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Euthanasia threatens improvements in end-of-life care, experts say

Loving care

Loving care: A sister listens to the concerns of a resident at the Little Sisters of the Poor Jeanne Jugan Residence in Washington in 2009.
Photo: CNS file/Nancy Wiechec

LEGALISING euthanasia risks undermining people’s access to loving, holistic care as they face the natural end of their life, many experts at a Vatican conference said.

As more parts of the world, like in Quebec last year, passed right-to-die legislation allowing the terminally ill to request lethal drugs, euthanasia was being treated as if it were a legitimate form of medical care, a bishop from the province said.

“Killing is not care. True care is palliative care because it is accompanying the person with compassion, true compassion,” Bishop Noel Simard of Valleyfield told Catholic News Service.

The bishop was one of more than 100 religious, medical and legal experts who attended a workshop on March 6 dedicated to “Assisting the Elderly and Palliative Care”, sponsored by the Pontifical Academy for Life. He and others spoke with CNS the same day.

Associate director of the United States bishops’ Secretariat for Pro-Life Activities Richard Doerflinger said assisted suicide can pose a “threat” to working to improve palliative care.

Some places like Oregon and the Netherlands had seen that legalising euthanasia “undermines the ability and willingness of doctors to practise this more difficult art of addressing patients’ real problems”, he said.

Supporters of euthanasia say it gave people more options to choose from for end-of-life care, Mr Doerflinger said. “But as one doctor practising in the Netherlands said, assisted suicide doesn’t get added to medicine, it replaces medicine,” he said.

He said if euthanasia became seen “as the quick fix, even fewer doctors will learn the real art of palliative care” for patients with a terminal disease; palliative care included pain control, treatment of depression and other symptoms, along with spiritual care.

Bishop Simard said palliative care allowed patients to experience real dignity with dying.

“The last moments of your life are important. Sometimes they are moments where you can reconcile with other family members, when you can just accept the reality of the promise of eternal life”, especially when patients can receive absolution and the sacrament of the sick, he said.

“When you just give a person a lethal injection, you may deprive the person of this very important moment for himself and with family members,” the bishop said.

Mr Doerflinger said part of the issue was a “can-do” pragmatic attitude in a culture that had “almost an obsession with solving problems”.

“Assisted suicide offers the illusion” that dying can be “fixed”, he said, “but it doesn’t solve the problem, it just eliminates the person telling you that he has the problem.”

People had a natural fear of pain and of becoming a burden to others, Mr Doerflinger said. But when they can receive medical care to alleviate their pain and along with compassionate support to relieve their sense of hopelessness, “the desire for suicide vanishes”, he said.

“Often even the initial request for death is really a call for help. It’s not saying, ‘I want to die’, it’s saying, ‘I don’t want to be like this'”, and palliative care can address those problems, he said. “Ultimately the solution is love,” Mr Doerflinger said.

Director of the Centre for Ethics and Culture at the University of Notre Dame Carter Snead said the best people to offer that love for the elderly and dying was the family.

“It would be an easy thing for us to say that it’s the job of the government, the job of social service agencies to care for the elderly but that’s kind of passing the buck in a way that lets us off the hook in a way that’s not appropriate and not just,” Mr Snead said.

“The government can’t love you, and we love our family, and to show that love, we have to care for them,” he said.

A neurosurgeon at the University of Texas in Austin and a psychiatrist Robert Buchanan said every person he spoke to who “had a failed suicide attempt would wake up from trying to kill themselves and say, ‘I’m glad that didn’t happen. I’m glad to be alive.'”

“But where there is this organised euthanizing process” that administered a lethal injection, “there is no chance for a second chance”, he said.

Joan Panke, who is a nurse practitioner in the Washington, DC, area who specialises in palliative care, said effective pain management was the critical first step so patients can “get to what was more important: the spiritual, existential, family concerns”. She said so many patients had told her “that their symptoms are so severe that they can’t even pray”.

In addition to pharmacological and medical support, healthcare providers must be better listeners and communicators with a more human touch, Ms Panke said.

She recalled how her late father, who was a general surgeon, interacted with patients: “He’d pull up a chair, sit with a patient; he knew how to connect, how to communicate.”

With patients and family members, she said, it was “not so much what we say, but how we listen” and tried to decipher unspoken concerns, especially through body language and other non-verbal clues, she said.

Doctors, nurses and social workers should have more “reflective time in their training” as well as supportive mentors and guides, Ms Panke said. “And I think society as a whole needs to better understand what the experience of illness and death is because it’s so basic to our human experience.”

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