REALity Volume XXXVI issue No. 5 May 2017
Advocates of physician-assisted suicide paint a pleasing picture of an individual, with full use of his/her faculties, receiving a lethal injection to bring about a gentle death, surrounded by loving friends and family. These advocates paint another picture of the alternative to this scene which is a “bad” death causing intense suffering created by those who cruelly deny kindness and compassion to the patient by way of a physician-assisted suicide.
These advocates don’t mention the ugly underside of physician-assisted suicide which is usually referred to in deceptive language as “medical aid in dying” or MAID. This name obscures the unpleasant fact that it is a physician who is providing the lethal injection in order to kill the patient.
Advocates also fail to mention that many individuals die of physician-assisted suicide without having full awareness of their situation. These include the frail, vulnerable aged and those with disabilities such Down syndrome or Alzheimer’s. Such individuals may be sent to their deaths unaware of what is actually happening to them. This occurs because those responsible for their lives think that they are relieving suffering. The latter, however, can be accomplished by other more positive means, such as proper medication and a comforting environment. There are others, usually a child of an elderly person, having power of attorney, who will see “their” inheritance dissipating due to the cost of residential care for their elderly parent, and will authorize the death. Research shows that high on the list of reasons why people want to die is that they feel they are a burden to their family. The family’s response to this concern makes all the difference in the decision for assisted suicide.
Assisted Suicide Deaths Can be Slow and Painful
Advocates of physician-assisted suicide also paint the picture of an assisted death as being quick, efficient and painless. This is a misconception. Patients can vomit up the pills they take. Some don’t take enough pills to die, and wake up instead of dying. Patients in a Dutch study vomited up their medications in 7% of cases. In 15% of cases, patients either did not die or took a very long time to die – hours, even days. In 18% of cases studied, doctors had to intervene to administer more lethal medication. The problem is that the amount of medication required to kill a patient may vary, depending on the patient’s weight and/or among other reasons, for example: a patient already taking a high dose of opioids, and dependent on them, requires an astronomically high dose of a narcotic to stop breathing. Some patients may have diseases that alter normal organ function which affects the speed at which drugs are absorbed in the small intestine or metabolized in the liver.
Dying artificially by physician-assisted suicide isn’t necessarily simple, nor pleasant, nor gentle and can instead be a horrifying experience.
Assisted Suicide Raises the General Suicide Rate
In every jurisdiction that has legalized assisted suicide, the general suicide rate has increased. This is not surprising since government sanctioned assisted suicide endorses suicide as an appropriate response to suffering. Suicide is the leading cause of death in young adults, and this is increased by legalized assisted suicide. Young adults don’t need any more encouragement to die unnaturally.
Assisted Suicide and Organ Transplants
Organ harvesting after assisted suicide is a reality in Belgium, and the Netherlands which has had assisted suicide since 2002. In these countries, when a patient is provided assisted suicide, and agrees that his/her organs be used for transplant, death takes place in one room and then the dead body is quickly transferred by gurney to an adjoining room where the transplant team is waiting to remove the body parts, while the body is still warm and the body parts fresh. To describe this situation as ghoulish is an understatement.
Canada and Assisted Suicide and Organ Transplants
Since the assisted suicide legislation was passed in Canada in June 2016, 744 people have been killed by this method. Canadian physicians have begun to harvest organs from those who have undergone medically-assisted suicide. For example, in Ontario 26 people out of 338, who have died by medically-assisted suicide, have donated organs: eyes, skin, heart valves and tendons.
This raises a concern that a patient may be induced to consent to assisted suicide by the argument that by doing so, he/she is saving other people`s lives. What happens should a patient change his/her mind about hastening death? Would the patient feel compelled to go through with the act of death anyway, knowing that medical tests have been carried out and that a recipient is waiting for his organ? This creates more pressure on the patient to continue with the act of death even though he may still want to continue living.
A major difficulty with organ harvesting after assisted suicide is that many patients who request death have advanced cancer, which typically makes their organs unsuitable for transplant. However, organs from those suffering from neurological disorders, such as multiple sclerosis or Parkinson’s disease are more useful for transplantation purposes as such organs may be retrieved much sooner. This is sometimes because the heart will stop within two and three minutes after the lethal injection, providing better organs for transplant. In comparison, in natural death, it can take up to two or three hours, during which time vital organs, like the heart and lungs, deteriorate from lack of blood flow and oxygen.
Canadian Doctors Having Second Thoughts about Assisted-Suicide
In view of these concerns about physician-assisted suicide, it is not surprising that dozens of physicians in Canada, who had initially signed up to assist in terminating the lives of patients, have now removed themselves permanently from a voluntary referral list to do so. Another 30 physicians have put their names on temporary hold. The Canadian Medical Association does not know exactly how many more physicians are having second thoughts.
This reaction by physicians is not surprising, given the Hippocratic Oath which provides that physicians “do no harm” to patients. Also, the legislation permitting assisted suicide is ambiguous. It provides that assisted suicide may take place when there is a “grievous or irremediable condition” and where “death is reasonably foreseeable”. This description, however, could apply to many chronic conditions. This could subject the physician to legal sanctions, such as prosecution for murder. Therefore, assisted suicide can also be a dangerous undertaking for a physician.
There are physicians who are not burdened by their conscience while carrying out assisted suicide. This comes as a result of a process of incremental desensitization which causes physicians to become blinded by the conviction that they are acting in the best interest of the patient. This blindness to the horrors of deliberately terminating human life occurred in Nazi Germany. Many physicians at that time did not see that their acts, motivated by a belief that they were being compassionate, resulted in the horrors of the Holocaust. These doctors eliminated so-called “inferior” human beings: the mentally ill, the handicapped and aged, with impunity, in the belief that they were helping society as well as these unfortunate individuals. This situation is exactly what is occurring now in Canada by the physicians who are justifying their actions for assisted suicide as compassionate care for the suffering.
It seems also that some physicians think they are not paid enough to undertake assisted suicide. They complain that their efforts require driving to the home at their own expense, spending considerable time at the home, preparing the documentation and coordinating the medicine with the pharmacist. They complain that palliative care physicians are well paid, so why not them? Why are physicians, who no longer make house calls, willing to do so to kill a patient?
In short, we are already experiencing desensitized physicians in our own era.
Assisted Suicide Physicians Conference
Concerns about physician-assisted suicide are only beginning in Canada. A conference is to be held in Victoria, B.C on June 2nd and 3rd, 2017 to determine the “best standards of practice” for physicians carrying out assisted suicide. Four of the speakers are from the advocacy group “Death with Dignity”. Other speakers are physicians who have already enthusiastically participated in assisted suicide practices. No doubt they will also be discussing how to be paid better for such services.
Those advocates, enabled by the liberal Supreme Court Judges, believe in an individual’s absolute right to be killed, without any provision to balance this “right” with the protection of vulnerable persons.
These advocates are leading Canada down a treacherous, dark, and frightening path for which there is no light at the end of the tunnel.