Tuesday, May 18, 2010
The Case for Suffering.
Arguments against euthanasia are complex and far more difficult to make, she said.
"Today, the argument for euthanasia is the easiest to make," she said, noting the concern for the autonomous individual. "It's my right, my body. The individual has the right to choose death."
The arguments against euthanasia concern its effects on institutions, such as the health care system, hospitals, doctors and society as a whole, she said.
People often argue that we are merciful to dogs by euthanizing them, so why shouldn't we do the same for human beings, she said. "We're not dogs!"
Somerville said one of the biggest challenges is to argue there is something special about human beings without using religious reasons.
Traditional religion used to serve as a way of putting talk of death into a context of eternity, she said. "It is very difficult to justify suffering without some form of religious argument."
The Opposite of Love is Fear?
Talking with patients about their impending death is never simple. However, it’s easier if it’s done with a certain kind of love. This love is related to compassion, the willingness to suffer along with another human being in pain. A quiet joy can emerge when people suffer together like this. Medical training seems to have little to say about death, and even less to say about this kind of love.
Common wisdom tells us that the opposite of love is hate. But that’s only true on the surface. Love and hate are two sides of the same coin, the coin of attachment. Humans are just as attached to the people they hate as to the people they love. Either way, they just can’t stop thinking and talking about each other. Look at the world of politics.
In reality, the opposite of love is fear. Whereas love connects us, fear cuts us off from each other. Fear fosters abandonment, which can take many forms. Some are more obvious than others, but all are damaging.
At times we abandon our patients by ignoring or rejecting them. More often, paradoxically, we abandon them to further treatment, treatment that may or may not extend their lives, never thinking to ask them how they feel about it. High costs can accrue from this thoughtlessness. These costs are not just economic, but emotional and spiritual as well.
None For Me, Thanks.
On Sunday in New Orleans, Robert Fine and I did a pro-con debate on the Texas Advance Directives Act during an ethics session of the American Thoracic Society. There were around 150 people in attendance. One particularly telling moment was the following.Bob asked who thought that a PVS patient should be dialyzed. Almost nobody raised a hand. He then asked who thought a severely demented patient should be dialyzed. Again, almost nobody raised a hand. Bob finally asked (perhaps wondering if the audience was participating) who has done it or seen it done. A majority of physicians in the room raised their hands. There is your standard of care.
PVS Patients and Gender.
Hospice Does End of Life Planning.
Re “Lifesaving Devices Can Cause Havoc at Life’s End” (Business Day, May 14):
As a doctor who specializes in hospice and palliative medicine, I see more patients and families facing critical decisions about advanced technologies near the end of life each day. People should consider hospice not only to assist with pain and symptoms, but also to facilitate decision-making around goals of care and advanced technology devices like defibrillators.
Hospice teams have the knowledge, skills and resources to guide patients and families through these difficult decisions.
R. Sean Morrison
President, American Academy
of Hospice and Palliative Medicine
New York, May 15, 2010