Tuesday, April 16, 2013

Euthanasia Prevention Coalition's Newsletter / Dr. Catherine Dopchie

The latest Euthanasia Prevention Coaltion's Newsletter arrived in the mail.  On page 2 is an article written by Dr. Catherine Dopchie, an oncologist in charge of a palliative care unit in Belgium.

I'll try to give some of it here.

"Palliative care is so efficient today that even the proponents of euthanasia say that failing to relieve physical suffering is medical incompetence.  Euthanasia is mainly applied, not for pain, but for the suffering of loss of meaning of life."  

"The patient does not believe that it is possible to integrate the richness and the poverty of his condition, and find there a source of healing.  He has reduced himself to a person in his pain and he has reduced the doctor from his function.  For us physicians, there is no longer the "always help/care" as we partake in his helplessness.  We find ourselves no longer in a particular place where two parties are in the center on this last and final act of giving.  Instead, he has convinced himself that he is insurmountable and must be in control.   The doctor who aims rather for wholeness of the person, and refuses to practice euthanasia, can no longer become involved in the relation of therapeutic union that engages two people in the situation of fragility.  We end up in the impasse to choose between the right of our conscience or rights of law."  

"Actual pain is subjective, not measurable.  The fact that a patient might only be suffering the fear of pain is no longer an obstacle to euthanasia.  To the doctor who believes that he can predict when suffering might become unbearable, anticipated suffering justifies killing under the law. A doctor who believes he is capable of predicting human suffering may be more dangerous than a doctor who believes in pursuing aggressive therapy.  By becoming an "expert" at predicting suffering, the doctor may dispense with actually assessing the pain of a dementia patient, or an infant."

"In end of life situations, where psycho-spiritual activity is intense, people completely change their minds about their desires.  ... It is not reasonable for a doctor to assume that he is competent to predict the patient's feelings in a situation which is not yet here."

"To the psychology of a young person, not yet a mature adult, it may seem difficult to avoid the pitfall of false freedom, especially in the current materialistic society.  An adult knows from experience that it is possible to evolve through his suffering. But the young person needs to witness the journey of adults facing suffering in order to find his way.  However, if all that person hears is that he has the right to refuse care, and if palliative care is relentlessly labeled as aggressive treatment, they can lose hope.   All of the development still needed to optimize psycho-social and spiritual care will be suffocated in the egg.  Only through suffering along with the patient can we acquire compassion.  Without that, caregivers will become increasingly intolerant and therefore incompetent. The mystery of the dignity that proceeds from carrying each others' human pain is disparaged by those who do not know how to do it.  Euthanasia is a cheap technical way to pay off the account of human suffering.  Can we honestly consider that it is real progress?"

Wow.  This doctor has deep insights gained from experience, we can tell.

Personally, I can speak to the dying of my own parents.  It was each time traumatic since we children were still fairly young.  But death is always traumatic.  My mother died at home after several rounds of chemo for leukemia.  My father died at home of cancer, also.  In the case of my mother, it was decided in consultation with the doctor that further aggressive treatment was unlikely to be very successful and therefore it was discontinued.  She came home and we daily did for her what we could.  The local health unit helped with equipment and dropping in for care.  I read the gospel of John to her and we decided she was getting too ill to chance another family holiday we thought we might be able to take.  It was a very difficult time but we spent it together.  We talked and sang and read and prayed.  It was not pretty.  There was nausea, depression, problems with feeding and voiding.  Very tough.  We children were 15, 17, and 19 years old.

My father died at home and had a family physician trained in palliative care.  She made housecalls and came over regularly.  I remember her being asked about helping him die.  She said she could not do it.  We had morphine and we sat with my father til he died.  He did not die suddenly.  In the end the death rattle came and we all knew and he did too, that he was within hours of his inevitable death.  I held him.  I sang to him.  I gave him his morphine.  When he was conscious he was extremely lucid.  He felt very humbled and chastised by it all.  I just kept saying that we too will be in this exact place.  It is our common human experience. The sense of loss was overpowering.  But we had each other.  We could talk.  We could care.  In the end, I had a sense of strength.  This too can be done.  We will be able to die.  We will be able to do it.

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