…at the end of life as at the beginning. Here Margaret Somerville highlights how Quebec doctors aren’t likely to be able to debate legalized euthanasia well, since they don’t appear to know what it means:
Dr Barrette said that in caring for terminally ill people, “doctors are aware they can be charged with murder if they administer a ‘palliative sedative’ before a patient is on his or her last breath.” This is not euthanasia, although, like Dr Barrette, 49 percent of Quebec physicians recently polled mistakenly thought it was. Palliative means the sedative was necessary to relieve pain and suffering and was not given with an intention of killing the patient. That cannot result in a murder charge, or any other legal charge, unless the patient refused it.
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The mention of ‘intent’ doesn’t look to reassuring. A sedative given to someone near death probably will hasten it – and if it comes down to intent, how do you determine if the doctor viewed that as an unavoidable consequence of reducing pain or as an aim in itsself?
I have worked in long-term care for more than 20 yrs, as a Registered Nurse, and have worked with countless palliative patients. Our goal when working with palliative residents is to keep them as comfortable as possible. That may mean administering a sedative or pain medication, which may also have the side effect of depressing their respiratory system. My intent when administering them has never been to hasten someone’s death.
I have also cared for my mother-in-law, who died from cancer 5 years ago. She was given pain medication and sedation, at her request and with my father-in-law’s blessing (and on doctor’s orders). The medication probably did cause depressed respiratory function, but she died peacefully and free from pain at home. This was not euthanasia. Our intention was to keep her comfortable.
It is not unlike chemotherapy drugs (to give another example). They are used to give the patient the best chance possible to recover from cancer. But the unavoidable truth is that they may also hasten death in some cases- the patient may not be able to handle their potent side effects. Does that mean we don’t use them? All medications have side effects- some have life-threatening side-effects. I rarely hear intent called into question when administering them.