A sensible and humane decision on helping the dying

Doctor applauds court ruling ordering a change in the law

A short while ago I had the pleasure of attending my 56th class reunion in Holland.

It was great to meet up again with people from an increasingly distant past and to hear where their various careers had led them.

I was also confronted with the fact that it was 50 years ago that I graduated from medical school.

The occasion gave me pause to reflect on my own career in the world of medicine. Many things have changed beyond recognition, and yet numerous others have stayed the same.

Giving birth has become a lot safer and longevity has increased remarkably, thanks to better science and technology. Still, death awaits us at the inevitable conclusion of our journey through life.

Many people do not want to talk or even think about the last part of our stay on this planet, while others cannot stop thinking about the event itself and what may be in store beyond.

I recall a very religious, wealthy widow in her 80s who went to church every day, sometimes twice, to pray that she would not have to die. She even had a praying stool in her living room to do more of the same.

Praying is supposed to be a comforting activity, but for her it remained an obsessive and frantic plea for the Creator to perform a miracle.

Physically, she was in remarkably good health, but her state of mind prevented her from enjoying her time on earth with her large and truly lovely family. They tried to convince her that instead of continuously worrying about dying, she should put her wealth to good use for herself and others and that when her time came, to look forward to cash in her well-earned first class ticket to heaven.

Then one day she fell and broke her hip and ended up in the hospital. As part of my care I needed to discuss the risks during and following the surgery to repair her hip. In the course of the conversation, she opened up and told me she had her doubts about the existence of heaven, God and many of the things her church had taught her. That was why she was so afraid of not knowing what to expect.

Suffice it to say, she died in her sleep at the age of 95, and I will never know the answer to her doubts.

Then there are people like Gloria Taylor, who now has gained the right to physician assisted suicide.

After the court’s decision, she has clearly stated she is still enjoying life and in no hurry to exercise her newly granted right.

But when her disease inexorably progresses to the point where she no longer wants to live, she can ask to be put out of her suffering, without dire repercussions for her doctor.

It is anybody’s guess if and when she will decide to exercise her right.

I have had patients who begged me to put an end to their incredible suffering and meant it. I would have complied with their wish if the law had allowed me, but I had to say time and again that under the current law I would lose my license, get a criminal record and go to jail.

All I could do was to ameliorate their suffering to the best of my ability and face every day how little that was.

During my training to become a doctor, not a word was said about how to make the last stage of my patient’s lives as pain-free and comfortable as possible. My professors were totally focused teaching us how to save and prolong life with all this new and exciting technology and drugs, never mind the wishes of the patient.

Of course, saving lives and curing diseases is what doctors are supposed to do and do it well. And we have been spectacularly successful in making it possible for many people to grow quite old in reasonable health. New hips, knees, hearts, lungs, powerful antibiotics, eye-surgery to correct blindness and many other interventions will prevent a premature or miserable death for many.

Palliative care is a relatively new discipline in medicine and many of our local doctors are currently enrolled in a course to learn how to best deal with end-of-life issues.

Since my semi-retirement, I have had the privilege of teaching our future doctors enrolled at UBC the knowledge and skills how to better look after our terminally ill patients, and when my time comes, I can expect a much more humane and skillful physician to look after me than when I was a freshly minter doctor looking after dying patients.

I think it is only sensible and humane that Madam Justice Lynn Smith has granted an exemption under very strict rules for Ms. Taylor, who has  ALS, to allow her to ask for the assistance of a physician to end her misery.

Moreover, Madam Justice has charged our lawmakers in rewriting the current unconstitutional law within a year.

If our politicians can muster the wherewithal, there may soon be a new choice for terminally ill patients at the end of our common  journey between the mysteries of birth and death.

Dr. Marco Terwiel is a retired family physician who lives in Maple Ridge.

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