palliative care

One inspiring doctor, one inspiring interview

July 23, 2009 by Véronique Bergeron Leave a Comment

In yesterday’s Part Two of The Current on CBC. Find the interview with Dr. Balfour Mount here. I heard the reply to Dr. Mount in this morning’s The Current. Interestingly enough, while proponents of euthanasia present it as a dignified, compassionate way to die, the follow-up interview (not available online yet) wasn’t nearly as hopeful and optimistic as Dr. Mount’s argument for proper palliative care.

One particular point touched me: when asked why euthanasia never really leaves the public discourse, Dr. Mount — who suffers from cancer of the oesophagus — attributes it to the compassion of the Canadian people for those who suffer. We do not like to see people suffering, we want to alleviate the pain, and euthanasia appears on the surface like a compassionate thing to do. Dr. Buckman, in his rejoinder, attributes it to the bigotry of a vocal minority of right-wing religious groups. Hope and compassion versus intolerance. Who would you rather have as your doctor?

Proper palliative care is a right, not a privilege

March 3, 2008 by Véronique Bergeron Leave a Comment

Heard an interview on my local CBC morning show with Loïse Lavellee. The interview began this way: “Robert Latimer. To some he is a monster. To others, he is a kindred spirit…”

The essence of the interview was that Lavellee sympathized with Latimer on a very personal level: She also lost a disabled child, her daughter Éloïse. If I heard correctly over the morning chaos of my house, Éloïse died of natural causes after being denied life-sustaining treatment. “Latimer,” Lavellee said, “didn’t get that chance. So he had to take his daughter’s suffering into his own hands.” When asked what she had to say to disabled people who felt threatened by the whole Latimer affair, Lavellee said she understood their fear but that “the issue with Tracy was not her disability, it was her pain.”

But can Tracy’s pain and disability be so easily separated? I have read that Tracy’s pain control consisted of Tylenol. Whether that’s all she was able to take or all she was allowed to take is irrelevant. Either way, Tracy’s unrelenting pain could not have been so easily ignored had she not been disabled.

I once asked one of my teachers in bioethics how much of the euthanasia debate hinged on improper research, investment and education in palliative care. He thought about it for a minute and said: “Most of it.”

Tracy didn’t have a right to die. But she did have a right to proper, effective, medical care which included adequate pain control. The system failed her and she paid with her life.

Sticks and stones may break my bones

February 12, 2008 by Véronique Bergeron Leave a Comment

Words can be violent and ugly, as these were:

“Two young girls who froze to death last week on the Yellow Quill First Nation reserve…”

“Froze to death,” I thought, have mercy on the parents: Do we really need to say they froze to death? Could we not write “died of cold-induced cardiac arrest”? I feel better thinking they died of cardiac arrest. Makes it sound quicker. But in the end, it still means they froze to death. And there is no way to wash-off the violence of dying alone in the cold.
It reminded me of a seminar I attended recently entitled “When is it ethical to withdraw nutrition and hydration from critically ill children?” or, in lay-person’s terms “When is it okay not to feed and give water to dying and/or very sick children?”

This time, the discussion involved a case study in neonatal intensive care where a chromosomal anomaly had not been diagnosed by prenatal genetic testing. One of my colleagues observed:

“This is problematic because the parents would have terminated the pregnancy had they known about the genetic anomaly. They had wide latitude to decide not to raise an impaired child while pregnant and lost that choice when the baby was born. One day, they could terminate the pregnancy for any reason. The next day they would be committing infanticide by withholding fluids and nutrition.”

The speaker, a well-known scholar and experienced physician, interrupted: “I don’t like using the word ‘infanticide.’” The conversation continued and I asked: “If food and water were discontinued, would death occur by starvation or would the baby die of its underlying condition?” Nobody seemed to see a material difference between the two but the speaker took issue with “starvation.” Apparently, he didn’t like that word either.

Words create images and form realities. We don’t like what “starvation” and “infanticide” suggest so we try to change their violent reality into something more manageable. In the end, there is no escaping the fact that denied food and water for long enough, genetically- impaired infants starve to death.

We can argue whether or not this is ethical but let’s not hide violence behind euphemisms. Sticks and stones may break my bones–and words can also hurt me. So be it.

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