Wednesday, July 21, 2010

A humane health-care system is what's needed - not euthanasia

This is a reprint of an excellent article that was in the Montreal Gazette on July 19, 2010 by Ramona Coelho and Daniel Cere.

Why is the Quebec government suddenly so interested in euthanasia? Why are advocates eagerly fuelling public anxiety by fostering the belief that many Quebecers will eventually face the desperate prospect of hopeless suffering or uncontrollable pain, a plight that only euthanasia can remedy?

We now have better mechanisms for controlling pain than in any period in human history. Palliative-care units can offer patients good pharmaceutical pain control, psychological support, stress-releasing massage therapy, spiritual counsel, and music and art therapy. Palliative care units attract numerous volunteers dedicated to providing patients company and friendship to ward off loneliness. If effective pain-control, care and support are available, why is euthanasia so attractive?

The issue, of course, is that most people's experience of the hospital system is far more negative. Pain, fear, isolation, and loneliness often seem to plague our hospitals. How many patients are terrified of the "emergency-room experience"? How many wait far too long for someone to answer their call for attention? How many patients linger alone without visitors?

The question then becomes: Why is there such a stark discrepancy between what the hospitals can offer, especially to those facing death, and what is actually offered?

Denys Arcand's film, Les Invasions barbares, makes a convincing case that the attraction of euthanasia is directly related to these problems. The film presents euthanasia as an escape from the malaises of a public health-care system. The main character, Remy, is a retired professor, a "sensual socialist," who had lived his life chasing his prettiest students, savouring fine wines, and propounding the fashionable philosophical and political "isms" of the day.

We meet him dying, isolated and alone, trapped in an impersonal and uncaring health-care system that is riddled with corruption and bureaucratic control. Remy's suffering is deepened by his own brokenness and alienation from family and friends.

However, in the midst of these trials, Remy's estranged son and his ex-wife begin to draw near to him. Remy eventually finds a way to flee from the public system to die among friends and family. And a dose of illegal heroin, acquired by his affluent globe-trotting son, brings his life to an end.

It seems clear now that the Quebec government, which has setup a National Assembly committee to hold hearings on euthanasia, is gearing up to close this "under-the-table" escape route. It seems to want to be intimately and actively involved with our dying.

That would mean that instead of using our resources to bolster personnel, improve our hospitals, increase palliative-care knowledge among physicians, the government would supervise and control our dying with the usual thicket of bureaucratic regulations, codes and protocols.

In Arcand's film, Remy's real solace comes not from heroin but from finding friends and family to accompany him in his dying. Far from being an answer to the loneliness and pain in dying, euthanasia promises to only exacerbate the malaises of the health-care system.

The abuses we observe in countries that have legalized euthanasia should give us pause. Studies indicate that the fear of the future is far more likely to drive an individual to choose euthanasia than uncontrollable pain.

In the Netherlands, it is not uncommon for the physician or the family to "suggest" euthanasia to the patient. We can only imagine the psychological pressures that such a suggestion puts on a person who is vulnerable and suffering. The dying and the elderly generally fear being a burden on loved ones. Legal euthanasia sends out a loud and clear message that there is a publicly approved way to cease being a burden: Let the government take your life.

What people with terminal illness need love, care, and support, not government mercenaries waiting for the signal to take lethal action.

It is possible to provide palliative care that respects the human dignity and rights of those who are most vulnerable, but it will require constructive reforms to our health system and, ultimately, a change of our own hearts in response to family members or friends who are dying.

Ramona Coelho is a doctor and a lecturer in McGill University's faculty of medicine. Daniel Cere is an assistant professor of religion, law, and public policy at McGill.

1 comment:

Anonymous said...

Robert Greig made this comment in the Montreal Gazette:

I'm a long-term care patient at the Montreal Chest Institute, and I appreciate reading your July 20 Opinion piece, " A humane health-care system is what's needed -not euthanasia."

My answer to the "discrepancy between what the hospitals can offer and what is actually offered" is this:

Let this filmmaker make a film showing how hospitals should be. Let's see a film where nurses and aides get to work and are happy to see the patients, go out of their way to be helpful, and go find chairs for visitors. A few caregivers are courteous and helpful -but very few!

During the 10 years I've lived here, I've known a lot of people who have died. None of them complained that they needed a law passed so they could "die with dignity."

Robert Greig Montreal