I was shocked by this statement, and blurted out “No!”  Another of my classmates nodded, but the rest did not seem to have as much of a concern about this.  I remember wanting to say more – to say that it is not our right to hasten someone’s death, even if they are dying and in pain.

Now, working as an RN with palliative cancer patients, I see the great suffering that they endure.  I have become close with patients who are dying and who are scared of what is to come.  I have been with patients in pain or struggling to breathe in their last days, and have had patients express their wish to go.  Yet my reaction to these patients has not been the desire to help them to commit the act of ending their own lives.  I realize that it is not for any of us to decide when someone’s life should end.  My desire has been to comfort these patients, to help them realize how much they are valued- by their families, but also by the healthcare team who is caring for them.  My desire is to encourage them that their suffering has value and that it is helping others to learn to love freely.  I would never want the option of euthanasia or assisted suicide for my patients.

Theresa, RN from Hamilton,Ontario

Bill C-384, the bill that proposes to legalize both euthanasia and assisted suicide in Canada will be debated in parliament on Tuesday April 20th, 2010. It will be the second hour of debate for the bill. It will voted on – Wednesday April 21st.

The Canadians for Care Letter and list of signatories was submitted today (April 19) to the Justice Minister Rob Nicholson, Health Minister Leona Aglukkaq, the Office of the Prime Minister, Liberal Party leader Michael Ignatieff, NDP Leader Jack Layton as well as a number of other Members of Parliament interested in the issue.

Thanks to all of you we were able to submit the signatures of 97 physicians, over 60 nurses and medical students – they are joined by over 200 concerned citizens.

We have spoken for care and on Wednesday hopefully politicians prove that they have heard us.

Canadians for Care

Le semestre dernier, j’ai accompagné une physiothérapeute durant son travail à l’hôpital et j’ai eu la chance de rencontrer une patiente qui m’a beaucoup frappé.

C’était une femme âgée d’une quarantaine d’années, atteinte de sclérose en plaques. Ce jour-là, c’était sa dernière visite au centre de réhabilitation; lors des derniers mois, sa condition avait cessé de s’améliorer.

Durant la session de physio, j’ai pu voir de mes yeux les effets de cette maladie: une paralysie progressive – dans son cas surtout au niveau des jambes – et de l’incontinence. L’effet le plus dévastateur de cette maladie est le fait de devenir de moins en moins indépendant.

Mais ce qui m’a surtout frappé a été le rapport que la physiothérapeute avait avec la patiente: un regard humain qui ne se concentrait pas sur la maladie, mais sur la personne elle-même. Durant la session, je me demandais: «Comment est-ce possible? Où cette pauvre femme trouve-t-elle la force de continuer à vivre, de faire ses exercices, en sachant que sa condition ne peut que se détériorer?»

À la fin de la rencontre, la patiente a fait ses adieux à la physiothérapeute, et elle s’est retournée vers moi en disant: «Tu sais, c’est grâce à des personnes comme elle que je peux dire que la vie vaut la peine d’être vécue.»

Cette phrase est une provocation pour nous, membres du secteur de la santé, mais également pour tout le monde; elle signifie que l’humain qui entre en relation avec l’autre évoque en ce dernier (et en soi-même!) un plus grand désir, et ne peut y rester passif. Le patient est avant tout un être humain; il ne peut être regardé uniquement par rapport à sa maladie. Nous tous désirons beaucoup plus qu’une simple guérison «physique», nous avons besoin tout d’abord d’être aimés: voilà ce qu’est la dignité.

La véritable «dignité» que l’on invoque si souvent dans les débats sur l’euthanasie au Québec ne peut pas s’accomplir en donnant la mort, mais en posant un regard différent sur les patients parce que leur vie vaut la peine d’être soutenue.

Gardons la phrase de cette patiente comme un défi et un point de départ pour se lancer dans une grande aventure!

Joseph, Physician
Calgary

Cette provocation n’est pas banale, ni théorique. La question du suicide assisté se pose concrètement dans notre expérience : « Ma vie a-t-elle une valeur? Mon existence mérite-t-elle d’être embrassée?» Cette demande si cruciale, qui se pose en face de la maladie, m’a incitée à me consacrer au service des malades, à eux qui sont un rappel vibrant que l’essentiel de la vie, sa beauté, est présente à tout instant. Oui. Il existe une tension dans le coeur de l’homme vers l’infini, un désir insatiable qui le mène vers la réalisation de son destin. Le suicide est déshumanisant, puisqu’il sous-tend que l’être humain est néant, alors qu’il est fait, il est.

Laurence, Etudiante en médecine

Montréal

It is an area of medicine that according to the World Health Organization (WHO) addresses the physical, emotional and even spiritual needs of the patient. Moreover it is an area that offers care to the family and friends of the person requiring care – loved ones are “part of the unit of care,” says Slaven.

This relatively new area of medicine is critical to the debate on euthanasia and to providing care for those who need it.

View the program notes here.

“Ça abime quelque chose de fondamentale dans la relation médecin-patient que de donner au médecin le droit de donner la mort” dit le Dr. Bourque.

