Trial of a former doctor for involuntary homicide: a patient “euthanized” or suffering properly alleviated?

Did a former anesthesiologist from Laval correctly alleviate the suffering of a patient or did she hasten his death? The court must decide on this thorny issue, now that the Crown and defense have presented their final arguments.

• Also read: Involuntary homicide of a patient: a former doctor claims to have followed the rules

• Also read: Involuntary homicide of an 84-year-old patient: a niece grieved by the death of her father, then her uncle

• Also read: Trial for involuntary manslaughter: a former doctor “euthanized” an 84-year-old patient, pleads the Crown

Former doctor Isabelle Desormeau has been on trial since this fall for the involuntary homicide of Raymond Bissonnette, at the Cité-de-la-Santé Hospital, in Laval, on 1^is November 2019.

The parties formally submitted their pleadings in writing on Monday to Judge Marc-André Dagenais, who must render a verdict.

“It was not up to the accused to decide when and how Mr. Bissonnette died. His decision-making autonomy was violated and the inviolability of his person transgressed,” believes the Crown, which believes that the 84-year-old man was “euthanized.”

Desormeau swears, for his part, that her “aim was to provide him with quality palliative care in order to prevent him from suffering and to respect his consent to care while he was artificially kept alive […]».

No relentlessness

It all started the day before Mr. Bissonnette's death, when he presented himself to the emergency room with stomach aches.

In the operating room, the D^r Hubert Veilleux discovered necrosis on his small intestine. This put an end to the surgical procedures, as the eldest did not want any “hard work”.

Raymond Bissonnette's niece was then informed of the octogenarian's state of health. This was his contact person as the victim's daughter has an intellectual disability.

“This patient was going to die. We were talking, at least to my knowledge […]of a few hours, of one to two days maximum,” D.^r Veilleux.

The initial plan was to transfer Raymond Bissonnette to intensive care. However, during a call with the accused, the intensivist on duty understood that “the process towards death had begun and would be quickly completed,” indicates the Crown.

Desormeau's lawyers counter that Mr. Bissonnette's transfer was instead refused by the intensivist.

Natural death?

The accused's behavior then shocked colleagues in the operating room.

She allegedly removed Mr. Bissonnette from life support and administered a “cocktail” of drugs containing fentanyl, midazolam and propofol.

“It will be over quickly, we can send him directly to the morgue,” the accused would have said.

According to a nurse, the 54-year-old woman judged that the patient “has an unfit daughter, so [il n’a] no family.”

It remains to be determined whether Desormeau has criminal responsibility in the circumstances of the death.

In the eyes of the defense, the necrosis in the patient's small intestine explains the death of the octogenarian and the intervention of the accused was of “therapeutic nature”.

“Had it not been for the non-consented removal of the ventilator, Mr. Bissonnette would not have died of asphyxiation in the operating room at 5:04 a.m.,” the lawsuit estimates.

Judge Dagenais intends to render a decision in February.

M^es Karine Dalphond and Alexis Marcotte Bélanger represent the public prosecutor. M^es Nadine Touma and Stéphanie Lozeau defend the ex-doctor.