Re: Assisted suicide vs end-of-life care

Issue: BCMJ, vol. 56, No. 3, April 2014, Page 124 Letters

On 10 February 2014, André Picard’s column in the Globe and Mail describes the case of Margot Bentley, whose explicit directions for how she wanted to have her life end were rejected. What a travesty of common sense this has become. A few days later I was heartened to see that the January/February 2014 issue of the BC Medical Journal had four items on the topic of end-of-life care.

As physicians we are often actively involved in helping our patients determine how they wish to end their lives, so there is greater pressure on us to sort out our thinking on this matter. Fortunately, our position in society as God-like authority figures has diminished, yet the mantle is easily picked up by organizations—in the Bentley case, by the Maplewood Seniors Care Society and the Fraser Health Authority. The complexities of end-of-life issues need to be discussed openly, especially by the professionals involved in caring for the dying. Because of our active role in this matter, we tacitly confirm these as health issues, or, as is happening now, as bureaucratic/legal issues.

The core problem is a moral one. Though we may disagree with our patients’ moral values, in most cases we can establish a working relationship and provide  medical services without difficulty. If there is a sticking point we don’t force our patients into our value system, nor are we obliged to use treatments that offend our moral values.

Society depends on a dynamic balance between the rights and responsibilities of the one versus the group. Dr Allan Donkin (BCMJ 2013;56:6) identified the inherent difficulties in resolving these differences and clearly stated his position along the continuum. My position leans more toward the individual. I believe the ultimate decision on how to die must stay with the person (or delegate) taking that journey. We agree with this sentiment by accepting our patients’ requests to stop treatments, but their wishes are often deserted as patients reach the end of life.

Let us continue to broaden these discussions.
—William Gardner, MB, ChB
West Vancouver

William Gardner, MBChB,. Re: Assisted suicide vs end-of-life care. BCMJ, Vol. 56, No. 3, April, 2014, Page(s) 124 - Letters.

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