“The legalisation of the right to end life would weaken the therapeutic link between care-giver and the patient, going as far as to break it”

Publié le : 20 March 2013

 After an IFOP survey in September 2012 revealed that 86% of French people are favourable to a law legalising euthanasia, a collective of cancer-treatment practitioners in the Institut Curie, made up of doctors, nurses and physiotherapists, published an article in the daily Libération on how to interpret this statistic.

First of all, the care-givers explain that in their daily work in hospitals, they are "only very rarely confronted with this type of request [for euthanasia] that persists over time." Also, they ask: "how can we not see in it […] a certain loss of confidence in us, the ‘care-givers’, and the fear of not being cared for, listened to, understood and relieved until the end of life?" In practice, they point out, it is only "in rare case that patients at the end of life present physical symptoms that are ‘refractory’ to our treatments," and then, "according to the law, the doctors can propose treatments provoking sedation to relive the patient physically and psychologically, even if it means accelerating the occurrence of death." But the collective of practitioners adds: "sedation must neither be commonplace nor under-used. Its purpose is to relieve and not to provoke death, a major difference of intention for the patient, the family and for us also, the care-givers. The Leonetti law also reaffirms the right of patients to refuse the treatments that they regard as futile." But often, "doctors, are confronted with the opposite situation: patients asking for the continuation of the anticancer treatments whereas the medical team is envisaging their interruption.". The practitioners also state that requests for euthanasia are "rare and often transitory" and that "many come from the families and not from the patients directly. Others correspond to a period of distress arising from a symptom difficult to tolerate and which must be treated. There are many examples of patients who make such a request in a moment of discouragement and despair, and afterwards they recognise that if we had granted their request they would not have been able to carry out certain important personal projects."
Whereas "some care-givers would like to see a modification of the law to enable patients to put an end to their life through an anticipated arrangement" and "in the name of the independence of the patient," the collective of practitioners emphasises that "most warn against the predictable risk of abuses" and asks: "what message will then be received by the most fragile, who have become ripe for euthanasia?: ‘Do I still have my place in society?, ‘Must I ask for death to relieve my family?’ And what about the lasting traumatism to the family and the care-givers after carrying out such an act?". Thus, "would not the extension of the medical team’s power lead to a dehumanisation of the medical profession which would have this power to kill?"
For the collective of care-givers, "the legalisation of the right to end life would weaken the therapeutic link between care-giver and patient, going as far as to break it. Would patients dare to trust their care-givers if they can remind them that they have possibility of finishing them off quickly?". According to them, the Leonnetti law on the end of life "provides good guarantees of the respect for the patient’s independence, accompaniment, relief and sometimes sedation. It forms a fundamental framework and a guarantee of serenity for all. It is envied by numerous European countries. It is probably insufficiently known to care-givers or to ordinary citizens."

Thus, the group of care-givers wishes it to be known that they "defend the values of medicine that is both competent and humanistic," and they point out: "for us, providing palliative care centred on the expectations of the patient – with whatever physical or psychological vulnerability that the illness imposes – is the best guarantee of respect for their dignity. For the patient at the end of life, we want access to quality effective care. We practise medicine that is not all-powerful, which knows its weaknesses and its limits, and which cannot grant every request. We want above all to maintain the link of trust up to the end."

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