We believe in HOPE not euthanasia.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

As I approach the Christmas Season I focus on the importance of hope.

Many people seek death by euthanasia based on a loss of hope, meaning and purpose. We believe in HOPE.

It is a harder to have hope when the Canada Post strike is causing the Euthanasia Prevention Coalition financial distress. (EPC Donation Link)

A medical practitioner should provide hope not death. Euthanasia undermines hope and sends the message that your life is not worth living.

Sometimes hope is for a cure. Sometime hope is for better health. Sometimes hope is for a peaceful death. Hope always upholds life. 

An excellent article by Sharon Worchester titled: One Patient Changed This Oncologist’s View of Hope was published by Family Practice News on June 19, 2024. 

Worcester begins the article by writing about an experience of Dr Richard Leiter. 

Carlos, a 21-year-old, lay in a hospital bed, barely clinging to life. Following a stem cell transplant for leukemia, Carlos had developed a life-threatening case of graft-vs-host disease.

Dr Leiter, a palliative care doctor in training, spoke with Carlos's mother. The mother had hope that her son would get better. Dr Leiter knew that Carlos would not survive but he didn't offer hope to the mother.

Worchester then comments on a conference presentation by Dr Alan Astrow.

Hope is not only a feature of human cognition but also a measurable and malleable construct that can affect life outcomes, Alan B. Astrow, MD, said during an ASCO symposium on “The Art and Science of Hope.”

“How we think about hope directly influences patient care,” said Dr. Astrow, chief of hematology and medical oncology at NewYork-Presbyterian Brooklyn Methodist Hospital and a professor of clinical medicine at Weill Cornell Medicine in New York City.

Hope, whatever it turns out to be neurobiologically, is “very much a gift” that underlies human existence, he said.

Physicians have the capacity to restore or shatter a patient’s hopes, and those who come to understand the importance of hope will wish to extend the gift to others, Dr. Astrow said.

Worchester writes that Dr Steven Z. Pantilat explains how doctors need to ask their patients what they hope for. Dr Pantilat told the story of one of his patients:

Dr. Pantilat recalled a patient with advanced pancreatic cancer who wished to see her daughter’s wedding in 10 months. He knew that was unlikely, but the discussion led to another solution.

Her daughter moved the wedding to the ICU.

Hope can persist and uplift even in the darkest of times, and “as clinicians, we need to be in the true hope business,” he said.

Worchester reports how Pantilat recognizes that hope can differ:

While some patients may wish for a cure, others may want more time with family or comfort in the face of suffering. People can “hope for all the things that can still be, despite the fact that there’s a lot of things that can’t,” he said.

“We want to be honest with our patients — compassionate and kind, but honest — when we talk about their hopes,” Dr. Pantilat explained. Sometimes that means he needs to tell patients, “I wish that could happen. I wish I had a treatment that could make your cancer go away, but unfortunately, I don’t. So let’s think about what else we can do to help you.”

Hope provides benefits. Worchester explains:

One recent study found, for instance, that patients who reported feeling more hopeful also had lower levels of depression and anxiety. Early research also suggests that greater levels of hope may have a hand in reducing inflammation in patients with ovarian cancer and could even improve survival in some patients with advanced cancer.

Worchester ends the article by going back to how Dr Leiter could have offered hope to Carlos's mother:

For Dr. Leiter, while these lessons came early in his career as a palliative care physician, they persist and influence his practice today.

“I know that I could not have prevented Carlos’ death. None of us could have, and none of us could have protected his mother from the unimaginable grief that will stay with her for the rest of her life,” he said. “But I could have made things just a little bit less difficult for her.

Hope is expressed in many :

“I could have acted as her guide rather than her cross-examiner,” he continued, explaining that he now sees hope as “a generous collaborator” that can coexist with rising creatinine levels, failing livers, and fears about intubation.

 “As clinicians, we can always find space to hope with our patients and their families,” he said. “So now, years later when I sit with a terrified and grieving family and they tell me they hope their loved one gets better, I remember Carlos’ mother’s eyes piercing mine ... and I know how to respond: ‘I hope so, too.’ And I do.”

More articles on HOPE.

• Psychiatrists: Do we offer hope or do we offer death? (Link). 
• Abandonment. That's what euthanasia is all about (Link).
• Jeanette Hall. I say NO to assisted suicide. (Link).