Bouthillier Marie-Eve, Perron Catherine, Roigt Delphine, Fortin Jean-Simon, Pimont Michelle
Bureau de l'éthique Clinique et Département de Médecine de Famille et de Médecine d'urgence, Faculté de Médecine, Université de Montréal, Montréal, Québec, Canada.
Centre d'éthique, Direction Qualité, Évaluation, Performance et Éthique, Centre Intégré de Santé et de Services Sociaux de Laval, Laval, Québec, Canada.
HEC Forum. 2022 Dec;34(4):355-369. doi: 10.1007/s10730-022-09484-w. Epub 2022 Sep 8.
The purpose of this text is to tell the story of the implementation of the Act Respecting End-of-Life Care, referred to hereafter as Law 2 (Gouvernement du Québec, 2014) with an emphasis on the ambiguous role of ethics in the Interdisciplinary Support Groups (ISGs), created by Quebec's Ministère de la santé et des services sociaux (MSSS). As established, ISGs provide "clinical, administrative and ethical support to health care professionals responding to a request for Medical aid in dying (MAiD)" (Gouvernement du Québec, 2015). It is suggested that their composition includes the participation of a person with an expertise in ethics. These ISGs represent an important innovation for stakeholders involved in MAiD. To date, no scientific research has specifically addressed ISGs and little research has been conducted in other jurisdictions on the roles, operations and practices of MAiD support structures, especially the implication of ethics. Several ISGs have certainly developed promising practices that could benefit all stakeholders in the wider field of ethics and end of life. We will explore the development of ISGs in Quebec as a support structure for MAiD by highlighting the role that ethics has played (and should play) in these morally and humanly challenging situations.
本文的目的是讲述《尊重临终关怀法案》(以下简称第2号法案,魁北克省政府,2014年)的实施情况,重点关注魁北克省卫生和社会服务部(MSSS)设立的跨学科支持小组(ISGs)中伦理所扮演的模糊角色。如所确立的,跨学科支持小组为回应医疗协助死亡(MAiD)请求的医护人员提供“临床、行政和伦理支持”(魁北克省政府,2015年)。建议其组成包括一名具有伦理专业知识的人员。这些跨学科支持小组对于参与医疗协助死亡的利益相关者而言是一项重要创新。迄今为止,尚无科学研究专门针对跨学科支持小组,在其他司法管辖区,关于医疗协助死亡支持结构的角色、运作和实践,尤其是伦理的影响,所开展的研究也很少。一些跨学科支持小组肯定已经开发出了有前景的做法,这些做法可能会使更广泛的伦理和临终关怀领域的所有利益相关者受益。我们将通过强调伦理在这些道德和人性方面具有挑战性的情况中所发挥的(以及应该发挥的)作用,来探讨魁北克省跨学科支持小组作为医疗协助死亡支持结构的发展情况。