Sunday 22 April 2012

Dying With Dignity

I always listen the radio when I'm driving and today was no exception.  I was on my home from visiting Nicholas when I tuned in to a CBC show about life in Quebec called "C'est la vie".  The guests were two provincial parliamentary representatives (MNAs) who had worked for two years on a non-partisan committee on palliative care.  The results of their work was a newly released report called "Dying with Dignity".  

It was interesting listening to these women talk about death and dying.  They had borne witness to so many stories of intractable pain, anger, desperation, joy, release - they admitted crying and sometimes laughing with their constituents.  I had no doubt that these representatives did their best to represent the lessons learned from the hearings and recommend measures that would assist more people have a good death.

In 2005, Nicholas was diagnosed with severe central and obstructive sleep apnea.  His condition was so severe that the medical team suggested Nick might have two months to live, perhaps a little more.  We refused surgery to remove part of the back of his tongue and the placement of a tracheotomy.  We were placed on palliative care.

During our posting in London, our palliative care physician came from a local hospice called St. John's and St. Elizabeth's.  Dr. Chris Farnham was a tall, gangly man who was somehow all smiley and sad-in-his-eyes all at once.  His voice was gentle and his humour sweet.  This was a kind man, but one of strength - Chris was a man of character.  As the years passed and Chris made home visits, prescribing different versions of oral morphine and muscle relaxants, I began to understand the differences between palliative and curative medicine.  The palliative physician medicates, the mind, body and soul.  They do this in the comfort of home or hospice.  Everything is done with comfort in mind.  Time moves slowly in palliative medicine, there is time for message, for chats, for home visits.

Nicholas hasn't died yet and I suspect that he has no plans to do so anytime soon.  But palliative medicine suits us very well.  Now in Ottawa, we have a wonderful doctor who is very like Chris.  His name is Dr. Robert Eaton - a GP with all the qualities of a gentle, knowledgeable caretaker and one who would go to battle for us and win.  He is a personal and a community hero.

The recommendations of the Quebec report "Dying With Dignity" include greater access to palliative care and protection for physicians who medicate their dying patients in order to assist them to die without pain.  Two physicians have to sign their consent for a terminally ill patient who requests assistance to die without pain, even if this speeds their demise.

Some might say that any assisted death is euthanasia and that it is wrong.  I suggest that those people read "Dying With Dignity" and listen to the sadness and wisdom in the voices of the parliamentarians who worked for two years listening to stories of dying - some good and some appalling.

Death is a difficult subject to talk about, personally and publicly.  But it is a necessary conversation and I for one, am glad that some politicians are working on protecting me from a terrible death.  "Dying With Dignity" is a public validation of best practice in palliative care - and palliative care means protecting life with all available resources, and then easing a transition to death as painlessly and peacefully as possible.  I have argued elsewhere many times against euthanasia because I believe it is a slippery slope for people with complex and severe disabilities, but I believe that "Dying With Dignity" is an honest effort to come to grips with some guidelines for helping all concerned have a long life and a good death.

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