Assisted Suicide Considered when Pain is Not Controlled

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From: nhl-info

Most dying cancer patients say doctor-assisted suicide should be

legal: survey

ANNE-MARIE TOBIN

Published Wednesday June 6th, 2007

For years, debate has raged in Canada about euthanasia and

physician-assisted suicide without much study of the people who are

arguably most affected - those who are themselves dying.

Now, new research shows that 63 per cent of palliative care cancer

patients who took part in a survey said they believed that assisted

deaths should be legalized in this country.

The 379 patients were interviewed between 2001 and 2003 in St.

's,

N.L., Quebec City, Ottawa, Winnipeg, Saskatoon, Edmonton, Kelowna,

B.C., and Vancouver.

Forty per cent said they would consider making a future request for

doctor-assisted suicide if their situation deteriorated to a

" worst-case scenario, " according to the study, funded by the Canadian

Institutes of Health Research and published in the U.S. journal

Health

Psychology.

These people tended to explain they were worried

about " uncontrollable

pain " and might feel comfortable knowing they could have access to

assistance in ending their lives, lead researcher Dr. ,

an

associate scientist at the Ottawa Health Research Institute, said in

an interview Wednesday.

Ten per cent believed that if the option had been legally available,

they would already have requested euthanasia, usually because of

uncontrolled pain. But the study found that when the pain was brought

under control, they tended to change their minds.

A total of 22 participants - 5.8 per cent - said that if they could

have access to euthanasia or physician-assisted suicide, " they would

definitely initiate a request to end their lives right away, in their

current circumstances, " the study said.

" It turns out, for those 22 people we're talking about, the issues

were much more complicated than pain, " said , who is an

associate professor of medicine at the University of Ottawa and a

psychologist at the Ottawa Hospital Rehabilitation Centre.

" They didn't tend to have any more pain than the people who didn't

want assisted suicide. But they did tend to feel sicker, they did

tend

to feel weaker. They were more likely to be depressed, and they felt

that they had become a burden to others. "

These people tended to be less religious, and less likely to be Roman

Catholics, but they were otherwise comparable to other study

subjects.

The Vatican opposes euthanasia and Pope Benedict has often talked

about the importance of human life all the way to its " natural " end.

said it's difficult to put the numbers in context with what's

happening elsewhere, given that assisted suicide isn't legal in

Canada.

In the Netherlands where euthanasia is openly practised, he said

between six and 10 per cent of people with advanced cancer die this

way.

" But in the state of Oregon, where they have access to

physician-assisted suicide but not euthanasia, it's well under one

per

cent. So there are differences even in places where they're legal. "

For this study, euthanasia was defined as a doctor giving an overdose

of medication, usually by lethal injection, to purposely end a

patient's life. Physician-assisted suicide was defined as providing

drugs and/or advice so a patient could end his or her own life.

" Both actions were framed within the context of patients who were

informed, mentally competent, ill with a life-threatening disease,

and

asking voluntarily for their physicians' help in hastening their

deaths, " the researchers wrote.

Earlier this week, Jack Kevorkian, a retired pathologist dubbed Dr.

Death for claims that he participated in at least 130 assisted

suicides, was released from a Michigan prison after eight years.

Ruth von Fuchs, president of the 400-member Right to Die Society of

Canada, said Kevorkian accomplished something.

" He got a lot of people, just ordinary folks, talking about it over

the breakfast table and maybe they made living wills, maybe they

checked with their doctors, " she said.

" People likely wouldn't consider, and their children wouldn't want

them to consider, giving up life for the sake of their children, if

the life they were having was like it had been during their youth and

middle age - fulfilling and mostly pleasant, " said von Fuchs, 66,

whose own mother died about 20 years after suffering from lymphoma.

" But at the end of life when your body is wearing out and you're

having and can only have a life that is, in your view, pretty

terrible, no life at all can really seem to be better. "

said the proportion of study subjects - 63 per cent - who

thought euthanasia and physician-assisted suicide should be legal in

certain circumstances is about the same among healthy individuals.

" When it comes to people's overall opinions about social policy, what

should Canada do, what should they not do, there's probably not that

much different from people who are quite sick versus people who are

reasonably healthy. "

said the research will inform the debate in Canada.

" It helps to bring a bit of light into a dark issue, and when it

comes

up again and people start saying 'should we or shouldn't we?' at

least

there's a better body of information. "

" The reality is most pain, not all, but most pain, tends to be

controllable and that it's a more complex set of factors that are

contributing to euthanasia requests than just pain, " he said.

" Some of them are mental factors, some of them are social factors and

some of them are physical factors ... it's not a simple issue. "