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

A former anesthesiologist from Laval accused of the involuntary homicide of an octogenarian claims to have had to provide end-of-life care to the patient directly in the operating room because he did not want “therapeutic relentlessness” and that It was impossible to transfer him to intensive care.

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

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

• Also read: Involuntary homicide of an 84-year-old patient: he still had at least a few hours to live, according to his surgeon

“By what right would I give myself authorization to continue treatments to which the patient has not consented?” asked Isabelle Désormeau during her testimony Tuesday at the Saint-Jérôme courthouse.

The ex-doctor is currently undergoing trial in connection with the death of Raymond Bissonnette, 84, on 1^is November 2019 at the Cité-de-la-Santé hospital in Laval.

The day before, Mr. Bissonnette had 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 Mr. Bissonnette had indicated before the operation began.

Isabelle Désormeau said she heard the surgeon calling the patient’s niece. This was his contact person as the victim’s daughter has an intellectual disability.

The D^r Veilleux, however, testified that he had no memory of the accused being nearby during this conversation.

“He sees that I am there, he signs me “no”, meaning that the family will not come,” said the former anesthesiologist.

As it was very early in the morning, Line Bissonnette, who was already preparing her father’s funeral, did not see the “urgency” to go to the hospital, she testified, specifying that the surgeon had told her that his uncle had a few hours to two days to live.

Palliative care

The D^r Veilleux and Ms. Bissonnette then agreed to close the abdominal wall and provide palliative care.

For Isabelle Désormeau, the objective of palliative care is “to stop any treatment that is not intended to relieve the patient or provide them with well-being. Any active treatment which does not have this objective must be stopped.

She therefore considered that maintaining mechanical ventilation and intubation was “therapeutic relentlessness”, which Mr. Bissonnette had refused before entering the operating room.

Isabelle Désormeau indicated that Mr. Bissonnette was “kept alive artificially” and was in “progressive septic shock”.

In the operating room

The initial plan was to transfer the patient to intensive care. However, the intensivist on call would have mentioned that it is “not a dying room” and would have refused the transfer, according to M.^me Désormeau.

The accused and her colleague then agreed that “palliative care would be done in the operating room,” she testified.

This was the first treatment stoppage provided by Isabelle Désormeau in 24 years of practice.

The ex-anesthesiologist administered midazolam, propofol and fentanyl to Mr. Bissonnette, before giving him a second dose of anesthetic a few minutes later “with the sole intention of continuing the sedation for the comfort of the patient until ‘at the end”.

The death of the octogenarian was noted in the operating room by Isabelle Désormeau at 5:04 a.m.

She resigned from her position a week later during a meeting with management “where the die was cast”.

The cross-examination of Isabelle Désormeau will continue on Wednesday before Judge Marc-André Dagenais.

– With Laurent Lavoie