Johannesburg - The wrongfulness of dying, the loss of dignity and the fear of unbearable pain. These are the compelling arguments made for euthanasia, even more so since advocate Robert Stransham-Ford won the right to commit medically assisted suicide earlier this year through a ground-breaking ruling by Judge Hans Fabricius.
But is there a choice other than assisted suicide?
Dr Liz Gwyther, chief executive of the Hospice Palliative Care Association of South Africa (HPCA), and the incoming chairwoman of the Worldwide Hospice Palliative Care Alliance, argued at the South African Medical Association’s conference on Friday that there was – palliative care.
“The ethical and compassionate response is surely effective pain management. Ninety percent of cancer pain can be effectively controlled with complete freedom from pain through the simple measures described in the World Health Organisation’s manual on cancer pain control,” she said.
Gwyther said that Stransham-Ford’s application was written before he had requested and received palliative care and that she had confirmed with his family that his palliative care doctor said his symptoms were greatly alleviated through palliative care and contributed to his sense of dignity and meaning at the end of his life.
The WHO defines palliative care as an approach that improved the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.
“In contrast to the expectation that people want to die because of severe pain or loss of dignity, research has shown the most common causes of a sustained desire for hastened death are hopelessness and depression,” Gwyther said.
She quoted Dr Gary Rodin who said in a study he led titled “The desire for hastened death in patients with metastatic cancer” that, “The will to live tends to be preserved in cancer patients prior to the end of life, in spite of significant emotional and physical suffering.”
Gwyther said a mistake doctors often made was trying to restore a patient’s old life and returning them to their previous worlds.
“The role of palliative care is to help people re-script their lives,” she stated.
Minister of Health Dr Aaron Motsoaledi said that euthanasia was as much a medical question as it was a spiritual one.
He quoted the Hippocratic Oath taken by doctors on the issue of remembering that there is art to medicine as well as science and that warmth, sympathy and understanding “may outweigh the surgeon’s knife or the chemist’s drug”.
“That’s the problem of the health care system today, the warmth and sympathy of health care workers has been found wanting – those issues are important,” he said.
The Star