Eight days before he died of terminal brain cancer, prominent Canadian physician Donald Low recorded a video which stirred up a fair amount of controversy. Throughout his career, Dr. Low wasn’t shy about speaking publicly, and he’s best known for being the calm public voice to soothe Canadians through the SARS outbreak of 2003.
During the most controversial section of the video, he discussed his desire to live in a place with a carefully crafted Death with Dignity law and appealed for Canadian lawmakers to take up a serious and open conversation about physician-assisted dying. As an internist, he knew when doctors discovered his brain stem tumor in February, his prognosis wasn’t good.
Knowing he was facing the end of his life wasn’t his foremost concern. What bothered him was knowing the likely challenges he’d experience before he died, “I’m worried about how it’s going to end. I know it’s going to end; it’s never going to get better. So, I’m going to die, and what worries me is how I’m going to die.”
What bothered him most was his sense of losing control over how he would live out his final days:
I’m just frustrated not being able to have control of my own life. Not being able to make the decision for myself when enough is enough. Ya know, we’ve come far enough, it’s time to bring it to an end. And I really envy countries like Switzerland and the Netherlands and the United States where this is possible.
Many advocates for Death with Dignity laws have applauded Dr. Low’s candid discussion about the need for these laws. Not surprisingly, opponents of these laws also chimed in about his recording but not with their typical fear mongering. Rather, some have said his statements do a disservice to hospice and palliative care professions and somehow his desire to control the manner and timing of his own death means he just never learned how to be a “good patient.”
I find this notion quite confusing and frankly a bit paternalistic and condescending. Everyone will have our own ways of facing death, and we’ll feel differently about how we want to die if the decision is up to us. There aren’t right or wrong answers, only what is best for each of us. To say a patient who desires end-of-life options in addition to high-quality palliative care is somehow a “bad patient” seems a grand departure from the patient-centered care model in which palliative care thrives.
Many people die comfortably with the help of end-of-life options like hospice and palliative care, and many more could benefit from earlier intervention of these treatments. But, assisted death doesn’t work in opposition to high quality comfort care. In fact, a poll by National Journal and The Regence Foundation found the opposite; people in states with Death with Dignity laws were more knowledgeable about end-of-life care terminology than the American population in general.
As the Oregon and Washington reports of annual usage show, it’s a small segment of the population who opts to exercise their rights under the states’ Death with Dignity Acts. It’s a seldom used option, but it’s a decision which rightfully resides in the hands of people who are dying and no one else.
View full post on Death with Dignity National Center
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