Euthanasia and Assisted Suicide

Caring Not Killing

Source: Roman Catholic DIOCESE OF LONDON, Ontario, Canada

http://www.rcec.london.on.ca/~euthanasiaprevention/Articles/articles.htm

Tomorrow, you might be faced with cancer, heart disease, or a life threatening illness.  Many people believe that when they are experiencing serious health problems or nearing death that Assisted Suicide or Euthanasia should be an option for them.  Before considering the decriminalization of Euthanasia or Assisted Suicide you should know these facts...

Euthanasia is an act or failure to act which intentionally causes a person's death

Assisted Suicide is providing the means for someone to kill themselves with knowledge of that person's intention (ex. providing drugs for a person knowing that the person intends to commit suicide).

Why some people would like to Legalize Euthanasia or Assisted Suicide:

1. They fear experiencing uncontrollable pain.

2. They fear becoming a burden upon family members and others.

3. They fear becoming abandoned or being left alone in their last days.

4. They fear receiving extraordinary medical treatment without their consent.

5. They fear living with terminal illness and losing their abilities or person autonomy. 

6. They fear death.

It is not necessary to legalize Euthanasia or Assisted Suicide because:

1. You already have the legal right to remove or refuse medical treatment.

2. To withdraw or withhold treatment when the risk or burden of that treatment is greater than its benefit is a legal and common practice.

3. Pain management drugs and palliative care methods are capable of effectively controlling pain more than 95% of the time.

We are opposed to Euthanasia and Assisted Suicide because:

• It undermines the truth that intentionally killing a human being is always wrong.
• It erodes our respect for human life and establishes killing as an acceptable solution to problems that are best solved through caring options.
• It changes the trust relationship between the medical professional and the patient.  At what point will people fear for their life when they are in need of help?
• It would probably begin as a "choice" for those people who are suffering and near to death.  Once killing becomes an acceptable solution for one problem, what other problems will killing become an acceptable solution for?
• It is a threat to people experiencing depression which is the most common factor in suicide attempts.  Depression is usually a cry for help.  How many requests for assisted suicide would be granted rather than the required help?
• It is a threat to the weak and defenseless people in society (the mentally and physically challenged, the elderly and the chronically ill) who might be vulnerable to family members and medical care givers who already question their right to live.  These people might either be pressured into "choosing" an earlier death or killed without their giving consent.  One person's freedom to "choose death" might be the only "choice" offered to someone else.

Palliative and Hospice Care:

See below for additional information on Palliative Care

Is the supportive care of a person's symptoms and not the curing of the person's ailment.  Palliative care is concerned with relieving a person's physical, psychological, emotional, and spiritual suffering.  Palliative or hospice care is a service that involves a team of health professionals and volunteers who provide care and support for patients and families.

Palliative care drugs and techniques oriented to management of physical pain are capable of effectively controlling  pain 95% of the time. The problem is not that we are unable to control pain, the problem is that too few medical care givers are properly trained in palliative care. If you know of someone who is experiencing uncontrolled pain, you need to ask WHY?

Consider becoming a palliative care or hospice volunteer.

To oppose assisted suicide, we are challenged as a people of life to give of ourselves to others in the service of life.  Consider becoming a palliative care or hospice volunteer or simply consider visiting those in your community who need your presence.  By giving of yourself to others, you can give new meaning and purpose in their lives.  There are volunteer training programs in every community where you can be trained and supported in the service of life.  By serving the lonely, the sick and the chronically ill people in our community, we become builders of a new culture of life.

Caring not Killing!

The fears that lead people to consider assisted suicide are real and legitimate.  We know that every fear has a corresponding life affirming answer.  For many people who are lonely, suffering and possibly dying, the prospect of assisted suicide might grant them the feeling of control over an otherwise helpless situation.  The reality is that in our society there is no reason for people: to suffer uncontrollable pain, to be a burden on family members, to be abandoned in their time of greatest need, or to fear receiving medical treatment without giving consent.

What you can do to make a difference:

• Become informed and be willing to inform others.

