Assisted Dying is a topic one sees all over social media, blog posts, and in the news; although other terms used are assisted suicide, euthanasia, and dying with dignity.
In June, Quebec became the first province to pass legislation which will come into effect later this year. Although the wording is ‘respecting end of life care,’ it is a step in the right direction. For those concerned that either family members or institutions will implement euthanasia or assisted suicide without the patient’s consent; please note the wording of the bill is: “Patients themselves would have to repeatedly ask a doctor to end their lives on the basis of unbearable physical or psychological suffering. They would have to be deemed mentally sound at the time of the requests.” Quebec is the first province to vote in such legislation in Canada.”
On the other side is patient’s making choices themselves without legislation in place. A woman in the province of British Columbia recently ended her own life after living with dementia for a few years. Others who are living with a chronic illness/disease or degenerative neurological disease have chosen to go to Switzerland for Euthanasia.
Assisted Dying is a controversial topic with emotional, religious, and cultural implications for some. The topic is controversial much like abortion-should one have the right to choose? Some will say yes, some will say no, and others are unsure.
While advance care directives, living wills and the like can explicitly detail an individual’s wishes should they become cognitively incapacitated or unconscious, I have to wonder if they will be honored/followed by family and medical professionals. There are cases where they have not and a person was kept alive by force feeding. Some medical professionals disregard advance care directives as it goes against their medical training and oath to do no harm. What is the point in writing one if it will not be honored?
The other side of the debate is individuals who are in ICU or elsewhere in the hospital receiving what could be seen as futile and/or unnecessary medical procedures and/or surgeries when there is little chance of recovery or success. This costs money, uses up hospital and medical resources, and creates longer waitlists for needed and necessary medical procedures, tests, and surgeries for others where the rate of success would be higher. Could those that would have little chance of success or have written advance care directives re: futile procedures and surgeries instead be transferred to Palliative Care? This means more palliative care beds are needed both in the community and inpatient facilities should the patient and family choose this option.
Even if an individual expresses their wishes in a living will or advance care directive it does not mean when the time comes and they are conscious that they could not or would not change their mind. In reality, none of us knows when the time comes what we will decide. To me it comes down to options and choice. This means legislation needs to be in place to allow for the option of assisted dying should one want it.
There are many states and countries that have legislation in place and more will follow. There will continue to be discussions, raised awareness, blog posts and articles to read.
What are you thoughts on this topic?
By Victoria Brewster, MSW
Thank you for this great state-of-the-issue summary, Victoria. I agree that legislation needs to be in place to allow and encourage consideration of all possible choices and creation of clear and enforceable chosen directives. And, when the time comes, we need to honour the choice that has been consciously made by the person who is now dying. Funding of supportive hospice and palliative care environments and services is also an essential corollary. The private sector cannot bear this burden exclusively nor will adequate creation of such services happen overnight. We must work together across all political and geographic boundaries to ensure quality of life through the end of life.
What I like about topics like this is the poke in the brain. Read it and you are encouraged to verbalize your thoughts, come down on one side or another, or sit atop the fence and hedge back and forth. Even that however, is a position.
You’ve laid things out in a thoughtful respectful way with your article, and I join with Julie in thanking you for the thought-provoking piece.
There was an interesting case in Pennsylvania that I referred to in two of my blog posts: The Conversation Project, 2-11-14 (in the comment section), and A Controversial Issue Worthy of Comments, 4-19-14. I was, however, unsuccessful in my attempt to “poke a few brains” as kgmitchell put it. Maybe some of you will visit my blog, “What to Do about Mama?” and add a comment or two. It may be a difficult topic, but it is important.
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