Dr. Chris Simpson, incoming president of the Canadian Medical Association. Simpson is professor of medicine and chief of cardiology at Queen's University in Kingston. Photo: Dwayne Brown/Handout While there “may well be” legitimate uses for medical marijuana, doctors have been thrust into an “untenable” position by being made the sole gatekeepers to legal pot, says the incoming president of the nation’s most powerful doctors’ lobby.
“We have Health Canada telling us that marijuana is not a medicine, we have our malpractice insurance company telling us to be very cautious because nobody is taking responsibility for the safety of it,” says Queen’s University cardiologist Dr. Chris Simpson, who will assume the helm of the Canadian Medical Association at the organization’s annual general meeting in Ottawa later this month.
Simpson said that while he has heard “many compelling anecdotes” that marijuana can help patients with hard to treat seizures, HIV and other conditions, “we have people out there saying marijuana can cure cancer, which seems quite improbable.”
“Somewhere in between those two extremes is the truth, and I think we need to find the truth, and the way to do that is with the appropriate research.”
His comments come after the CMA’s outgoing president, Dr. Louis Hugo Francescutti, drew ire from some doctors for telling an Ottawa Citizen reporter that people who seek the drug in a doctors’ office are just looking for “dope.”
Simpson suggested it’s time to regroup.
“We need to just back up, take a deep breath and talk about the facts,” he said. “Let’s figure out what the appropriate role for marijuana is, if there is one.”
The controversy over medicinal pot will be high on the agenda at the annual doctors’ meeting, dubbed the “parliament of Canadian medicine,” where confirmed speakers this year include Federal Health Minister Rona Ambrose, NDP leader Tom Mulcair and former Quebec premier Jean Charest.
Other issues to be tackled at the Aug. 17-20 meeting include medical professionalism and end-of-life, including the highly charged debate over euthanasia.
The CMA officially opposes euthanasia and doctor-assisted suicide in a policy that has not been updated since 2007.
Some doctors are arguing it’s time the CMA moved beyond the “yes” or “no” arguments and prepare for a future where euthanasia is legalized across the country, and not just in Quebec, which has passed into law legislation permitting “medical aid in dying.”
Simpson said doctors are divided, “just like society is split on it.
“At the end of the day, we may not have consensus so much as we have the reality of an environment where it may be permitted. It will be a question of how to prepare for that.”
Simpson is more concerned that the focus on euthanasia has taken much needed attention away from palliative care and advance care directives — legal documents that spell out life-prolonging treatments people would and would not want should they ever lose the capacity to speak for themselves.
Simpson’s specialty is sudden cardiac death due to heart arrhythmias. “I implant a lot of defibrillators in patients.” The purpose of a defibrillator is to rescue people from dying of an erratic or abnormal heart beat.
“Obviously we put them in because we think their life isn’t ready to end and we want to prevent a preventable death,” he said.
But he also discusses with patients the day the defibrillator should be turned off — “when other conditions intervene and it’s clear that they are coming to the end of life and then it becomes no longer appropriate to shock them and put tubes in their throat and do all these aggressive things.”
“When that time comes it’s a simple matter of turning it off.”
Those discussions help avoid the “furious, futile Code Blues,” where frail and dying patients are resuscitated if their heart stops and they have not made clear in advance what they would have wanted.
Advance directives affect “magnitudes” more patients than the small number who may request a doctor-hastened death, Simpson said.
Yet polls show the vast majority of Canadians don’t have one; fewer than half have even discussed the issue with their families. Without any guideposts, the fallback for doctors is to keep going — provide intensive and invasive care that ultimately prolongs dying.
“Our society is still so worried about talking about something as completely natural as death,” Simpson said. “But I’ll tell you, when you do it, patients are always thankful.”
Born in Moncton and raised Nackawic, a small pulp mill town in western New Brunswick, Simpson obtained his medical degree from Dalhousie University. He completed internal medicine and cardiology training at Queen’s University in Kingston, where he’s now professor of medicine and chief of cardiology.
In university, he played saxophone with The Thomists, a 20-piece big swing band that toured the Maritimes, playing at weddings, graduations, bar mitzvahs and conventions.
His parents, Bob and Rowena, both served as mayors of Nackawic; his father was also a member of the provincial legislature “way back.” His parents taught him the value of public service and volunteer work. “Any of the good that’s in me came from them.”
Simpson chairs the Wait Time Alliance, an association of medical societies lobbying to reduce wait times for surgery and medical care. He has authored or co-authored more than 300 peer-reviewed papers and abstracts.
He said the CMA’s focus this year will be on pushing for federal strategies for seniors’ care and dementia, including tax incentives and respite and community care to provide support to families looking after relatives with the memory-robbing disease.
He wants to learn how countries like the U.K. “went from being mediocre to one of the best in the world by focusing relentlessly on system improvements. That’s where I think we need to go in Canada.”
He’s a supporter of the move toward more “patient-centred” care. At the Kingston General Hospital, where he heads the cardiac program, “we have a patient on virtually every hospital committee and it has fundamentally changed the way we talk and the way we discuss things.”
“I love the fact that patients feel empowered and in control. I love the fact that they question me. I love the fact that they demand to know, ‘Why do you say that?’ Ten years ago that just didn’t happen.”
On his days off, when he isn’t in the operating room or clinic or teaching, the 47-year-old father of four enjoys mowing his lawn. He likes to try to shut his mind off. “I like to do mundane things.”
But most of his leisure time is spent with his children, “watching my kids compete in sports, or play at a piano recital or sing in a choir. That’s where I have my fun.”
skirkey@postmedia.com
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