• Oppose any political action aimed at legalizing euthanasia and assisted suicide.
• Know your rights as a patient, especially your right to: considerate and respectful care and information.  Designate someone to speak for you when you can't.
• Respect those who are mentally or physically challenged, elderly, or chronically ill.
• Remember that our choice of words can dehumanize, devalue and discourage others.
• Show concern for those in your community who are elderly or chronically ill.  Often these people are isolated and lonely.  It doesn't financially cost anything to offer compassion and concern to someone in need of our presence.
• Support palliative care and hospice programs.

Palliative Care

Source: Source: Roman Catholic DIOCESE OF LONDON, Ontario, Canada

http://www.rcec.london.on.ca/~euthanasiaprevention/Articles/palliativecare.htm

WHAT IS IT?. . . . . . .

Health and Welfare Canada defined palliative care as: A program of active compassionate care primarily directed towards improving the quality of life for the dying.
                Health and Welfare Canada, Palliative Care Services Guidelines,
                  Ottawa, 1989, Cat. No. H3932

Dame Cicely Saunders, who in the late 1960s pioneered palliative care units, or hospices for the terminally ill in the United Kingdom, speaks of it as, "ELC - efficient loving care."  Her philosophy and methods of care for dying patients have spread to all parts of the world.
              Comfort and Dignity: Care of the Terminally Ill in Ontario, Ontario Advisory Council on
                  Senior Citizens; Position Paper, June 1991

Palliative care began in Canada in 1975, when units were opened at the St. Boniface Hospital in Winnipeg and at the Royal Victoria Hospital in Montréal.  One of the first leaders of the hospice was Dr. Balfour Mount, of the Royal Victoria Hospital.  He described the philosophy of the movement as follows: "Several features characterize hospice care as being distinct from traditional health care programmes.  There is a concern for the family and other loved ones as well as the patient.  The fears and doubts of all involved, the strain on relationships and financial resources, the need for spiritual care, are all considered in addition to the more traditional issues relating to the disease itself.  There is also a relaxation of institutional regulations concerning visitors, food, pets, and other details of daily life.  When the length of remaining life is recognized as lying outside the influence of further treatment, the focus is not on curing or prolonging life but on its quality each day; not on death, but on life and on living in the moment!"
                  Balfour M. Mount, M.D., "Palliative Care of the Dying," Care for the Dying and Bereaved,
                  ed. Ian Gentles (Toronto: Anglican Book Centre, 1982), pp. 7, 18.

Palliative care units have been established in many hospitals across Canada.  Many daycare and outpatient support services have also become available for those who are able to spend their last days away from a hospital.  The goal of those involved in offering palliative care is to relieve pain and thus to reduce the great fear of pain that is sometimes associated with dying.  It is this fear which drives people to accept euthanasia as the only available option.

Dr. Larry Librach of the Mount Sinai Hospital palliative care team, formulates the essence of palliative care in this way: "Palliative are is committed to healing, and that is something different from curing.  Healing is to make a person whole, to relieve suffering and to give the individual a sense of who he or she is as a person.  Palliative care is person-centred, not disease-centred."
             "Comfort and Dignity: Care of the Terminally Ill in Ontario," Ontario Advisory Council on
                 Senior Citizens, Position Paper, June 1991, p.4.

Dr. John Scott is the Director of the Regional Palliative Care Service in Ottawa, and Head of the Palliative Medicine Program at the University of Ottawa.  He describes present day palliative care service as: "...a philosophy and a system of care that affirms life when a person with irreversible disease is approaching death...Palliative Care involves a shift of treatment goals from cure and prolongation to the control of suffering.  This shift will often be reflected in the cessation of some therapies and the initiation of new symptom directed therapies.  However, Palliative Care is not passive euthanasia.  At the heart of Palliative Care is the affirmation of life, not the choosing of death."
                 John Scott, M.D., Submission to the legislative committee on Bill C203,
                 November 19, 1991, p.1.

