Saturday, October 31, 2009

Pro-Life/Catholic Groups Argue For Suffering, Against Continuous Deep Sedation.

As I wrote last week, the increasing successes of the aid in dying movement and the U.S.' recent attempts to reform health care have caused "pro-life" and Catholic groups to retool their machine, focusing on the end of life (or the "euthanasia") issue on their platform (which includes the money-maker, cultural-divider abortion; stem cell research; cloning; and the sadly forgotten "unjust war" and capital punishment.)

Euthanasia will never surpass abortion in its ability to raise money or rally activists behind the "pro-life" cause, but efforts to focus "pro-life" resources on the issue have hit their stride. Where these efforts deviate from established "pro-life" talking points (conception to natural death) is most telling.

A recent study, reported by TimesOnline, concludes that CDS is commonly used to ease suffering patients to their death. "Pro-life" organizations are up in arms, willfully conflating pain alleviation with euthanasia, despite the fact that CDS is most likely used by medical staff in Catholic hospitals and hospices in Britain and the US.

Continuous Deep Sedation (CDS) is what "pro-life" and Catholic organizations are most focused on at the moment regarding end of life issues, thanks to the above study. And yet, it muddies their argument for "natural death" because CDS is basically the most simple and widely used manner of keeping a patient in pain comfortable in their last days.

While these groups are accustomed to arguing for or supporting pain and suffering, at least in the abstract, regarding abortion (witness their disregard for a woman in crisis or a dying mother or a woman's right to autonomous decision-making), elders are seen as victims of disease and death. Women, it seems, are inherently evil and in need of paternal guidance from men and the church.

"Pro-life" and Catholic opponents to CDS are left to face the realities of physical suffering. Their arguments in support of painful death are blatant and revealing.

The practice of sedating a patient to alleviate pain in the end stages of dying is legal in the U.S. because doctors are protected by what is called the double effect: because their intention is to relieve pain and not hasten death, they are permitted to employ heavy sedatives. This stage of death often marks the end of feeding and hydration, hence the accusation that patients are being "killed" by dehydration. (Members of the Catholic clergy have recently called for a clarification of the Church's Artificial Nutrition and Hydration (ANH) policies.)

In addition to "pro-life" and Catholic efforts to maintain jurisdiction over suffering (which is considered redemptive, Christ-like, and necessary), two other factors play into this discussion:

- the medical profession has failed to make serious advancements in palliative care (an area of medicine that focuses on pain and symptom management)

- and our society fails to prepare families and patients for the death of a loved one, thus allowing, even demanding, that doctors "exhaust all options" with aggressive treatment, even when those treatments may prolong death and suffering for the family and the patient.

The medical industry has failed to put resources into end of life and pain management research because, well, they have had few financial or other incentives to do so. Sending a patient to hospice in the last months or weeks of their life deprives the hospital of end of life revenue (famously the most costly period for American seniors and the terminally ill), it requires that doctor's admit they can no longer save a patient, and it demands that family members accept the impending loss of their loved one.

Opponents of CDS (and, in a horrifying leap of misunderstanding and conflation, of assisted suicide and euthanasia) have argued in favor of family participation in such end of life decisions and against it (fearing coercion); opponents have argued for the sanctity of the "doctor-patient relationship" and against it. Their messy siding with different participants in the end of life decision-making process, depending on which serves their purposes, paternally shy away from patient planning and advanced directives (God alone can make such decisions, they claim).

And so, rational, consistent arguments have failed to come out of Catholic and "pro-life" organizations. Their only consistent allies remain God and suffering. It is a more raw and alarming argument for suffering than we witnessed in the debates over abortion; and it is vastly more unpopular with the public.

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