Thursday, August 15, 2013

August 15, 2013 blog entry



Last week, I wrote about Gifford-Jones’ piece in the Toronto Sun extolling the virtues of assisted suicide/euthanasia.  I pointed out that there were problems with his position: namely, lack of real-world connections, saying there were no problems with medically provided death.
In this post, I point out there is an alternative way of looking at the issue: cost savings.  It is said that our medical system is broke.  So when Thomas Walkom ran a column in the Toronto Star on Saturday June 15, 2013, he made some good points no-one else ever seemed to make: it’s all about the money.  Walkom provides a more cogent argument than Jones: he does not resort to name-calling or ad hominem attacks in his piece.  This apparent distance makes the tone of his article a little easier to take.

For example, Walkom points out that “Quebec, however, is talking about more than assisted suicide.  Its Bill 52 would allow doctors to administer the lethal dose.” [A8]  This is different than standing by while an infant is starved to death over a course of days or weeks.  It is this activity that some doctors find unpalatable: the notion that killing has become part of curing.  And that is how Bill 52 is stated: euthanasia is now considered part of palliative care in Quebec’s Bill.  

Walkom also says, “But the reality for what the Quebec bill gently calls ‘end-of-life’ patients is rarely heroic. … It is more likely that of an elderly patient suffering slippage – a bout of pneumonia here, a bit of dementia there.” [A8]  I think the reality goes deeper than this: I think it will be that the bill will be creatively applied to those not intended to be covered: infants and disabled children for example.

Walkom also says something I think is correct, on my experience: “Throughout, the assumption is that death is not only inevitable, but welcome.  Family members are encouraged to sign do-not-resuscitate orders.  Should someone deemed suitable for death need acute care, medical help is often provided grudgingly.”  Some rebuttals:

     What if death is not welcome?  How do we know if someone’s wishes are followed?  We don’t.
b 
     Family members are encouraged…what about the idea that this is an individual’s choice?  The Bill states that the patient themselves must make the decision. So now it’s the family that stands in loco patientis, as it were?  That’s a shift before the bill is even signed…

Do-not-resuscitate orders are already put on charts silently, as per McIvor, and there is no legal requirement for doctors to inform families or patients of this. 

We also have the Star’s exploration of the ‘slow-code-blue’ situation, wherein people are given care, but not urgently or with any haste to save life, on the understanding that this person’s life is over already.  We have already seen this in cases where people have been denied antibiotics for treatable illnesses and then put on a palliative track, as in the Christopher Robin Home situation of the early 1990s.

Finally, Walkom betrays his position twice: first, he states that “There will always be those who, for painfully understandable reasons, want to end their own lives…” [A8]  The Proposed Bill 52 would include incurable, unbearable physical and psychological suffering, which means that a bout of depression could be redefined as a terminal illness of convenience.  Are those understandable reasons?  Would Rehteah Parsons therefore be eligible in Quebec if she experienced her abuse and suicidal thoughts there?  I know this might be a ‘cheap shot’ but my point is clear: as Koch [2012] points out, utilitarianism allows others to make choices that might be bad for them and we cannot judge…or interfere. [paraphrased]

Then Walkom says in the second-last paragraph of his article, “As euthanasia bills go, this one is relatively careful.  It sets strict eligibility criteria…” which means that those obstacles will be hurdled to capture a greater market share; “It attempts to ensure that the person being killed really wants death…” but Walkom himself says in his column that family members can request death as a stand in decision maker; and “It would not permit doctors to kill children…” Yet: parents could request it for their children the way the Bill is presented.  And the definition of suffering includes psychological suffering, which is a nebulous concept at best.  So what if a family member thought grand-mere was suffering psychologically and that needed to be relieved?  Can this person request euthanasia for that person’s own good?  This is a thin edge wedge to push the debate wide open and to encourage others to do the same.  Remember Kathleen Wynne said, according to the Toronto Sun, that we needed “…to have a chat ‘…about end of life in Ontario.’ ”  And remember, the Ontario government recently de-listed diabetic test strips, meaning that Ontarians now have to pay for those out of pocket.  Some seniors cannot afford those strips…

The trouble is that there are too many things that can go wrong a la the ORNGE and Chemotherapy mixing scandals, and once a human being is dead, that life is lost forever.  No-one seems to think that this is a bad thing, if there are errors made in euthanasia: better death than potential suffering.

So Thomas Walkom shows us the opposite view as espoused by Gifford-Jones; yet these two writers are not opposed.  However, they are also people who should be taken carefully, because we do not know what their ideological leanings are; if they are members of right-to-die societies, we don’t know it.  Neither one of them touches on the possibility of mistakes, or God help us, ideological situations as in the residential schools tragedies, and both those things are all-too-common when politics and human lives mix in Canada.  It’s just that Walkom brings up the crux issue: money.

It is clear we need better basic care, and better end of life care that is truly caring, rather than the simple and cost-effective offer of death.

SOURCE: “What’s Behind Quebec’s Right to Die Bill: Money”, Thomas Walkom, Toronto Star, Saturday June 15, 2013, P. A8.


Interestingly, in the same issue of the Star, there is an article about parents outraged that their disabled child who has a degenerative disease was marginalized in the class photo: he was shown off to the side in his mechanical chair while the rest of the class was front and centre.  He was still smiling, but his parents were livid.  It’s a good metaphor for how we really think of disabled people and how inclusion really works in our culture.  That is precisely what we can expect to happen to the disabled once medically provided death is ‘legalized’ by the way, and that cannot stand.

Human lives are at stake.


SOURCE: “A class photo that boggles the mind”, Toronto Star, Andrew Nguyen, Saturday June 15, 2013, p. A3.

2 comments:

  1. I found your blog via Not Dead Yet. I too have been blogging on life issues..ie..."brain death" and the lies behind it since my son passed away. Unfortunately we don't learn about many of these issue's until it hits our families and then it is too late to do anything.

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    1. That's a good point about not knowing. And that's why we shouldn't make decisions until as opposed to before. I am sorry about what happened, but feel free to send me the blog name so I can present it to my readers, if you like. And thank you for commenting.

      A.

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