In the concluding portion of his submission to the legislative committee on Bill C203, Dr. Scott said: "As we watch suffering, we too share in the lament.  When death approaches, we cry out and at times even cry out for death, but we must reject the temptation to kill.  Hear the cry of life at the heart of the lament.  Neither physician nor legislator must presumptuously respond to the lament by silencing the one who issues the cry."

The provision of palliative care services is one means of stopping the call for legalized euthanasia.  At the same time, efforts must be made by governments, and by health care workers, to inform and to educate the public about the necessity of promoting the hospice philosophy of dying.  Good palliative care, in all its facets, is the alternative to euthanasia.

PAIN CONTROL

The New York State Task Force on Life and the Law emphasized the need for palliative care and pain management in its May 1994 report on euthanasia and assisted suicide.  The Task Force concluded and commented as follows: "Physicians, nurses, and patients must be aware that psychological and physical dependence on pain medication are distinct phenomena.  Contrary to a widely shared misunderstanding, psychological dependence on pain medication rarely occurs in terminally ill patients.  While physical dependence is more common, proper adjustment of medication can minimize negative effects."

The provision of appropriate pain relief rarely poses a serious risk of respiratory depression.  Moreover, the provision of pain medication is ethically and professionally acceptable even when such treatment may hasten the patient's death, if the medication is intended to alleviate pain and severe discomfort, not to cause death, and is provided in accord with accepted medical practice.

The education of health care professionals about pain relief and palliative care must be improved.  Training in pain relief and palliative care should be included in the curriculum of nursing schools, medical schools, residencies and continuing education for health care professionals.  Hospitals and other health care institutions should explore ways to promote effective pain relief and palliative care, and to remove existing barriers to such care.

Public education is crucial to enhance pain relief practices.  Like many health care professionals, patients and families often have an exaggerated sense of the risks of pain medication, and are reluctant to seek treatment for pain.  Nurses and physicians should create an atmosphere that will encourage patients to seek relief from pain.  Strategies for pain relief should also maximize patients' sense of control.
                 Executive Summary, When Death is Sought: Assisted Suicide and Euthanasia in the
                 Medical Context, The New York Task Force on Life and the Law, May, 1994.

Supporting References

We have daily contact with some of the most vulnerable people in society at the hardest times of their lives and we know that many of the problems that they suffer, they suffer as a result of poor resourcing.  If euthanasia were an alternative then the imperative to provide the resources for these people, whether it is in the education of doctors in pain control or provision of decent facilities for elderly people with physical illness, would be cut at a stroke.
              Royal College of Nurses, testimony to the Select Committee on Medical Ethics,
                 quoted in the Report of the Select Committee on Medical Ethics, House of Lords,
                 Great Britain, Session 199394, January 31, 1994, p.26.

Canadians must not believe the lie that they are faced with a choice between a quick good death and a slow painful death.  Palliative care has demonstrated to the world that the pain and other symptoms of advanced disease can be relieved.  The methods to relieve suffering are available now.
                 John M. Scott, M.D., "Cancer Pain: a Monograph on the Management of Cancer Pain,"
                 Health and Welfare Canada, Ottawa, 1984 (Cat. No. H4225).

We have to make it possible for people to die well in our hospitals.  We must examine the components of a good death: having the opportunity to be with family, to make peace, to be free of pain, perhaps even to be released from the confines of a traditional hospital room and routine...this has been happening for some time in palliative care, a specialty in health care that attends exclusively to the dying.
                 Bridget Campion, "Taking the Final Steps to a 'Good Death,'"
                 The Globe and Mail, Nov. 19, 1993.

It is not immoral to relieve the pain of the terminally ill even if the methods used unintentionally hasten death.  Deliberately causing death, on the other hand, is gravely wrong and can never be tolerated in a civilized society.
                 Vancouver Archbishop Adam Exner, News Release, "Response to the Attorney General's
                 Policy Guidelines on Active Euthanasia and Assisted Suicide," November 4, 1993.

See http://www.rcec.london.on.ca/~euthanasiaprevention/Articles/articles.htm

for additional articles related to these topics.