Euthanasia, assisted suicide and the treatment of unrelenting end of life pain are contentious issues today in the U.S., Canada and much of the world. One of the most pressing questions is, are we sufficiently medically advanced that dying in pain is now a thing of the past?
Dr. Gary Rodin, head of psychosocial oncology and palliative care at Toronto’s Princess Margaret Hospital, asserts that end of life pain is today tolerable and manageable:
“In almost any circumstance, we can now make people comfortable. There’s a common fear that pain will be uncontrollable in these situations, but that is not the usual case. We’ve just done a study, which is ready for publication, interviewing end-of-life caregivers. In 80 per cent of cases, they reported very good symptom control. In the remaining 20, there were some problems with pain control on the one hand and what we call ‘transcendent’ symptoms on the other; fear of death and dying. But we can do better than that with this minority as well.”
Facts on the availability of effective pain relief for terminal conditions have not been successfully disseminated to the public by large hospitals or various medical and palliative organizations. One of the reasons for this omission is that physicians formerly concentrated on life extension more than the alleviation of suffering. Today in most industrialized countries the reverse is now true. Secondly, physicians were too concerned with causing addiction in the administration of pain relief drugs like OxyContin and morphine. Dr. Rodin explains:
“The fear of addiction is misplaced in palliative care. It’s far more of an issue with chronic pain. But people with more advanced cancer, say, should not be concerned about addiction; it’s not a result in the cases, and, even if it were, it would be acceptable.”
(Moses Znaimer, “Pain Is A Four
Letter Word”, Zoomer,
March 2014)
“Pain medicine has matured into a specialty of its own, and billions of dollars have been invested into finding new treatments and methods to relieve pain and suffering. The armamentarium available to physicians has grown exponentially, and new medical journals are now exclusively dedicated to pain management and palliative care. When pain becomes an argument for ending life, it is the pain that must be killed, not the patient. Legalizing assisted suicide due to poorly treated or untreated pain is no different than legalizing assisted suicide due to poorly treated or untreated depression.”
The role of palliative care is
expanding and progressing virtually every day. The Mayo Clinic gives a broad
overview and clears up common misconceptions in their Mayo Clinic Proceedings journal article “Top 10 Things
Palliative Care Clinicians Wished Everyone Knew About Palliative Care”. Two
noteworthy excerpts are:
“Access to palliative care is rapidly growing and is available for many patients with a serious illness. More than 85% of US hospitals with 300 or more beds have palliative care consultative services, and such services are federally mandated in all Department of Veterans Affairs medical centers.”
“Access to palliative care is rapidly growing and is available for many patients with a serious illness. More than 85% of US hospitals with 300 or more beds have palliative care consultative services, and such services are federally mandated in all Department of Veterans Affairs medical centers.”
“In fact, the goals of palliative
care, such as improving quality of life through comprehensive symptom
management and patient and family support, are ideally applied throughout the
trajectory of a serious illness. An intensive focus on symptom management,
psychosocial support, and attention to advance care planning provided by early
palliative care integration has benefits for patients, families, and fellow
caregivers. Conversely, there is a growing recognition that increased intensity
of invasive interventions in late stages of illness does not necessarily
prolong survival or reliably improve quality of life. In addition, there is now
convincing evidence that early integration of palliative care, including active
symptom management, provided concurrently with disease-modifying care can
improve quality of life, minimize such invasive interventions, and potentially
have a measureable mortality benefit.”
Dr. Clare Wilmot, Medical
Director of North Country Home in
Littleton, NH, writes in the Journal
of Palliative Care & Medicine:
“Optimal oncology care requires
the provision of both state-of-art cancer therapy and impeccable palliative
care. Many people think of palliative care only as end-of-life care, but it
also focuses on the relief of patient and family suffering through the skilled
prevention, assessment, and treatment of cancer and therapy-related symptoms to
provide the best possible care, whether the cancer is curable or not.”
In a concise but comprehensive
summary entitled “What
Euthanasia is, and Nine Arguments for Why it’s Always Wrong”, the authors, five Montreal physicians,
Joseph Ayoub, m.d., André Bourque, m.d., Catherine Ferrier, m.d., François
Lehmann, m.d. and José Morais, m.d., write:
“Ending the patient’s life is not
a humane solution to tragic situations of pain and suffering: the physician’s
duty is always to kill the pain, not the patient. Proposing euthanasia shows a
lack of confidence in the progress of medical science. There are no limits
imposed on the physician’s means of relieving pain. The means are many,
accessible, increasingly sophisticated and constantly developing. In extreme
cases, heavy sedation that puts patients to sleep can even be a last resort to sustain
them through their suffering, until death takes place from natural causes. In
treating terminal cases, there are no obstacles to ending or foregoing
treatments considered useless or disproportionate by the patient or the
physician. There is always a way out, even in the most complex cases.” http://www.cqv.qc.ca/en/
A Little Girl’s Appeal To A King
Dr. Paul
Saba, a family physician in Lachine, Quebec and his four-year-old daughter
Jessica, make a personal appeal to the King of Belgium not to sign the law
extending euthanasia to Belgian children.
“Jessica was born in Montreal,
Canada in May 2009 with a severe cardiac malformation: a completely blocked
valve and underdeveloped ventricle. She would have survived for only a few
hours or days without a series of cardiac interventions, which were performed
at Montreal's Children's Hospital. At six days, her valve was unblocked
and gradually her underdeveloped ventricle began to form. If Jessica had been
born in a country where pediatric euthanasia is permitted, she might have been
a candidate for euthanasia and her story would be very different than the one
in the video.”
ABC
News: The Power of Palliative Care
Myths About Hospice Care -- Get
All The Facts
Current Trends
‘Suicide with the approval of society’: Belgian activist warns of
slippery slope as euthanasia becomes ‘normal’
Palliative Care, the Treatment That Respects Pain
Choosing to go gently into that good night
Petitions - Canada:
Petitions and organizations against euthanasia in the U.S and worldwide:
Photo: http://gnrd.net/seemore.php?id=808
Jerry De Luca is a Christian freelance writer who loves perusing dozens of interesting and informative publications. When he finds any useful info he summarizes it, taking the main points, and creates a (hopefully) helpful blog post.
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I can see where this pain management technique is useful. At some point we have to decide if the patients quality of life is there. I know that I would never want to be left in a vegetative state left to suffer in horrible pain. Thank you for sharing, this is a decision often times families have to make on their older loved ones and it is a difficult choice. My dad had to make this very decision a few years ago for my mom who was critically ill and wasn't going to recover.
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