Two years ago, Evelyn Martens
allegedly helped two terminally ill women kill themselves.
Police found so-called 'exit bags' in her car. These are
specially designed suffocation bags complete with velcro
sealer at the neck and a hose to pump in a deadly dose
of helium. The longtime right-to-die activist's case is
now at trial in BC where a publication ban has been imposed.
For many terminal patients nearing
the end, concepts like being 'made comfortable,' and
'pain control' have lost all meaning. They want their
suffering and dependency to be over; they want to die
with dignity. But one has to wonder ? is dying with
a helium-filled bag over your head dignified?
MORAL
HIGHJACKING
"Dignity has been highjacked by the movement," says
Dr Harvey Chochinov, a professor in the department of
psychiatry at the University of Manitoba, who's written
extensively about end-of-life care. "The problem with
the dignity movement is that it removes the argument
from the bedside."
Dr Chochinov's research looks specifically
at the factors that influence this sense of dignity.
"The approach that we have taken with the issue," he
says, "is to step outside the politics of the issue
and really look at the clinical and bedside issues."
These include asking if and why patients want to end
their lives, looking at factors such as depression,
abandonment and pain management.
Dr Chochinov has managed to nail
down some of the sources that influence a sense of dignity.
He cites three major points: physical symptomalogy;
socially mediated influences like privacy, respect and
the perception of how they are seen; and, the most complicated
in Dr Chochinov's view, the psychological and spiritual
makeup of the person, such as their outlook, connectedness
and disconnectedness. Dr Chochinov admits that though
clinicians can measure depression and pain, there's
no way to quantitatively measure dignity. "Dignity is
in the eye of the beholder," he says.
THE
DIGNITY DEBATE
Martin Frith, director of the counselling program at
Dying with Dignity ? a right-to-die society ? agrees
with Dr Chochinov's findings, but not the approach.
"We can treat pain," says Mr Frith, "but we really can't
treat suffering." Through his work with terminally ill
patients he has come to understand some of the reasons
why patients decide to end their lives. "Loss of autonomy
is the number one reason," he says, and autonomy always
takes dignity down with it.
For Dr Elizabeth Latimer, a palliative
care consultant and professor at McMaster University,
with an interest in the dying with dignity debate, the
idea of reacting to these feelings by demanding suicide
is not only wrong but wrongheaded. "I think euthanasia
promises a way of relieving suffering and pain," she
says. "It also promises to relieve people of a poor
quality of life and whether it actually does isn't clear."
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