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Fifty Questions on Love and Life

If Not Euthanasia, Then What?

If euthanasia is not acceptable, what kind of solution do we offer to alleviate the sufferings of people with incurable diseases?

Between euthanasia and extensive therapy, there is a third way, the principles of which were defined forty years ago in England. This is palliative care.[1]

This term encompasses various initiatives to increase not the "quantity" of life of the patient - since we are here talking about persons in the terminal phase - but the "quality" of their lives.

First of all, it requires doing anything one can to relieve the physical pain. Thanks to specific medication (sedatives), this is possible in 95% of the cases.

It also means that the care of the patient must be regular: the washing of the patient must be done rigorously, to prevent bed sores (as they occur if a patient remains too long in their bed) waterbeds or air mattresses should be used; there should be water pulverizations of the mouth as it tends to become parched in many terminal cases; the use of a complementary source of oxygen should be made possible, and so forth.

But in addition to this physical aspect, palliative care includes all kinds of efforts to accompany the patient in order to spare him too great a moral distress as death draws closer. One must help the relatives and close friends to stay with the person if they so desire: a delicate task where attentiveness and availability are essential. Often it is volunteers, trained and backed by a psychologist, who can make themselves available to the patient and their family. Numerous examples show that, in these emotional moments, communication can be difficult: the presence of a third party might provide an emotional outlet for the patient who might not want to involve his family. Or, they might help the relatives take a break from their duties which can be exhausting.

A volunteer told us he had accompanied an elderly man who fell one day into a semi-comatose state. He went to the patient's bedside with the man's wife. Unaware whether he was conscious or not, the woman wanted to tell her husband, as the last proof of her love for him, what would become of her when he is gone: she would go back home and tend to their grandchildren and so on. The presence of a third party allowed her to keep talking which would not have been possible had she found herself alone with her unconscious husband.

In all cases, the patient who wishes to be informed about the physician's diagnosis should be told the truth: the person has the right to know where he or she stands. It should be noted that most people who have requested some kind of euthanasia before the palliative care is given have second thoughts about it once their moral or physical distress has been reduced.

The over-riding principle is to help the patient live their last days without unnecessary interference and to approach death as peacefully as possible. For the Christian, this escorting (accompaniment) can be a true preparation, with serenity and abandonment, to put one's life into God's hands and, in the end, to consider death as the last conscious act of one's life.

[1] The hospice movement


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