Monday, 20 October 2014

Let's discuss palliative care, not assisted dying

One of the joys and burdens of pastoral ministry is that death is not a stranger. From the moment of call through to the last days of active ministry, you walk in the shadow and face of death. And while it is not a friend, it becomes part of your living presence; you learn to walk with death along the journey of life.

I say that because it is the context in which I approach the matter of physician assisted death which is now before the Supreme Court.

This is an important issue for every single one of us. No mater who we are, what our beliefs are or what culture we live in, we will all, one day, die.

The arguments are overwhelming. They go to the core of our own sense of personal autonomy. They raise critical issues of medical care and decision-making.

In a recent blog post the Moderator of the United Church, The Right Rev. Dr Gary Paterson said, "...we are called to do is first listen to the struggles of those who are facing hard decisions and to make sure that they are not alone in those decisions, and second, to trust people with difficult choices about their own lives."

"We also live, however, within the legal framework of our society and are bound to honour our laws. But laws change and this is an area where I think they should change in order to allow physician-assisted dying in circumstances that meet carefully defined criteria."

With all due respect to my colleague in ministry, I disagree. I don’t believe it is a time for laws to change. It is time for deep conversation as a society and for a comprehensive national strategy for palliative and end of life care.

I have seen death in many forms. I have seen long and agonizing deaths where suffering has been extreme. I have seen sudden, violent death, where trying to cheat the laws of physics simply does not work. I have seen death by cancer, gun, COPD, motor vehicle collision, ALS and much, much more.

If there is a common denominator it has been that for all, death is final. If there is be one thing I would change it would be that there be an open and frank conversation about death and dying, where fears are named, love is assured and the words of the poet Dylan Thomas, "Do not go gentle into that good night. Rage, rage at the dying of the light." are an aberration and not a fact.

I have seen first hand what a difference quality palliative care can make. I have seen good deaths, where pain and suffering is alleviated and support is given to both the person dying and to their friends and family and, in the end, dignity is maintained and life and death affirmed.

As a Christian, I firmly believe the words of the United Church’s Statement of Faith; "In life, in death, in life beyond death, God is with us. We are not alone. Thanks be to God."

I think there is common ground and support in Canada for a comprehensive, high quality, national palliative care strategy. Physician assisted death is not part of that. Quality care in dying, supported by all of us, physicians included, is.

I will leave the last word to Dr. Balfour Mount of Montreal, a pioneer of palliative care in Canada.

"I have had a permanent tracheostomy for seven years. With each breath I take I realize that I may not be able to take the next one because it takes a remarkably small amount of secretions to block the tube.

"I realize that when I become unable to care for myself, the question gets a lot more interesting. What I would never ask, even if the legislation changes, is for a doctor or anybody else to end my life intentionally."

"I would far prefer to be asleep consistently until I die, as I described in my paper When Palliative Care Fails to Control Suffering, 20 years ago. The goal isn’t to kill, but to improve quality. It is a palliative goal."

And I agree.


Rev. David Shearman is the minister of Central Westside United Church, Owen Sound and host of Faithworks on Rogers TV - Grey County