Last Updated: Friday - 09/24/2010

Euthanasia would rob the dying of rich moments near death

Palliative Care expert says when physician's toolbox is emptied, patient confronts mystery of life

Dr. Patrick Vinay

OTTAWA - Legalizing euthanasia could rob many people of some of the richest, most meaningful moments of their lives, palliative care experts told a conference here March 25-26.

"We are not fighting merely to keep euthanasia a crime, but because it takes away the few days that are of extraordinary importance in a person's life," said Dr. Patrick Vinay.

As death approaches, the priority for the patient ceases to be the illness and becomes relationships with others - to say something important, to forgive, said Vinay. It energizes the family, brings about a new sense of community and makes everyone more spiritually alive.

Things are said in these moments that have a huge and lasting impact on family and friends, he said. Families gain a new perspective on their loved one.

There is a new face of the sick person under the suffering, he said. Contacts with family and others gain a whole new importance, a density of meaning.

Vinay is head of palliative care at Montreal's Hôpital Notre-Dame and he was one of several speakers at a seminar organized by the Catholic Organization for Life and Family (COLF).

He outlined the process a person goes through after the first "earthquake" of receiving a diagnosis of a fatal illness.

A sick person first enters into a "bubble of power" as he seeks to be in control of his illness, he said. His family, doctors and hospital share that same bubble, encouraging him to fight that spot of cancer, isolating the disease.

In this phase, the patient's personal life is "absent" as he is pushed from exam to exam, chemo to chemo, and treated almost like a guinea pig.

SECOND EARTHQUAKE

But as the disease progresses, the patient experiences a second earthquake, where defeat sets in and the doctor's "toolbox is empty," Vinay said. There are no more treatments available and the sick person's death looms like an elephant in the room.

The patient leaves the bubble of strength and enters a bubble of powerlessness, he said. "The person has to live out this helplessness a prisoner of his failing body."

Yet something mysterious and dynamic begins to happen in the pain and disorientation and the loss of autonomy the dying person experiences, Vinay said. The sick person needs to ask for help. But the family also enters this bubble, as do the doctors. This makes them extremely uncomfortable.

"I see my own incapacity to help the person," he said. "We are in a situation of defeat, where professional answers are insufficient. I feel completely incompetent."

FALLING INTO CHASM

"The patient falls into a chasm, yet still opens his hand to the specialist, who takes off the white coat of an expert and the patient encounters another human being," he said. "They are now both equals, facing the mystery of life."

"It is so easy to run away from this space," Vinay said, urging instead a decision to be present, to experience the relationship of one being with another because they are both facing suffering and powerlessness.

Then something precious happens, he said. "I feel within my own heart that I am reaching that sick person."

A sense of resonance that develops between the mutual recognition of the "I" and the "sense of presence" is a universal, non-religious phenomenon, he said. The resonance has an immediate impact on the patient that transforms the bubble of helplessness into a bubble of meaning.

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