Tuesday, January 05, 2016

Palliative Care and Assisted Dying

I found this program on NPR interesting: Morning Edition

The doctor who is quoted says:

"'Patients feel as though their choices are between untreated suffering or physician-assisted suicide,' she told NPR's Renee Montagne. 'Palliative medicine, when it's applied skillfully and at the right time, often relieves most of the suffering that prompts people to ask for [death] in the first place,'" she says.

"Van Zyl is head of palliative care medicine at Los Angeles County-USC Medical Center.
Heidi de Marco/Kaiser Health New/Heidi de Marco/Kaiser Health News
But palliative care, which is focused on managing symptoms and relieving pain, isn't available to everyone, van Zyl says. There are smaller hospitals that don't have palliative medicine teams, and it may be hard to get treatment even in urban areas. Van Zyl thinks more work should be done to make palliative medicine more accessible. 'I worry that we make [lethal medication] available before we put the necessary effort forward,' she says."

I think that is the point: saying the patients have a choice in dying means they also have an opportunity to be pressured into something else.  As long as someone doesn't have all three options and doesn't have legitimate information, "aid in dying" is a tragic proposition.

Addendum: Janet Parshall had an interesting program this week about the new rules in Canadian medicine.  Her guest, Wesley Smith, made the point that we are moving from eliminating suffering to eliminating the sufferer.  I tend to agree.  Is this a slippery slope?  I have often felt that slippery slope is an over-used accusation of logical fallacy, and that the law of unintended consequence is stronger than the pull of slippery slope logic, especially when death and life issues are involved. 

A student last year was going to give a speech on "death with dignity" and I asked her if she was saying my mother, who had just died in hospice care, had not died with dignity.  I think I made my point with her; she at least had enough sense not to use the phrase in the speech. 

I do understand the concerns of people with terminal illnesses.  But it seems letting nature (or dying processes) take its course with the help of pain meds and making people comfortable would be the more humane thing than hastening death.

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