Standardizing euthanasia can be dangerous »MercatorNet

Euthanasia: Seeking the Full Story: Experiences and Perspectives of Belgian Doctors and Nurses would be a good deal at any cost, but it’s free downloadable from the website of Springer, the publisher of many medical journals.

Euthanasia, although legal in Belgium, is contested by some health professionals. This collection of essays contains inspiring ideas and stories drawn from the professional experience of the authors.

The authors are ten Belgian health professionals, nurses, university professors and doctors specializing in palliative care and ethicists who fear that euthanasia has become normalized and commonplace.

Far from being controversial, the perspectives of this book present another facet of the patient autonomy story. As Margaret Somerville, an Australian bioethicist and Wes Ely, an American critical care specialist, observe in their foreword, there is a dearth of literature on the societal ramifications of legalizing euthanasia. They write that: “The argument against euthanasia is much more difficult to promote, not because it is weak – it is not – but because it is much more complex. This case requires looking not only at the present but also our “collective human memory” – that is, history – to learn from the past and our “collective human imagination” to try to anticipate the full consequences. and broader legalization of euthanasia. “

The following is a selection of reminiscences by Francois Trufin, hospital emergency nurse in Belgium.

Euthanasia, a step in accepting your illness

A request for euthanasia is not the end of the road. We must see it as a new phase, among the other stages of mourning, on the road to acceptance. At the end of this process, we hope that the person, with the help of the palliative care team, can die of natural causes, having lived their life fully to the end. A patient who requests euthanasia is generally in the grip of terror: fear of suffering, of dying, of being a burden … Euthanizing in this distress deprives him of the time to allay his concerns and find answers to his concerns. Questions. Moreover, it confirms a failure and denies them the hope of overcoming it.

The health care professional who is aware of this possible care path will no longer be apprehensive about a patient requesting euthanasia; they will take them by the hand and walk by their side to the end of the path.

[Once] a patient arrived in our department accompanied by her husband. She was around 50 years old and until now lived at home, taking 32 medications a day. Convinced that she was a burden on her husband and her two children, she repeated day after day: “Let go of me, I want to die, do not give me any more medicine”.

She has attempted suicide four times. On the fourth attempt, she pushed herself up the stairs in her wheelchair. Her husband, who loved her deeply, was totally overwhelmed. He was devastated that he couldn’t stop her from throwing herself up the stairs. For the GP, it was clear that she wanted to die and he referred her to the hospital for euthanasia.

When she entered, her husband shouted, “Don’t let anyone get in the way, she must be euthanized.” The team started to panic. I went to see the patient and we had a 4 hour conversation with husband and wife. We had an argument and since I did not agree to carry out the euthanasia, he wanted to bring his wife home and send her elsewhere.

I told her, “The choice is yours, but right now your wife cannot be transported; any movement is extremely painful and we have to deal with its pain first. I guarantee you that we will do everything possible to make her comfortable. When she is, you can always decide if you want her transferred to be euthanized ”. So the situation calmed down, the husband decided to leave his wife in our department, and we worked together.

Seeing how, with the combined use of pain relievers and controlled sedation, his wife was resting peacefully in her bed, he became convinced that palliative care was working. A very tactile man, he appreciated the massages with essential oils that we offered to his wife. We encouraged him to bring the CDs they listened to together.

The two children, both young adults, followed suit, although they were uncomfortable at first. They feared betraying the determination of their mother who had insisted from the start that she wanted euthanasia. We reassured them by saying that she was no longer receiving medical treatment and that we did nothing to prolong her life, only to make her comfortable.

This lady passed away peacefully in her husband’s arms, listening to the music they had played at their wedding. After a week, her husband returned, asking to see me. He thanked me with a box of chocolates… and asked if I could save a place for him in our palliative care department when the time came!

The sad part is that it took 32 drugs and four suicide attempts for this woman to be heard and treated, rather than being the object of therapeutic obstinacy.

Euthanasia as an awakening of indifference

During the Christmas holidays, a 75-year-old lady, whose recovery from hip surgery was difficult, suffered several falls at home. Feeling relatively well but no longer able to live on her own, she was placed in a nursing home – which was sorely understaffed – by her overworked children.

