Thank you, Dr. Mégie.

The latest report is from April 2021. Unfortunately, in Quebec, data on palliative care are very scarce. In this study, which was conducted from 2002 to 2016, we collected data on eight palliative care indicators. These indicators had been used in the past and were reviewed. Of the 10 indicators previously used, we kept eight. In this report we looked at what was happening to the population that could benefit from hospice palliative care. This study did not look at people who were receiving palliative care at home or in settings such as residential and long-term care centres. These indicators provide a lot of information about what is happening in Quebec.

I'll give you an example. Thanks to these indicators, we now know the place of death in Quebec. The main place of death in Quebec is the hospital. Four out of 10 patients likely to benefit from palliative care will visit an emergency room in the last two weeks of their lives. One in 10 people likely to benefit from palliative care will stay in intensive care. These indicators show us that early identification is not happening and that there is no integrated palliative approach.

Patients are said to have access to palliative care, but they actually have access to end-of-life palliative care when a catastrophe or complication occurs and the patient did not know they were going to die. The patient is in shock and distress. That's what it's all about. The patient is in distress because of their imminent death. They are transferred to palliative care, because curative care is no longer possible, and medication is started to relieve their symptoms.

There is a misinterpretation by the general population, and even by some professionals, that a patient receiving morphine will soon die. If the patient had been started on morphine five years earlier for pain or shortness of breath due to heart failure, for example, no one would say that morphine killed him at the end of his life. The myths would stop and people would stop being afraid of drugs. Indicators are extremely important because they allow all responsible authorities to understand the impact of decisions on everyone and to monitor progress.

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