Dying comes with choices

By James Buchok

WINNIPEG — Euthanasia and assisted suicide eliminate tragedy and suffering by eliminating the sufferer and epitomize the ultimate abandonment of a person by a community, according to Dr. George Webster, a Winnipeg-based clinical ethicist.

“People dying need care and relief from pain, ” said Webster. “The question is, how do we best care for the dying person?”

The question is more profound in 2010 than it was in 1910, Webster said. “In the past, illness was characterized by rapid onset and a speedy resolution. A person either lived or not. Now death comes from chronic degenerative diseases. The transition to death is much slower and dying comes with choices.”

Webster is with the Health Care Ethics Service at St. Boniface General Hospital in Winnipeg. He is engaged in ethics consultation, ethics education and research ethics with the Catholic Health Corporation of Manitoba. He provided a presentation on euthanasia and assisted suicide June 3 sponsored by Micah House, the Archdiocese of Winnipeg’s centre for social justice.

Webster said there have been a number of private member’s bills introduced in Parliament over the years to legalize euthanasia and assisted suicide. The most recent was Bill C-384 introduced in May 2009 which would have made euthanasia available to people “experiencing physical or mental pain without prospect of relief or suffering from a terminal illness.”

Webster said the reference to those suffering mental pain goes far beyond what has been made legal in countries such as Switzerland and the Netherlands. Webster said he found the wording of the bill “startling.”

Bill C-384 was defeated on April 21 by a vote of 228 to 59.

“You may hear that a poll says 80 per cent of Canadians support euthanasia but you don’t know what the question was that the pollster asked. If you were asked, ‘If you are suffering at the end of life would you want your life ended?’ how would you answer?”

Webster said there is a distinction between intending death by assisting a suicide and allowing death by discontinuing treatment at the request of a dying person.

“Allowing death means death comes from the disease. In choosing to allow death a person is saying, ‘I no longer have an obligation to battle this disease.’ But euthanasia requires the action of another. With euthanasia, my actions are an integral part of securing the death of the other.”

Some proponents of euthanasia say it is justified because it relieves “the indignity” of unrelenting or unbearable pain, Webster said, while others see it as the ultimate expression of autonomy and self-determination. “It is for many an expression of control; they are in charge of their dying.”

Others, said Webster, “see it simply as a private matter, believing, ‘If my actions do not harm another or compromise another, then I should be free to choose.’

Webster disagrees: “I say strenuously that death is not a private matter.”

Webster said a person’s opposition to euthanasia is usually owing to legal concerns, religious beliefs concerning the sanctity of life, philosophical principals or professional codes of conduct.

“Some argue a care provider who endorses euthanasia changes the underlying ethos of the health care profession. How can you reconcile healing and caring with taking a life? Many can’t.”

Webster said many supporters of euthanasia have suffered themselves or witnessed the long suffering of family members. “Loss of control and fear of a painful, protracted dying process are basic questions for us all,” he said.

“We have to offer an alternative. People must be involved in decisions. There has to be a change in the whole culture of health care. Patients must be assured that they will not be abandoned, left to die in isolation, or excluded from important choices at the end of life.”

To truly honour and respect the dying, he said, “is to keep company with these people and respond in concrete ways that communicate faithfulness and commitment.”