At home for an entire month, she saw people stay in bed – even for meals – three or four consecutive days during long weekends, for example, when the staff were reduced. Sometimes calls for help from residents to go to the bathroom went unnoticed, etc.

Fearing to find herself in a similar situation, she preferred to end her life immediately. She communicated her wish to the general practitioner, completed the documents properly and obtained permission to be euthanized. The nursing home sent her to the hospital.

As she was not dying imminently, the law had to provide for a period of one month between the acceptance of the request and the actual euthanasia. During this time, she was taken care of by our palliative care team, even though her condition did not warrant it. The psychologist saw her regularly.

When I heard the following sentence, it rang like thunder in my ears: “Have you noticed? I had to ask for euthanasia so that people started to take an interest in me ”. Indeed, she had several visits a day, received appropriate care, saw the psychologist, some people brought chocolates… Even people from the retirement home came to visit the star she had become. And it all happened after she volunteered for “death row.” It was a very unhealthy situation where it seemed like the request for euthanasia was becoming an “open sesame” to receiving proper care and support.

This patient caused a professional electroshock for me! She made me realize how important those moments at a patient’s bedside are, when you have time to talk or even play cards, and just be human. Her experience prompted me to assemble a group of volunteers who volunteer their time to go and sit at a patient’s bedside. It also taught me that, whether a request for euthanasia comes from the patient or a member of his family, it is worth checking if they want to test the medical world. I was pleasantly surprised to find that when we calmly say, “No, we don’t perform euthanasia, but we have something better to offer you,” people are ready to listen. And when we explain that the pain will be relieved and that their quality of life is our main concern, the request for euthanasia quickly fades. Most patients and families yearn for pain relief and to be treated like a human being.

When trust meets professional integrity

But I do not despair. Even though today many are trained in euthanasia, believing it to be part of patient care, I am convinced that there will always be enough people to look reality in the eye and not run away from the tragedy of life. And I hope they can find out for themselves what I have come to understand.

One day, I was returning home after facing a particularly difficult situation. I was in total turmoil, at the end of my tether. Getting home from the hospital takes me about half an hour, through beautiful landscapes. That evening, the sun was emphasizing the autumnal colors, and suddenly it dawned on me: “Fortunately nature doesn’t react like us humans … What if the leaves said at the end of summer:” I want to die . Soon there will be no more tree sap, so it would be better to end my life right away ”. If so, we’d be missing out on the beauty of the fall. By July, many still green leaves littered the ground and there would be none left to display their colors in the fall.

The richness of autumn lies in the time it takes for the leaves to let the vital juice dry and die. In the spring and even more in the summer all the leaves are green, but in the fall an extraordinary variety of colors is displayed.

Likewise, a human being in the twilight of life lets go of his masks and reveals his true nature. In everyday life, running after time, we all have green leaves and sometimes it is only at the end of our life that we realize that under the green there is a wide range of warm and exquisite colors.

Palliative care is the fall of our lives; this is the time it takes for the leaf to gradually detach itself from the tree. Even though the sun is not always shining and there are difficult times of heavy downpours and windstorms, the leaf clings to the tree with all the colors it has left. Could we imagine a year with only three seasons? Could we go from 35 ° C in summer to -10 ° C in winter without any transition period? No!… However, this is what happens with euthanasia ”.

I have met all kinds of people throughout my career, from the humblest to those who are used to being in the limelight. For each of them, the masks fall off at the end of their life. It is undoubtedly very difficult for the person, but it is also very beautiful to watch. They reveal their inner self and remind us that they are unique and irreplaceable. We see a person preparing to leave this life. Of course, their bodies often fall apart, and their minds slow down, but what is said, what we experience, is of a beauty and intensity that remind me of autumn leaves …

François Trufin is a hospital emergency nurse. He is secretary of the palliative care platform of the German-speaking Community of Belgium and vice-president of the Belgian Chamber of German-speaking nurses. More By François Trufin

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