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Palliative care nurse: ‘Death anxiety,’ economic concerns behind Canada’s euthanasia push

One nurse close to the issue claims that legalizing assisted suicide and euthanasia in Canada will inevitably lead to involuntary euthanasia and will corrupt physicians and nurses who take part in it.
Fri Feb 19, 2016 - 12:06 pm EST
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TORONTO, February 19, 2016 (LifeSiteNews) – The Ontario Liberal government's town hall meetings on euthanasia and assisted suicide were simply public relations exercises that gave no credence to anti-euthanasia views, says the president of the Euthanasia Prevention Coalition.

Jean Echlin, a palliative care nurse for 37 years who was instrumental in founding the Hospice of Windsor, and an adjunct associate professor of nursing at the University of Windsor, holds a number of those views.

Echlin is candid that legalizing assisted suicide and euthanasia in Canada will inevitably lead to involuntary euthanasia and will corrupt physicians and nurses who take part in it.

"I call infliction of death on a human being the ultimate act of violence," she told LifeSiteNews in a telephone interview. "How dare we ask our doctors and nurses to kill us? How can we dare do that?"

The Liberals' January town hall events were, in Echlin's view, "simply an effort in the Ontario government being able to say, 'Well, we ran town hall meetings, we had input from everyone.'"

"No, they didn't. They had input from those who believe in it, what should be included," she said. "From those of us who don't, there was no choice of any description" and "no discussion as to why or what we can do to protect the vulnerable, since this is going to be law."

The Supreme Court struck down Canada's prohibition against assisted suicide and euthanasia as unconstitutional on February 6, 2015. That ruling takes effect June 6, 2016.

The Court has also ruled that in the meantime, Canadians outside Quebec – which has its own legislation – who want to be killed by a physician can apply to their province or territory's superior court for permission. 

Ontario's Superior Court was the first, and at this point is the only, court outside Quebec to come up with interim directives for implementing physician-assisted suicide or euthanasia in that province.

A federal all-party special committee of 11 M.P.s and five senators is scheduled to deliver its recommendations for legislation governing assisted suicide and euthanasia on February 26.

Meanwhile, Ontario's Liberals established a provincial and territorial expert advisory panel on assisted suicide and euthanasia, which included as panelists euthanasia activists Jocelyn Downie and Maureen Turner and undertook its own consultations.

These included an online survey and the January in-person town hall meetings, which were based on the expert panel's November 2015 report – which advocated, among other things, that euthanasia be available for children. It also conflated assisted suicide, where the doctor prescribes a lethal dose of drugs that the patient self-administers, with euthanasia, where a doctor kills the patient directly with a lethal injection.

The external panel advocated that "nurses and nurse practitioners also be allowed to kill people," Echlin said. "I mean, this is bizarre."

And in January, the College of Physicians and Surgeons of Ontario ratified its highly controversial policy requiring that physicians who conscientiously object to assisted suicide and euthanasia provide an "effective referral" – that is, to a physician they know is willing to kill their patient.

For the CPSO to be so "putting heat on their doctors" is "prejudicial and discriminatory against people who have values and beliefs, those with a moral compass," Echlin said, adding, "What happened to democracy? The Charter of Rights and Freedoms? Where did it go?"

People haven't thought out "what will happen to the psyche of doctors and nurses who participate" in physician-assisted suicide or euthanasia, Echlin observed. "It's not medical care. This is death care or death management. It's nothing to do with health care."

There should be group of specialists, perhaps called "euthanologists," who can be trained to administer lethal injections by those who know how, which would be veterinarians, she said.

Indeed, Montreal ethicist Margaret Somerville holds a similar view, telling the joint committee in her February 4 presentation that Canada should have a "new profession" of euthanasia practitioners who are "trained, licensed and have travel money provided to give people across Canada equal access to euthanasia."

Failing that, "two publicly available lists of physicians and institutions" of those who will euthanize people and those who will not should be established, said Somerville, a professor of law and medicine and founding director of the McGill Centre for Medicine, Ethics and Law.

"This is a reasonable compromise between Canadians who agree with euthanasia and those who oppose it or fear it."

Echlin, who is 84 years old, admits to her own trepidation.

"I fear going into acute care," she told LifeSiteNews. "I'm due for surgery. I am terrified to go into hospital, because what if I don't heal as rapidly as I should, and become a 'bed-blocker' for a while?"

A "bed-blocker," she explained, is hospital slang for "the elderly who take up acute care beds."

Not only will the old and the dying be targeted, but "people with physical and emotional disabilities will be at very high risk," Echlin added. "Their lives do not look worth living to those who want to move economically through this."

And as has infamously happened in the Netherlands and Belgium, euthanasia – which the Supreme Court ruled must be allowed for eligible adults who want it – will inevitably become involuntary.

In fact, that is already happening in Ontario, Echlin said.

"I've received calls from nurses in the province who have left very good management jobs and so on because they were being forced to stop feeding and hydrating people," Echlin said. "They would instead be instructed to give [the patients] a drug that makes them drowsy," and the patient, under sedation, would die of starvation or dehydration.

The Canadian Nurses Association's ethics board advised nurses about two years ago to avoid using the terms "physician-assisted suicide" and "euthanasia" because these are too "emotionally charged," Echlin added. The preferred euphemism is "physician assisted death" or "dying."

The push for assisted suicide and euthanasia is driven not only by economics, but by a "high level of death anxiety" in those who advocate it, Echlin said. "I call it 'death anxiety.' They may not be in pain, but they're afraid of it. They may not be close to death, but they're afraid of it."

People who are ill and dying have the "fear of being alone, and being left to suffer without care. You fear that the health care team is not going to pay attention to your symptoms."

And in fact, Echlin faults Canada's medical system for its notably poor pain management, observing that "drug addicts do better" in handling pain than those under medical care, and for its "abysmal" and "dreadful" long-term care.

Echlin echoed many witnesses for the federal joint committee in her insistence that Canada needs to provide proper palliative care.

Palliative care means that "we focus on living well until you die. That means good pain and symptom management" and providing "physical, emotional, social, and spiritual care," she told LifeSiteNews.

"So it takes a whole team effort, doctors, nurses, social workers, chaplains, physio, occupational therapy, the whole team to assist the person to have a quality of living," she said. With such care, people who have asked to be killed not only change their minds, but live longer.

But with assisted suicide and euthanasia available, people may not be given the option of palliative care for economic reasons and will feel obliged to ask to be killed, because they feel they are a burden.

"I think there should be federal elder program and a federal suicide prevention program," Echlin said. "We're losing so many of our young people to suicide already, never mind we make it legal."

Ontario has closed its online survey and completed its town hall meetings but is still accepting email comments, according to David Jensen of the Ministry of Health and Long Term Care (MOHLTC). These can be sent to [email protected]

In forming its policies, the Liberals will look to the forthcoming federal law. "Ontario believes that a consistent, national approach to physician-assisted dying is preferable, rather than a patchwork where each province develops a different approach," Jensen wrote in an email to LifeSiteNews.

"Several important issues are matters that fall within the parameters of the Criminal Code, which is under the jurisdiction of the federal government."

For those in the Windsor area, Jean Echlin will be speaking March 10, 2016 at 5:00 p.m. on "Societal Death Anxiety in 2016" at the Hospice of Windsor and Essex.


  assisted suicide, canada, end of life, euthanasia

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