Montreal – Canadians should be able to meaningfully express their preferences for end-of-life care through advance medical directives (AMDs). More values-based, collaborative approaches to AMDs offer a path forward for Quebec and other provinces, says a new publication from the Institute for Research on Public Policy.
Government efforts to increase the uptake of advance medical directives, and the legal constraints they impose on health professionals, are bringing greater scrutiny to provincial AMD regimes, say authors Louise Bernier of Université de Sherbrooke and Catherine Régis of Université de Montréal.
Since 2015, Quebecers over the age of 18 have had the option to indicate on a legally binding form their wish to accept or refuse specific medical interventions in cases where they become incapable of giving consent. According to Bernier and Régis, this process has several shortcomings. It limits individuals’ expression of their wishes to a simple checklist, and it relies on people to self-inform. More importantly, it does not provide them with an opportunity to meaningfully discuss their true preferences for end-of-life care.
“To be robust, the AMD process should include informed conversations with health care providers, individuals and their families to help people articulate their wishes for end-of-life care,” say the authors. A regime that requires and supports a deeper discussion of the concerns and constraints that influence a person’s choices can ensure they get the consideration they deserve, they conclude.
Improving Advance Medical Directives: Lessons from Quebec, by Louise Bernier and Catherine Régis, can be downloaded from the Institute’s website (irpp.org).
The Institute for Research on Public Policy is an independent, national, bilingual, not-for-profit organization based in Montreal. To receive updates from the IRPP, please subscribe to our e‑mail list.
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