Saturday, July 16, 2016

A response to Mark Bonokoski's column.

A Response to Mark Bonokoski: euthanasia is not the answer to the problem of a loved one not dying.

Mark Bonokoski’s March 27, 2016 Toronto Sun column ‘Doctors are already killing us, just not humanely’ about his dying mother and her treatment holds numerous errors and misdirections about palliative care.  In fact, it seems as though his column is nothing more than a projection of his feelings onto his mother’s treatment at the end of her life, but he does not allow for this possibility.

The headline is the starting point: Doctors are already killing us, just not humanely.  The implication will therefore be that there is a more humane way to ‘kill’ someone by its own words.

‘But he ignored the fact that medically assisted death is already happening across the country’,

Bonokoski writes of Archbishop Collins’ statement against euthanasia.  If this is true that ‘assisted death is already happening’, then there are two conclusions we must reach.
Bonokoski ignores 1. That killing might be a crime and 2. Ignores the known statistics on problems from Holland.

To continue ‘…the form it (palliative care) now takes is nothing but inhumane’, Bonokoski writes.  So palliative care, which is what Bonokoski writes about is, therefore, inhumane.  The question raised is why this should be defined as such.  As we shall see, Bonokoski conflates medically assisted death with terminal sedation.

Bonokoski alleges that his mother was ‘…denied fluids and intravenous sustenance.’
If this is the case, was this not abuse in practice and what did he do about it to stop abuse from happening?  We do not know, because Bonokoski does not say.  And as a family member, why does he not say anything to the caregivers about this situation?  Remember, he uses the word ‘denied’ in this context, which tells us that the decision to deny sustenance was not the family’s choice.
‘As a family, we had no options.’  This is his assertion; we are not given much detail about the issue, and we are not told what he did to ensure those options would be known.

He asserts that his mother ‘…had suffered a major stroke… that left her in a coma.’  As a result ‘…. she was sedated with morphine.’  If his mother was in a coma, why was she needing sedation with morphine?  If a person is in a coma, they are classically presumed as dead for all intents and purposes.  As well, if she was in a coma, how did he know she would have been physically uncomfortable if she was non responsive?

‘The doctors and the nurses who attended to her palliative care could have sped up the process, of course…’ Why the ‘of course’ in this sentence?  This happened before March, so if her death was imposed by Bonokoski’s demand, they could not ‘have upped the morphine to the point of overdose’ in any legal fashion.  In this phrase, Bonokoski shows how he is projecting his pain back onto his mother.  Remember, his mother was in a coma, so by definition of popular wisdom, she was not feeling anything.  If this is so, how much awareness of the situation did his mother have?

‘I sensed from hallway conversations that they would have helped nudge her along…’  This is what he is writing about his mother.

‘It would have been the humane thing to do in such a hopeless situation…’  Bonokoski writes.  Presumably, his dying mother was in palliative care, being treated humanely (she was one of the 30% of Canadians who actually get palliative care) but he wanted her killed faster.  No word on if she was dying from the stroke he described initially, either.  Palliative care is therefore presented in this column as the inhumane option which creates suffering, not alleviate suffering.

‘At the hospital where Mother spent her last week, we were assured she was oblivious to everything, including our presence at her bedside...’  If this is the case, and they chose to be at her bedside, we know by these words that Bonokoski is projecting his emotional response onto the situation.  He earlier writes ‘…her spirit had already departed and the wait was now on for her body to follow suit.’  This raises another question: how do we know this?  There was no objective measure of this situation.  

We are not told what the palliative care doctors or nurses actually said or did with his mother, or what they said to the family, so we do not have their side of the story.

Disturbingly, Bonokoski writes, ‘Had we been given the option of a quicker end for Mother, we would have signed off on it in a second.’  So the person who is in a coma, who cannot be reached, doped on morphine and therefore cannot be suffering, is in need of death decided upon by someone else.  He then argues that medically imposed death should be given as an option to those who are in coma.

Just to give the game away about Bonokoski’s view on the issue, ‘It will get messy, of course, when it delves into hastened deaths involving the mentally ill and minors.’  We can conclude the writer of this column approves of killing the mentally ill without boundaries, and also approves of killing minors.

He does not go into reasons, so presumably there is no boundary on why they need death or objections to their desires.

He finishes off with ‘If denying water and sustenance to a comatose patient is not killing them, then what is?’

In this one question he has illustrated why people should stick to what they know.  There is the theory of the double effect; that giving someone medication to help their pain and suffering, does not actually create a desire to kill.  Bono has said that he wanted his mother to die, if you remember what he wrote earlier.  He also shows us that he did not get adequate support when his mother was dying.

We are not told why it was decided to starve his mother to death, and why this was done.  We do not know what the options to care were, and who was involved in care as part of the team.  These are important things to know, but we are not given that information.  So Bonokosky writes about his direct experience with no theory, arguing all the while that it would probably be more convenient to kill his mother than wait.  He calls her starvation and dehydration inhumane and the answer to this is not treatment or ongoing care but, rather, a faster kill.  He also calls for the death of people who are mentally ill and for minors, and presumably for mentally ill minors.

What he does not discuss in this column, which is based on emotionalism and not rationality, is the trouble caused in Holland and Belgium.  He does not give us real-world bias, discrimination and steering vulnerable people face, although it seems as though his family was steered in care if we are to judge by the tone of his writing.  He does not write of those cases where people are treated or ignored, like the case out of Winnipeg a few years back.  So what we have is a column based on his projection of his wishes on what he thinks should have happened to his mother based on his imagination of her suffering, which he had no means of verifying.

To conclude, this was a propaganda piece for euthanasia enthusiasts’ clubs and a call for death on demand without explanation, apology and for any reason of the observer.  Issues of disabled people being steered and treated badly was ignored too; so was the notion that the treatment itself could have been different.  The only options we were told about was his mother living in a coma (despite her being 90 years of age) and her being killed.  Long-term care was never discussed.  We are also not told what hospital this takes place at, nor are we told what the palliative team was like.  We must conclude that this was propaganda of the worst kind as it projects the writer’s emotions onto the readers, and ignores real world options and the possibility that his experience could be unique, which is a poor place to start a social revolution.

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