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Kill the Pain Not the Patient

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October 1995

A Canadian study on palliative care, published in the August 1995 American Journal of Psychiatry, reinforced what past research had documented – when physical pain is controlled and depression is treated, terminally ill people do not want to die.

According to the research finding, the desire to die among the terminally ill was associated with clinical depression, a treatable condition. Other factors contributing to a desire to end one’s life were uncontrolled pain and the feeling that one had little family and social support.

The Canadian study’s author is Dr. Harvey Chochinov, associate professor of psychiatry at the University of Manitoba. The study’s participants were 200 patients at two Winnipeg hospitals. Their average age was 71 years and they survived about 43 days from the time of their interview until death.

Of the 200 people interviewed, 17 had a pervasive desire for death. After two weeks of inpatient palliative care, four of six people who were reinterviewed, changed their minds about wanting their lives to end. Only six of the 17 were reinterviewed as the others had died or were too ill to participate.

Dr Chochinov states that depression was far more common among the patients that wanted early death than among those who did not. “Our findings indicate that a substantial proportion of terminally ill patients who express a desire for death could potentially benefit from a trial of treatment for depression,” he said.

Being depressed and feeling hopeless makes such a person “more vulnerable to the suggestion of others, thereby increasing the potential for abuse” of assisted suicide. This is the case in the Netherlands, where patients are euthanized, even though their suffering is remediable.

Instead of killing the pain they kill the patient.

The Dutch euthanasia enthusiasts are assisting physically healthy but depressed patients to die. Instead of killing the pain they kill the patient. The tragedy in Holland is that they are eliminating the suffering person, instead of seeking ways to eliminate suffering.

The Canadian study verifies that the hospice alternative provides relief of physical, emotional, and spiritual pain and suffering.

This study shows that patients requesting euthanasia may be in depression and the physician;s calling is not to prompt the anxious and depressed to shrivel up and die but to give of themselves, to reach out with compassion, love and sensitivity, working diligently with other professionals and the patient until emotional pain is relieved. This is the dignified way to manage psychological distress. Once treated, the patient often begins feeling that life is worth living. Once a patient is comfortable, physically and psychologically, death is not desired and the person gets on with living.

When physicians, like those in Holland, are not versed in easing pain and dispensing palliative care, society pays the price. With killing as the solution to pain in the Netherlands, there is no incentive to treat the pain.

The solution to physical and psychological suffering is not licensing the physician to kill individuals victimized by it.

The solution is to enable individuals to live with dignity throughout the natural dying process.

The solution, as this study points out, is to enable individuals to live with dignity throughout the natural dying process. Compassion is offering pain-control and the treatment of depression.

It is saying I am going to do everything that I can to make you comfortable, conscious, and alert until you do die. I am not going to hasten your death or postpone it. I am going to relieve your physical pain and treat your depression. This palliation, not euthanasia, is the compassionate, caring solution.