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How Euthanasia Hurts Palliative Care

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Bioethics
Medicine
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Legalizing euthanasia can stunt the palliative-care sector. The Netherlands, for example, has traditionally performed comparatively poorly in this field. Indeed, one doctor once infamously said he didn’t need palliative care when he had euthanasia.

Forced to “Choose”

Now, in Quebec, the head of provincial medical association — who supports euthanasia — warns that some patients have been forced to “choose” to be killed because they couldn’t access quality palliative care. From the McLean’s story:

Provincial foot-dragging on plans to substantially expand palliative care services is actually denying patients the very choice that was promised in the shift to MAiD, and making it increasingly problematic to discern which patients truly wanted to have a doctor deliberately end their life, [Collège des Médicins President Dr. Charles] Bernard says.

“In certain identified cases, patients, for the lack of (palliative) care, might have had no choice but to ask for medical assistance in dying to end their days ‘in dignity,’ which deeply concerns us,” the Collège president tells the minister.

Worse, he adds, the Collège has been hearing increasing concerns from its member doctors about re-direction of already scarce resources from palliative care to medical assistance in dying, which risks a violation of both the letter and the spirit of Quebec’s law governing end-of-life care.

Paint my expression as completely unsurprised. The delivery of proper palliative care requires specialized training and can be very labor intensive. The most difficult cases may demand a great deal of inadequately compensated time from the doctor. Euthanasia doesn’t require anything like that kind of expertise.

Least Trained, Most Inept

In California, the Life Legal Defense Foundation learned in a lawsuit that a large percentage of lethal prescriptions in California have been written by Lonny Shavelson — a euthanasia crusader, not board certified in any specialty, much of whose medical career he spent as a part-time ER doctor, and who mostly pursued journalistic endeavors in recent years rather than treating patients.

Defenders of assisted suicide will respond to that charge by saying that prescribing morphine increased after legalization in Oregon — which is true. But it also increased in Rhode Island after that state outlawed assisted suicide and provided greater legal protections for doctors who prescribe strong pain-controlling drugs.

By Definition

Besides, I believe that legalizing assisted suicide — by definition — denies many of those who die by lethal overdose or lethal jab of essential palliative services.

Defenders of assisted suicide will respond to that charge by saying that many patients who take prescribed poison were in hospice. True. But they were denied suicide prevention intervention, an essential hospice service — as much a part of good palliative care as prescribing morphine.

The bottom line is: Hospice/palliative care and euthanasia/assisted suicide are mutually exclusive. One cares. The other kills.

Cross-posted at The Corner.

Wesley J. Smith

Chair and Senior Fellow, Center on Human Exceptionalism
Wesley J. Smith is Chair and Senior Fellow at Discovery Institute’s Center on Human Exceptionalism. Wesley is a contributor to National Review and is the author of 14 books, in recent years focusing on human dignity, liberty, and equality. Wesley has been recognized as one of America’s premier public intellectuals on bioethics by National Journal and has been honored by the Human Life Foundation as a “Great Defender of Life” for his work against suicide and euthanasia. Wesley’s most recent book is Culture of Death: The Age of “Do Harm” Medicine, a warning about the dangers to patients of the modern bioethics movement.
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