Last week I accepted an invitation from CityLife MAtv in Montreal to be part of a round table discussion on End of Life Issues. They positioned my contribution in the context of a paper that I had submitted and presented in 2010 to the Quebec National Assembly’s Select Committee on “Dying with Dignity”, about my father’s health condition.
In a nutshell, the story goes like this. My dad had suffered a heart attack and, although it did not leave him with any major physical consequences like paralysis, it did affect his overall quality of life. He was very much weakened physically and psychologically, becoming gradually more dependent on my mother. The reality of seeing his autonomy declining caused him distress associated with anxiety crisis. He then started to say: I don’t have a purpose here anymore, I am poisoning your life, I would rather be dead.
I had a first phone discussion with the TV program’s researcher, Amie Watson. I did appreciate her first question: “I read the paper you presented to the Committee in 2010…How is your dad doing? Is he doing well? I answered that “doing well” was a big word but that he had overcome his anxiety, fears of the future and desire to die thanks to professional help and the care and love of my mom, my two brothers and myself. I told her that he was still struggling to accept his age and condition but that was far from a perspective of despair.
Quebec adopted its Bill 52 in 2014 and became effective on December 10th 2015, legalizing euthanasia in Quebec through a twisted mechanism of presenting it as a medical aid. On its side, and following a Supreme Court ruling that section 241 of the criminal code is unconstitutional, the federal government is yet to present its new legislation regarding euthanasia and assisted suicide.
With this legislation in the making, I was pleased to have the opportunity to express in this program what I thought on the following questions:
How did your personal experience with your father lead you to not support the new dying with dignity legislation?
It is natural to think about death when one feels depressed, weakened and in chronic pain. Even though it is not easy, it is essential for family members and friends to be close to people who suffer and take the time to understand the content of a statement like “I want to die”. It needs to be decoded, to identify the various layers that lead a person to express that desire. Most of the time it is charged with multiple fears and anxieties regarding the future.
In the case of my dad, we all tried to help him realize that there were a variety of actions he could still undertake. So, more than focussing on what he had lost, we helped him to look at what he could do, even though it was little.
He progressively came to terms with his condition and accepted another way of looking at life. He discovered a dimension of himself that had not been activated, a quieter and peaceful one. If we had taken my dad’s repeated words “I want to die” at face value, and if he had been attended by a pro euthanasia doctor, he would probably not be with us today. He would not be there to enjoy my mom’s company anymore, to share the adventures of his children and grandchildren and to accompany the ups and downs of his siblings in their old age.
How did you know that asking for palliative care and letting your father die wasn’t the right choice for him?
My dad had been a happy person until then and proud to be independent and in control of his life. I understood that for him to lose these important dimensions of his life was very difficult and were equivalent of being dead. I knew that his despair although real, was subjective, and that he needed time and psychological help to gain objectivity on his overall situation. That is indeed what happened over several months.
How do you feel now that this law is passed in Quebec?
I am worried for many reasons. I will give only two for now.
I think that there will be less investment in palliative care, which is the solution for what many people want in their last moment: to go peacefully.
I am also concerned that there will be less funding and therefore less motivation to develop expertise in pain management and specialist clinics. This is urgent, taking into account that chronic pain affects approximately one third of the population, and that with the ageing population these figures will probably increase.
You wrote about the “Illusion of Peace of Mind » regarding Euthanasia. What do you mean by that?
I argued that it is an illusion to think that controlling the manner and possible moment of death will give peace. I think that it will have the contrary effect. People will be more anxious, even though they are in control of the end of their life because the thought of death will be more present. And this will be true even though the person is perfectly healthy. It is like walking around attached to a drip-line that is poisoning your life while you are healthy.
Do you strongly believe that no one should ever qualify for assisted death, no matter how much they suffer?
Yes, I do. I strongly believe that we need to invest much more in pain management clinics, in palliative care centers, in improving the care of people in the hospitals and the elderly who are in care facilities.
We should invest much more in improving the conditions and care of these establishments before going down the path of euthanasia.
Why was it important for you to testify in front of the commission?
It was a matter of conscience. I strongly feel for elderly people, for people who suffer any pain, and about the protection of disabled people. A person asking for euthanasia or assisted suicide represents a failure in the health system and society in general. Something went wrong somewhere.
Monique David writes from Montreal, Canada.