à répondre à quatre questions
aussi biaisées les unes que les autres impliquant, notamment,
que l’on fasse la démonstration de la preuve médicale “ qu’un
enfant est ou n’est pas un être humain avant le moment où il a
complètement vu le jour ”. Tout comme on voit déjà apparaître
les biais propres à chacun de ces experts, que ces biais soient
religieux ou scientifiques.
On imagine déjà le délire émotif et collectif dans lequel nous
aurions tôt fait de nous retrouver si une telle motion devait
être adoptée. Sans compter les très probables errements
démagogiques qui s’ensuivraient. La motion M-312 a déjà
fait l’objet d’une première heure de débats à la Chambre des
communes, le 26 avril dernier. Une deuxième heure doit avoir lieu
en juin, à l’issue de laquelle la motion sera soumise au vote, et,
si elle est adoptée, le processus serait enclenché.
En 2008, il y a eu urgence d’agir pour bloquer le projet de loi
C-484, une énième tentative de rouvrir le débat sur l’avortement.
Ce sont les gouvernements provinciaux, particulièrement celui du
Québec, et le tollé de la population qui ont forcé le gouvernement,
alors minoritaire, à reculer. Or, ce même gouvernement est
aujourd’hui majoritaire.
Stephen Harper a indiqué publiquement et à plusieurs reprises
qu’il s’opposerait à n’importe quelle tentative de créer une loi sur
l’avortement. Devant un sujet aussi explosif, et ayant démontré à
multiples reprises sa propension à contrôler totalement son caucus,
comment peut-il laisser sa députation mener cette offensive
à répétition ?
Il nous apparaît risible de voir Stephen Harper se réfugier derrière
le droit, pour ses députés, de déposer motions ou projets de loi
et de nous servir l’argument que “ le chef du parti ne contrôle pas
ça ”. Stephen Harper a trop souvent montré que, lorsque l’enjeu
en était un de principes, il exerçait tout son pouvoir pour gagner la
bataille et, dans le cas présent, s’assurer que toute sa députation
suive la ligne de parti. Conséquemment, nous ne pouvons que
conclure que le premier ministre accepte de rouvrir le débat en
optant pour un vote libre.
Stephen Harper a aussi dit qu’il avait les mains liées par le droit
parlementaire. En vérité, en vérité, je vous le dis, ses mains sont
plutôt liées par l’orthodoxie du lobby de la droite religieuse, lequel,
comme on le sait, milite intensément au Parti conservateur.
Que dire alors du Parti libéral et de son chef intérimaire, Bob Rae ?
Il semble que la classe ait deux élèves…
La cohérence et l’honnêteté exigent, qu’en tant que chef d’État,
Stephen Harper impose à sa députation la ligne de parti pour
s’assurer que cette motion soit rejetée et, surtout, il doit s’engager
publiquement pour ces mêmes raisons à bloquer toute nouvelle
tentative en ce sens.
Pour la FMSQ, qu’il s’agisse du projet de loi C-484 ou de la motion
M-312, les enjeux sont identiques : la défense des médecins
spécialistes sur le plan professionnel et juridique en raison des
poursuites qui pourraient être intentées advenant une telle
modification au Code criminel ; le déni du droit des patientes à
recevoir des soins de qualité dans des conditions sécuritaires et
appropriées ; le déni du droit des femmes à disposer de leur corps
comme bon leur semble ; le bris du consensus social existant sur
la question au Québec depuis plus de 30 ans.
Rappelons que la FMSQ était intervenue publiquement en 2008
pour contrer l’adoption du projet de loi C-484, qui avait pourtant été
adopté par 147 voix contre 132 à l’étape de la seconde lecture. Le
projet a finalement été retiré quelques jours avant le déclenchement
des élections fédérales.
À l’instar de l’action que nous avons menée en 2008 contre C-484,
la FMSQ entend bien dénoncer cette nouvelle tentative afin de
bloquer la motion M-312.
Syndicalement vôtre !
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Respite Caregivers

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