The passage of Quebec’s assisted-dying bill last week has spurred the usual round of debate, in which healthy people claim to know what’s best for total strangers whose personal agonies are unknown and unimaginable to the debaters.
There is nothing new about the arguments. They typically conflate assisted dying with euthanasia and predict the stereotypical “slippery slope” resulting in all sorts of patients, including the disabled, being bumped off by doctors (possibly abetted by greedy relatives anxious to get their hands on the estate).
This argument fails to recognize carefully worded legislation that clearly states that only the dying person can consent to his or her own death; nobody can approach the doctor and order that Aunt Gertrude be euthanized.
The slippery-slope argument also seems to imply that all doctors are latent Jack Kevorkians, or at best, ghouls waiting for just such legislation so they can deal out death on flimsy pretexts.
One of the arguments put forward by those who favour carefully worded legislation allowing an individual to choose assisted dying is that we don’t let pets suffer from terminal illnesses. We have them humanely euthanized when their suffering becomes too great. Veterinarians have always had the legal authority to put a suffering animal out of its misery, but this has not caused them to run amok with death-dealing hypodermics, killing sick animals on a whim.
Indeed, vets will try to prolong your aging pet’s life to the best of their abilities. When my 11-year-old Lab got cancer last year, the vet suggested surgery that would have given an old dog just three more months of life. We said no.
Nor should legislation ever force any doctor to assist a patient to die if it goes against the doctor’s beliefs — coercion being another fear the slippery-slopers raise.
But the main reason arguments against assisted-dying laws are specious is that the people making them generally do not have a clue what dying is like. They say that palliative care will take care of pain and make a patient’s last days if not merry, then at least comfortable. Voilà, problem solved.
Yet they infantilize those with terminal illnesses by essentially saying that these consenting adults have no right to make choices for their own lives and deaths. To dismiss it all by saying palliative care will manage the pain is simplistic and doesn’t address the realities of dying.
According to Yvonne D’Arcy, a pain and palliative care nurse practitioner writing in American Nurse Today, “as death approaches, many patients with chronic illnesses experience uncomfortable signs and symptoms. For those in heart failure, for instance, dyspnea (shortness of breath) from fluid retention may cause agony. For cancer patients, pain may predominate. Other common end-of-life symptoms include agitation and delirium, anxiety, fatigue, weakness, constipation, nausea and vomiting.”
Drugs can further compound the problems. Anti-nausea medication can “increase sedation, which necessitates adjustment of other sedating drugs, such as analgesics, sedatives and sleep medications.” A dying patient who is delirious might have to be physically restrained, but restraint can “exacerbate agitation.” Patients with “intractable symptoms” who don’t respond to treatment can receive palliative sedation.
Why would anyone presume to say what’s best for a mentally competent patient with a terminal illness who decides that he or she does not want to pass through all these horrors on the way out of life? And why would healthy people condemn that patient to suffer on the pretext that all life is sacred?
If all life is sacred, then respect the terminally ill patient whose sacred life it is and the choice that patient makes about dying. There is no reason the patient with amyotrophic lateral sclerosis, for example, should suffer the horrible death that disease brings, if he doesn’t wish to — merely because people going about their lives in the bright sunshiny land of the healthy think he ought to keep on keepin’ on in his private hell.
The choice must be the individual’s and no one else’s — including strangers who believe their ennobling ideals about sanctity should prevail over a terminally ill patient’s wish to be done with unbearable suffering.