Pour voir l’émission complète cliquez ici:

Sephora
MD Candidate, Class 2010
Ottawa

Since assisted suicide has become an option in my state of Oregon, I have had at least a dozen patients discuss this choice with me in my practice.  Most of the patients who have broached this issue weren’t even terminal. 

One of my first encounters with this kind of request came from a patient with a progressive form of multiple sclerosis.  He was in a wheelchair yet lived a very active life. In fact, he was a general contractor and quite productive.  While I was seeing him, I asked him about how it affected his life.  He acknowledged that multiple sclerosis was a major challenge and told me that if he got too much worse, he might want to “just end it.” “ It sounds like you are telling me this, because you might ultimately want assistance with your own suicide- if things got a worse,” I said.  He nodded affirmatively, and seemed relieved that I really understood what he was feeling.

I told him that I could readily appreciate his fear and frustration and even his belief that assisted suicide might be a good option for him. At the same time, I told him that should he become sicker or weaker, I would work to give him the best care and support available. At the same time, I told him that no matter how debilitated he might become, that, at least to me, his life was, and would always be, inherently valuable. As such, I would not recommend, nor could I participate in his assisted-suicide.  In response, he simply said, “Thank you.”

The truth is that we are not islands.  How physicians respond to the patient’s request has a profound effect, not only on a patient’s choices, but also on their view of themselves and their inherent worth.

When a patient says, “I want to die”; it may simply mean, “I feel useless.”

When a patient says, “I don’t want to be a burden”; it may really be a question, “Am I a burden?”

When a patient says, “I’ve lived a long life already”; they may really be saying, “I’m tired.  I’m afraid I can’t keep going.”

And, finally, when a patient says, “I might as well be dead”; they may really be saying, “No one cares about me.”

Many studies show that assisted suicide requests are almost always for psychological or social reasons.  In Oregon there has never been any documented case of assisted suicide used because there was actual untreatable pain. As such, assisted suicide has been totally unnecessary in Oregon. 

Sadly, the legislation passed in Oregon does not require that the patient have unbearable suffering, or any suffering at all for that matter.  The actual Oregon experience has been a far cry from the televised images and advertisements that seduced the public to embrace assisted suicide.  In statewide television ads in 1994, a woman named Patty Rosen claimed to have killed her daughter with an overdose of barbiturates because of intractable cancer pain. This claim was later challenged and shown to be false.  Yet, even if it had been true, it would be an indication of inadequate medical care—not an indication for assisted suicide.

Astonishingly, there is not even inquiry about the potential gain to family members of the so-called ”suicide” of a “loved one.” This could be in the form of an inheritance, a life insurance policy, or, perhaps even simple freedom from previous care responsibilities.

Most problematic for me has been the change in attitude within the healthcare system itself. People with serious illnesses are sometimes fearful of the motives of doctors or consultants.  A few years ago, a patient with bladder cancer contacted me.  She was concerned that an oncologist might be one of the “death doctors.”  She questioned his motives—particularly when she obtained a second opinion from another oncologist that was more sanguine about her prognosis and treatment options.  Whether one or the other consultant is correct or not, such fears were never an issue before assisted suicide was legalized. 

In Oregon, I regularly receive notices that many important services and drugs for my patients—even some pain medications—won’t be paid for by the State health plan.  At the same time, assisted suicide is fully covered and sanctioned by the State of Oregon and by our collective tax dollars. 

I urge Canadian leaders to reject the seductive siren of assisted suicide embodied in C-384.  Oregon has literally tasted the bitter pill (barbiturate overdoses) and many now know that our legislation is hopelessly flawed.  I believe Canada with its tradition of excellent palliative and hospice care should continue to strive to be a model for the rest of the world by rejecting this misguided legislation

“Le Collège des médecins du Québec pourrait ainsi continuer librement et sans crainte le travail entrepris — admirable — sur la recherche des soins appropriés en fin de vie, incluant la sédation terminale et l’euthanasie” (Lalonde)

Il faut dire que d’abord, la sédation terminale et l’euthanasie ne peuvent pas être mis ensemble. La premiere pratique est légale, et s’agit une methode de gestion de douleur lorsque d’autres thérapies ne fonctionnent plus. L’euthanasie, est un acte commis pour mettre fin intentionnellement à la vie d’un patient. Un soin est présenté avec un crime pour normaliser le dernier.

Ensuite, Lalonde a présenté ces preuves que les médecins, surtout ceux du Québec sont en faveur du pratique du suicide assisté et de l’euthanasie. Lorsque qu’elle a été questionné sur le fait qu’un group de plus de cent médecins ont signé une déclaration contre l’euthanasie, elle choisit d’attaquer les médecins au lieu d’adresser les arguments qu’ils ont présenté :

« Ces cinq médecins avaient le droit d’écrire ce texte, mais j’ai su que deux d’entre eux étaient des diacres et qu’un autre était membre de l’Opus Dei. On peut défendre sa religion, mais la religion des uns ne doit pas devenir la loi des autres. » (Lalonde)

La déclaration de ces médecins n’a aucun rapport avec la religion. Il s’agit de l’autre côté du débat et pour avoir un vrai débat il faut d’abord entendre tous les arguments et juger leurs mérites.

En fait Madame Lalonde ne veut pas de débat, elle veut nous faire un discours – elle veut que son message soit le seul message.