We would like to thank everyone who made this event a success. We would like to thank the speakers, Alex Schadenberg, Dr. Paul Zeni, Dr. Deb Zeni, Dr. Ian Gentles and our interns (Julia Giancola, Christina Holmquist, Conor Sweetman, and Martha McNeely) for their insightful speeches at the symposium. Thank you also to Kathy Matusiak and Lorraine McCallum who contributed so much to the planning and publicity involved in the event and Professors Keith and Elizabeth Ring-Cassidy for graciously hosting us. To everyone who attended the event: your presence was so important to us and your contributions to the discussion were much appreciated!
Alex Schadenberg started the Sunday night off with an overview of how the euthanasia and assisted suicide laws work in the various jurisdictions where it is legal, including individual case studies of people who have been affected by these laws. He mentioned that everyone is vulnerable at some time in their life and the widening of the law in Belgium and the Netherlands to include those with psychological suffering is extremely concerning. The safeguards which are proposed by law do not in fact operate as safeguards. Having two doctors to agree on euthanasia or assisted suicide does not make a difference because doctor shopping and the presence of right to die associations, such as Compassionate Choices in Oregon, allow easy access to a physician who will agree that assisted dying is necessary. The less than 6 months to live safeguard in Oregon also has little effect, since treatment is optional, Even non-terminal conditions, such as diabetes, can qualify for assisted suicide if they forego treatment. Finally, the mandatory reporting is not a safeguard, since it relies on self-reporting by physicians after the fact. They can easily lie if the patient did not request euthanasia and by the time anyone has seen the report, it is too late for the patient to receive help. Alex expanded on these concepts with individual case studies as well as a survey of the research on euthanasia and assisted suicide from Holland and Belgium. For more information on these topics, see Alex's blog.
Dr. Paul Zeni spoke next about palliative care, the ideal, its status in Canada, and how it will be affected by the legalization of assisted suicide in Canada. He emphasized that palliative care is difficult since it is about care and not curing the individual, a mindset that can be difficult for physicians to shift to. In Canada, although 73% of dying patients would benefit from palliative care, only 15% of dying patients receive palliative care. This can be considered a failure of the Canadian healthcare system. In the model of care emphasized in palliative care, the concept of pain is much broader than in other areas of medical practice. It involves social, psychological, emotional and spiritual aspects in addition to the obvious physical aspects. A method that gives patients the true ability to feel dignity as they are dying is called Dignity therapy. It includes: A- attitude of respect, caring, and listening B- behaviors that affirm patienthood, dignity, and connection C- compassion that understands the suffering and reaches our D- dialogue, acknowledging that the caregiver is will to listen. Fiving proper palliative care and attention to all aspects of the patient's suffering can be a time-consuming practice that requires patience.
Dr. Deb Zeni presented on doctors conscience rights as well as the awareness of physicians on the new status of physician assisted suicide in Canada. She reported that doctors who do not work in palliative care tend to feel that physician assisted suicide will not affect them and that it is not their concern. Some doctors feel that they will not be affected because they will not have to prescribe the lethal drugs, but will be able to instead refer the patient to someone who will. Dr. Zeni asked the question: If you are considered complicit when you refer someone to illegal drugs, why are physicians not complicit when they refer for assisted suicide? If doctors are required to refer for assisted suicide, their freedom of conscience will be considered less important than their patient's autonomy to choose their manner of death.
The following day of the Symposium was spent reviewing the content of our research which will form the basis for our upcoming book, "Its Not So Simple: Euthanasia and Assisted Suicide". Our research director, Ian Gentles, led the discussion and the interns each presented their chapter of research. We received a great deal of feedback from the attendees and keynote speakers on the content of the book, and suggestions for areas that should be emphasized. We are very excited to finish this project with the input we received from the Symposium!