As I wrote about here, in the Spring I had the great joy of giving a talk alongside my best friend from childhood, Dr. Julia Bright. We re-joined forces to share a stage again this Fall, this time speaking on euthanasia to an assembly of hundreds of high school students. Once again, I was impressed with Julia's message and decided to share it here in its entirety, below. As for what I shared, it was a shortened version of the presentation in the Youtube video above. May these help you help others.
Thank you for the opportunity to speak today about physician assisted suicide, or “medical aid in dying”. Since this is now legal in Canada, it is a reality that we need to know about. As was mentioned in the introduction, I am a family doctor. I’ve been working for 9 years in my office, the hospital, the hospice, and nursing homes. So I’m speaking to you today from the perspective of someone who works everyday with the sick and dying. But I also speak from the perspective of a person who faces her own mortality when thinking about these issues. And as a person of faith, who believes that our ultimate home is in heaven.
I find I am drawn to sick people. I feel comfortable in hospitals. That may seem strange, but it is because I see opportunities there to show my concern in practical ways. I spend much of my time trying to prevent disease and cure disease, but I recognize that eventually, our health always fails.
When I hear people speaking in support of physician assisted suicide, I sense an underlying lie being spread-that the time just before we die when we are suffering physically and emotionally is not important. That we’d be better off avoiding it. Or that we should be able to control how much of that time we have. But I have seen that this is untrue. Sick people can be happy. Dying people can acknowledge their death and still feel peaceful. My job is to try and help people with medicine and support so they are free to find that place of peace. As a Catholic, I know that the times when we suffer are sacred-because Jesus suffered. He brings meaning to our suffering. And He teaches us how to lessen it for others.
Why is this lie being spread, that says we should avoid suffering and ask our doctor to end our lives? I think it is because people have suffered without relief and their families have watched and felt helpless. But I don’t believe the solution is to kill those who suffer. The solution is to provide palliative care. This is a particular approach to medical care that involves focusing on comfort and relieving symptoms like pain or nausea, as well as providing emotional and spiritual support.
I think it is possible for people to have a “good” death. I think of my patients who come to the hospice when it is clear that their cancer is not going to be cured. They may choose not to have further treatment, based on the side effects. [This is an important point. Patients can still refuse interventions that seem too burdensome, even if they don’t believe in physician assisted suicide.] Once at the hospice, they have their own room. They are surrounded by their families until the end. They can accept what is happening and face it with peace, even though it is always sad to say goodbye. Nurses are present to try to ease their pain and take care of their needs. I think of the time they have talking to their loved ones. When you know that your time is limited, each conversation is more meaningful. Each moment together matters. Families will not forget those moments.
Palliative care is not easy-it requires people to be creative. Like helping people redefine their goals. Sometimes if a parent has a terminal illness, this means helping them write letters to their children to be opened at specific times-like high school graduation. Even though the parent longs to be there in person, they can still be present through a meaningful letter. Palliative care takes flexibility-like nurses coming into a patient’s home to give medication. Or setting up a mini hospital room on the main floor of a patient’s house if the bedroom is too hard to get to. Mostly, it takes compassion-a willingness for everyone involved to “suffer with” the patient. It isn’t easy to visit patients in the hospice-there’s a lot of emotion in the room. But taking that on for a few minutes with them is such an important part of palliative care-at least as important as giving medication.
I have several fears about physician assisted suicide becoming accepted into our society. Firstly, I worry about vulnerable patients feeling pressured to hasten their death. What if your family lives far away or there is not enough money and the option of physician assisted suicide is seen as the responsible thing to do? Their request for death wouldn’t be based on a true desire for it, but rather on the guilt they feel because of their circumstances. Or what if a patient finds out they have early dementia and makes a decision to choose death instead of finding out how they feel as time progresses? They may assume they'll want something in the future that they can't really know until they are facing it in the present moment.
I fear how families will cope when they find out their loved one is choosing suicide. The choices we make when we’re dying have a significant impact on our families.
I fear what it will do to palliative care. What is the incentive to develop advances in care for the dying if we don’t cherish that time of people’s lives?
I am concerned about what it will mean for the culture of health care. I’ll give you a common scenario in my work right now to explain this. Let’s say I get called to a nursing home to see a patient who is 95. She has multiple health problems and is starting to lose her memory because of dementia. She needs a wheelchair to get around. It’s getting harder to look after her-she gets confused, tries to get out of her chair, and then falls. The nurses spend much of their time trying to redirect her to keep her safe. I get called to see her because she has a bad cough. I drive to the care home and ask the nurses what’s been happening. We’re all thinking about how we can best care for her and what treatment for her cough will get her through it and keep her comfortable. I sit with my patient for a few minutes and see if anything has changed from when I last saw her. I don’t think she really remembers who I am. I listen to her breathing. I think she needs antibiotics again. She keeps getting pneumonia. Maybe because she can’t swallow very well anymore and is choking a lot. I order the medication and call her daughter to let her know. I ask the nurses to call me if she isn’t getting better. Her cough improves for the time being and she wanders less now that she is feeling better.
Compare that to what my mindset could be in 20 years if I get used to physician assisted suicide. I’ve dulled my conscience and given in to patients who request to hasten their death. I’ve become indifferent-what the patient wants, the patient should have access to-I merely deliver that service. I get the same call to the nursing home. My patient made it clear before she got dementia that she did not want physician assisted suicide. It’s getting harder to look after her. I’m having a busy day when they call me about her cough. There’s lots of younger people to see at the office first. As I drive to the nursing home, I can’t help thinking-why is she still here? What is the point of all this? I have to suppress the thought—wouldn’t it be easier if she were like my other patients who chose death earlier on? How might that attitude affect the care I give her? What if she sensed what I was thinking? Is this why I became a doctor?
It seems scary. But I really believe there is hope. Creative and dedicated people are working on improving palliative care. And most doctors are listening to their consciences and upholding their commitment to help people live. God is still present to the suffering who call on Him.
I would like to challenge each of you today to think about how you can be defenders of life. One of the most important things that sick people need is companionship. People fear abandonment even more than pain. So if you know someone who is unwell or in a hospital or nursing home-visit them. Get to know them. If you feel awkward or don’t know what to say, just be present. Think about when you were a kid and your mom or dad sat by when you were sick-something about them being there was comforting. Pray for the people you visit. Read to them or listen to music with them. I think of the character in the book Still Alice who loves ice cream. Even as her memory fails because of dementia, she continues to enjoy the experience of eating an ice cream cone. Find out what people enjoy and make it possible.
When you’re thinking about your future career, consider how you can help improve the lives of sick, disabled, or vulnerable people. This could mean working directly in health care, but the possibilities are broader than that-think of interior designers who make nursing homes more beautiful, or chefs who prepare meals for patients in a hospice, or engineers who design new equipment to keep people mobile, or administrators who organize volunteers to visit the elderly.
Finally, don’t give in to the notion that our time is only worthwhile when we are young, healthy, productive, and independent. Look for meaning in the things that last-family, faith, goodness, and the simple pleasures in life. Don’t be afraid to discover how to live every stage of your life fully. We are each precious to God and He will give us the inner peace that we seek along the journey.