Thursday, June 13, 2013

Quebec Revisits "Right to Die"

The right to die - four words that evoke strong feelings. Assisting someone to commit suicide is illegal in Canada, as is euthanasia. Right to life is above all. But what about those who don't want to continue living the life that the law has made inalienable, undeniable? What about those who are going to die, often a painful, drawn out death, who wish to end life on their own terms, rather than that given to them by God or nature, depending on their beliefs?

Whenever a topic like this is discussed, there is talk of the slippery slope. This was brought up during the legalization of abortion - what this slippery slope abortion would lead to. And so there is fear that assisted suicide - legalized assisted suicide - would be the start of a very bad slide in our society.

Let's look at the arguments:

A person should be in control of his or her life and if there comes a time that this person decides that life is no longer worth living, the end should be permitted and even assisted, if needed. This italicized part is important because many people who are at the stage that they want to give up, can no longer face living another day, also cannot end their life on their own.

The argument for legalized assisted suicide is that the person's desire to stop suffering is paramount. It is this person's decision and no one else's. Often, when this is discussed, the issue of euthanizing animals and beloved pets comes into the forefront. After all, as a society, it is frowned upon to allow an animal to suffer and we often feel it is best to euthanize them, put them out of their misery. Many a pet owner can tell you how difficult and painful this decision is, but they are always told that they have done the right thing. Their beloved pet, a loved part of their family, is no longer suffering. And then people ask, if we can do this for the animals we love, why can we not do it for the people we love?

The counter argument is that we cannot, as a society, allow people to take another's life. While the idea may start with the best of intentions, helping someone end suffering, it could balloon into lives being taken because caregivers no longer want to provide care or there is no one left to provide the care.

As for people deciding that they want to die, there are some who argue that many times, this desire to die is temporary, such as untreated clinical depression. And if the underlying cause is treated properly, these people can go on to live full and productive lives - something that would not have been possible if they had been allowed to ask for help to die.

So, now what?

The Canadian province of Quebec has reopened the debate on the right to die. They are studying the possibility of making it legal to help someone commit suicide - under strict guidelines. They include:

- The patient must express the desire to die several times over a prescribed period of time.
- Two doctors must agree that the patient is sound and able to make this decision.
- A doctor has to be willing to give the injection.

It sounds simple enough, doesn't it? So why is it so difficult? Perhaps because we, as a society, don't treat dying with the dignity and the care that it needs and deserves. We spend so much time and money fighting death, that patients suffer needlessly for longer than they may have if the fight to save them hadn't been so aggressive. We also fear that with our aging population, that it is our seniors who will be targeted. After all, they are usually the sickest and frailest of our society.

Death is a part of life. It happens. It's inevitable. Death isn't necessarily a failure of the doctor or the healthcare team and this is where we have our problem.

Palliative care (hospice) resources are lacking. The number of hospice beds are sadly inadequate as are the number of healthcare professionals who specialize in caring for patients at the end of life.

I worked in palliative care for a few years. It is a very, very rewarding type of care. It allows you to help the patients and their families live their final days as well as they can. But I did come across some patients whose physical pain was very difficult to control, whose quality of life was not one that I would have wanted. I've had family members come to me and say, "why can't we do to our loved ones what I could do to my dog if he was suffering?" I had no answer, other than it was against the law. We do have the right to refuse treatment that will lead to death, we can have advance directives, but we don't have the right to cause death.

How do I feel about assisted suicide? I don't know. As I said, I've had these conversations with families who were in the midst of it. I've also worked on hospital floors where I saw doctors fighting their hardest to save someone who we knew, deep down, couldn't be saved - that their actions were only drawing out the inevitable, causing more pain for everyone involved.

But I also had a brother who did take his life; he died after years of mental anguish drove him to commit suicide. He died alone, thinking that no one loved him.  That will always haunt me. No one should die alone. But his pain, his illness would not have qualified him for assisted suicide.

Do I believe in the slippery slope that could result in legalized assisted suicide? Yes, that I do believe in. I do believe that if this ever does become legal, we will have to be so very, very careful to ensure that no one who doesn't want to die, no one who is unable to state it because of dementia or unconsciousness, will die. I do fear that we may get much more than we bargained for.

Related news stories:

Euthanasia in Quebec: Physicians group denounces right-to-die legislation

Quebec introduces controversial 'dying with dignity' bill

Quebec tables bill on medically assisted death

‘Demands of Quebec society’ behind controversial right-to-die bill, junior health minister says


Ailsa Turrell said...

I am very much on the side of freedom of choice - having had two friends commit suicide in violent ways because they had long painful illnesses and their pain could not be controlled or they were losing their autonomy. If they had known that they could have the right to die when they could not stand it any more they might have lived several more years rather than feeling forced to take violent action while they still could. They could have had the opportunity to say goodbye to family and friends. With the current system they have to keep their intentions secret.

Some interesting recent articles on this topic are:

A description by a Dutch doctor now living in NZ of assisting a patient who wanted to die.

How Rear Admiral Chester Nimitz and his wife chose to die,

An article by an Australian TV journalist regretting not helping her dying mother

Marijke Vroomen-Durning said...

Thank you for your comment and those links. I think it's helpful to look at all sides of the debate - but one thing that we can't ever forget is that it's not the debate really, it's the people who are involved.