Saturday, May 16, 2015

Harvey Chochinov, Steven Fletcher, Euthanasia and Assisted Suicide.

By Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Dr Harvey Chochinov

The National Post has published an insightful article by Dr Harvey Chochinov, concerning Steven Fletcher, Euthanasia and Assisted Suicide.

Chochinov, who is Canada's Research Chair in Palliative Care begins the article by stating how much he admires Steven Fletcher. He continues by offering an explanation of why the leaders of the disability community oppose euthanasia and assisted suicide. Chochinov states: 

According to a recent IPSOS Reid poll, nearly 70 per cent of Canadians support the availability of death hastening alternatives for people living with significant disabilities that might impair their quality of life. In other words, Canadians find it inconceivable to imagine themselves confined to a body that even remotely approximates the one Fletcher now permanently resides in. While the majority of Canadians admire him, at some level I suspect they are afraid of the abject vulnerably his life proves is possible within the repertoire of human experience. This fear is so deeply seated that they imagine themselves preferring death. For anyone wondering why physician-hastened death makes disabled people feel vulnerable, wonder no more.
Chochinov continues the article by comparing the personal experience of most people with significant disabilities to that of Fletcher:
Human beings are not good at predicting how they will react in circumstances that have yet to unfold. While Fletcher argues that death should sometimes trump disability, studies of people who become disabled due to spinal injuries, head trauma or strokes, offer a strikingly different perspective. Just under 10 per cent of these patients become suicidal and the majority relinquish their wish to die within a year or two. In his biography, What Do You Do If You Don’t Die?, Fletcher recounts suicidal thoughts that lingered long after his catastrophic accident. He says that had doctor-assisted suicide been an option after his 1996 car accident, he would have considered signing up and checking out. Thankfully it was not. His recovery took determination and strength, but such is the stuff that Steven Fletcher is made of. It also took the support of family and friends, the unwavering commitment of medical professionals and it took time.
Chochinov then explains how legalizing euthanasia or assisted suicide will change medicine:
Those of us working in healthcare understand that life-altering illness, trauma or anticipation of death can sometimes sap will to live. In those instances, health-care providers are called upon to commit time; time to manage distress, provide unwavering support and to assuage fear that patients might be abandoned to their hopelessness and despair. That is the essence of how medicine has traditionally responded to suffering. Stopping time by way of arranging the patient’s death has never been part of that response. In light of the decision by the Supreme Court, we must now contemplate Canada’s future euthanologists. ...
Chochinov continued by recounting his responses to Fletcher at a recent debate in Ottawa:
Fletcher said he did not want to die drowning in his phlegm and in pain. I assured him, on behalf of Canada’s palliative care community, that we would not let that happen. He said that he did not want to be reliant on machines to keep him alive. I told him that competent Canadians, under our current laws, are entitled to refuse or discontinue treatment, including life-sustaining measures. He described autonomy as a core Canadian value. I reminded him that autonomy has its limits, particularly when it causes others to feel more vulnerable and implicates the physician’s role in response to suffering.
Chochinov concludes by quoting from that same recent debate with Fletcher:
With too few Canadians having access to palliative care, little wonder that people are afraid. Offering the option to have their physician end their lives feels akin to confronting homelessness by eliminating guardrails from bridges. Nonetheless, Fletcher feels that safeguards, such as a “cooling off” period to establish that a request to die is sincere, not coerced and sustained are possible. If so many in your circumstance change their mind, I asked him, do we now require a two-year waiting period? His response was, “maybe.”
Maybe? Fletcher's euthanasia bill that is before parliament lacks a waiting period.

The Euthanasia Prevention Coalition is asking parliament to Give us time! EPC wants a Commission to give Canadians a chance to express their concerns and we support use of the Notwithstanding Clause (S 33) to give us time to devise effective protections for all Canadians.

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