We must demand real end of life care --not patient liquidation.

Gordon Friesen
President: Euthanasia Prevention Coalition

Gordon Friesen

In the past weeks there has been much discussion of a particular Ontario case involving an elderly patient who deliberately chose a Palliative Care facility where medical homicide was allegedly not practiced, but where she was nevertheless subjected to several very aggressive proposals for euthanasia; where, under worsening circumstances she was actually told that no other relief was possible; where faced with outrage, from her supporting entourage, it was finally admitted that palliative sedation did, in fact, remain an option; but where such sedation was ordered, not at once, but only for a future date; and where the patient died a natural death in the meantime. There are clearly several disturbing elements to this story.

First is the profound penetration which medical homicide has apparently achieved in the past ten years.

The Palliative care facility chosen has officially exercised its right to refuse medical homicide on grounds of moral principle. No euthanasia procedures are performed in that place. And yet notwithstanding this clear mandate: the doctors and nurses working in that institution are apparently relying on euthanasia as their go-to, first choice treatment.

Second, is the aggressive nature of this professional steering towards medical homicide.

In this case, professionals not only refused to take "No" for an answer (returning multiple times to the charge) but they actually went so far as to pretend that they possessed no other options to relieve the patient's distress. And, even after they were forced to admit that other measures (such as palliative sedation) are, in fact, available, they did not actually initiate appropriate procedures at once, but projected that initiation for some days farther off. And so it is that the patient's discomfort was only ended by natural death, not by the care of her physicians.

It is difficult to read that description without suspecting that medical homicide is literally the only "treatment" in which these professionals are now interested, at least for difficult cases, and that both pain and time are cynically seen as allies in obtaining consent to provide it. Or in other words: the apparent inability to relieve symptoms is not a failure, but a strategy.

And yet, what should most concern us about such evident malpractice, is the normalization of medical homicide, which it indicates, and the effects of that normalization --not only for Palliative Care, but for the entire medical industry.

For if patients are only sent from Long-term to Palliative Care in order to die, then doctors will soon ask why they should not kill those patients right now, and save them the journey.

And, indeed, the circle of this pessimism is already much wider than that. For we now see medical homicide adapted as a style of Preventive Medicine, whereby people are killed --not to relieve suffering-- but to avoid that suffering in the first place (such as at the moment of difficult diagnoses where consent is obtained under the weight of shock, contextual despondency and a pathetic trust in physician benevolence).

So also, we now see medical homicide proposed before major surgery, in cases of catastrophic accident, an in rehabilitation.

In the end, it is to prevent these outcomes that we must patiently wait: even at the very end, and even where death occurs under profound palliative sedation.

We must be willing to wait, because we do not wish the normalization of medical homicide --at the very end of Palliative Care-- to become the normalization of medical homicide before patients even arrive in that place.

Clearly, none of this is done to benefit the people. Let us not be fooled! Medical homicide is NOT OK where it is (at least for now). We must demand real end of life care --not patient liquidation. It is what normal patients want. It is what normal doctors wish to provide. It is what we all deserve. It is what we have handsomely paid for with our tax dollars.