This is another physician鈥檚 view on assisted suicide in response to the Nov. 23 commentary by Dr. Adrian Fine.
As a retired kidney specialist, Fine, in all likelihood, witnessed people dying primarily in kidney failure after discontinuing dialysis. I agree 鈥� people dying with renal failure usually have a painless and听peaceful parting.
As a family physician for 40 years and doing palliative care for a further five years, I have a somewhat different perspective on euthanasia and assisted suicide. I agree with Sue Rodriguez that a person 鈥渙wns鈥� their life and that they should have authority over when the end is appropriate.
I disagree with Fine when he states 鈥渄ying patients often have a horrible exit from this world鈥� and 鈥渃urrent palliative practices do not address their needs, leading to their intolerable suffering.鈥�
If you have experienced this with a loved one, I would suggest that your loved one may not have received the best palliative care. Fine thinks assisted suicide should be available to those patients who are 鈥渦ntreatable and terminal.鈥� He obviously does not feel that palliative care is 鈥渢reatment鈥� or his experience in the field of palliative care has been disappointing.
Palliative care should address all aspects of suffering of the dying patient, including 鈥渢erminal sedation鈥� in those patients where the suffering is deemed to be uncontrollable. (Terminal sedation is a means of keeping a patient asleep and pain-free until they pass on peacefully). A patient or their 鈥渁gent鈥� as outlined carefully in a personal directive can refuse all fluid intake and will usually pass on peacefully with the help of the palliative-care team. They pass on in renal failure, not unlike Fine鈥檚 renal-dialysis patients.
What is mandatory is that legislative bodies continue to work with patients and physicians and not interfere in the autonomy of the patient and their relationship with their doctor and the palliative-care team. Death is cost-effective, and in our cash-strapped health-care system, patients should be careful what they wish for.
Providing legislation that sets criteria for ending life may not be as liberating as we think.
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Dr. Al Wilke of Saltspring Island is former chief of family medicine at Rockyview and Holy Cross hospitals in Calgary.
