Pubdate: Mon, 30 Aug 1999
Source: Vancouver Province (Canada)
Copyright: The Province, Vancouver 1999
Contact:  http://www.vancouverprovince.com/
Author: Barry Ulmer

WHY CHOOSE SUICIDE WHEN DRUGS WILL HELP HALT THE PAIN?

Why is there such a strong interest in euthanasia and a strong
campaign by those who purport a need for it?

It probably stems from one simple emotion -- fear.

We fear cancer and other debilitating diseases and we're not well
supported when facing any condition that threatens to be chronic.

We fear becoming a burden to our families.

We fear being alive without really living.

We fear having life without lifestyle.

But, perhaps most of all, we fear severe, uncontrolled
pain.

Severe chronic pain can result in helplessness and hopelessness -- two
mental states that can lead to suicide for those who feel it's the
only way to avoid a painful life or an even more painful death.

But, controlling pain can help ease these states of mind and change
the belief that premature death is the answer.

Those voters in Oregon and Washington who recently endorsed a plan to
legalize physician- assisted suicide were saying they wanted a law
that gave them the right to choose to die, rather than live a life
destroyed by pain.

But, before we in Canada pass laws that are difficult to back away
from, we should take a good look at what can be done to address the
source of our fear: PAIN.

Back in 1990, a World Health Organization expert committee found that
the greatest improvements in the quality of life for cancer patients
and their families were to teach them about pain and pain symptom management.

The committee said that, with the development of modern methods of
palliative care, legalization of euthanasia is unnecessary.

"Now that a practical alternative to death in pain exists, there
should be concentrated efforts to implement programs of palliative
care rather than yielding to pressure for legal euthanasia," it said

Even with this strong statement, one must wonder why a recent survey
found Canadian doctors feel cancer pain has been under-treated.

Similar surveys in the United States indicate over 50 per cent of
cancer patients die in severe pain.

According to Dr. Betty Ferrell, a top professional in the field of
palliative care, the two greatest fears of cancer patients are the
fear of dying in pain and the fear of dying alone.

She notes that the suicide rate among people suffering from chronic
pain is nine times higher than that of the general population.

The fact is, there's a lack of leadership within the field of
medicine.

And there's a lack of education and public awareness.

This allows the healthcare system to spin out of balance, controlled
by a few ill-informed gatekeepers.

Also, regulatory bodies feel a need to maintain some control over
physicians at the expense of those in pain.

Some of the largest obstacles to solving the pain problem are the
laws, myths and out-dated attitudes towards morphine and other
opium-derived painkillers.  And yet these medications have effectively
treated many cases of intractable pain.

The International Narcotics Control Board (INCB) issued a special
report in 1990 which found that the availability of opioid analgesics
was insufficient to meet medical needs for the treatment of pain.

The board recommended governments examine the extent to which their
healthcare systems and laws and regulations permit the use of opiates
for medical purposes.

It suggested they identify possible impediments to such use and
develop plans of action to facilitate the supply and availability of
opiates.

The report also proposed that medical professionals be urged to
promote rational use of opiates for medical purposes, while keeping in
mind their responsibility to ensure they were not be abused.

Not enough Canadian health professionals, patients, families and
government policy-makers understand that the proper use of existing
drugs, coupled with psychological measures, can relieve pain and make
life worth living.

It's ironic that efforts to bring pain and symptom relief to people
with chronic pain conditions may be overshadowed by a much more vocal
movement which exploits the public's fear of pain -- but offers only
death as an answer.

And that is doctor-assisted suicide.

After all, we are closer to having a national policy on euthanasia
than to having one on pain relief.
~~~~~~~~~~~
Barry Ulmer Is Executive Director Of The Chronic Pain Association Of
Canada. 

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