A doctor’s plea for legalized assisted suicide
On Feb. 4, Barbara Kay wrote a column for the National Post titled “No one really wants euthanasia.” Suffering people want an end to their pain. As a full-time emergency physician, I have worked extensively for almost 11 years with suffering people, and based on my innumerable, heart-wrenching experiences in this domain, I cannot overstate just how much I find Ms. Kay to be wrong on this point.
In my years of practice, I have seen patients whose days have consisted of nothing but pain, from the moment they awake till the moment they fall asleep, who are no longer able to feed, toilet or bathe themselves due to their debilitating, incurable conditions. Many of these patients suffer from a progressive loss of effect from the painkillers we use, and in their final days, the only solution to alleviate their suffering is around-the-clock general anesthesia, until they eventually pass away from their illnesses. I have seen these same patients beg me for alternatives — anything to end their suffering in a dignified manner, and I have struggled to meet their gaze as I have had to explain to them that I have nothing more that will work. No, Ms. Kay, nobody “really wants” euthanasia — it is a last option when all other means to end suffering have failed.
Ms. Kay’s column makes some entirely misleading statements. She alludes to a slippery slope that ends with forced mercy killing, stating, “Euthanasia never stops … Once you accept the logic that suffering justifies killing, it is not easy to set boundaries.” In Oregon, assisted suicide has been legal for more than 17 years, and in that time there has been zero extension of the boundaries under which such an act may be carried out, and there has been no rise in the state’s overall suicide rate. The strict laws in place there provide extreme measures of patient protection, and there has yet to be a single documented case of abuse of Oregon’s assisted suicide law since its enactment. The experience of Oregon proves Ms. Kay wrong. There is no slippery slope like what she describes, and it is ludicrous to believe that legalizing assisted suicide in Canada would suddenly cause one to exist, or to cause our collective morals to suddenly turn 180 degrees toward allowing acts we universally believe to be wrong, such as forced mercy killing.
The column goes on to quote Dutch physician Joke Groen-Evers, who stated that patients offered euthanasia will ask for it, while patients offered palliative care will ask for palliative care instead, insinuating that patients’ choices for assisted suicide are wholly a result of not being appropriately offered alternatives. Such a position is neither nuanced nor informed. Palliative care and assisted suicide are not mutually exclusive, and I would have deep concerns with any physician who offered assisted suicide to patients without first having a thorough discussion of palliative-care options available.
It is illuminating to note that Stephen Hawking, despite having access to the best palliative care this planet has to offer for his ALS, said in a 2013 interview, “Those who have a terminal illness and are in great pain should have the right to choose to end their lives and those that help them should be free from prosecution. We don’t let animals suffer, so why humans?” Oregon’s experience bears out Mr. Hawking’s statement, where more than 80% of those choosing assisted suicide as their end-of-life option are already receiving palliative care. So no, Ms. Kay, the choice by many patients for assisted suicide is not just about the alternatives they are offered. It is clearly a choice made when such other options as palliative care are no longer effective.
Meanwhile, this country and its doctors are more united on this issue than on almost any other matter of national debate, and contrary to Ms. Kay’s assertion, they do want the right to choice when it comes to assisted suicide. In a 2014 national survey, 84% of Canadians stated that they should have the right to choose physician-assisted suicide if they were suffering unbearably and clearly stated their desire for it. And in August of 2014, 91% of delegates to the Canadian Medical Association’s general council voted to amend the CMA’s policy to allow Canada’s doctors to perform such an act if it becomes legal in this country. There can be little debate that “no one wants euthanasia” is a grossly inaccurate statement in our nation.
Ms. Kay ends her piece by stating that our focus should be on better palliative care — and I don’t disagree. This is a noble cause. But Ms. Kay, for all those for whom palliative care does not successfully alleviate pain — and there are many — I implore you to open your mind and adopt a position that does not doom so many poor people to prolonged, unnecessary suffering in their final days.
It is clearly a choice made when such other options as palliative care are no longer effective