{"id":1729,"date":"2016-03-25T20:56:45","date_gmt":"2016-03-25T20:56:45","guid":{"rendered":"http:\/\/tvndy.ca\/?p=1729\/"},"modified":"2018-11-06T18:55:53","modified_gmt":"2018-11-06T18:55:53","slug":"webcast-archive-suffering-revisited","status":"publish","type":"post","link":"https:\/\/tvndy.ca\/en\/2016\/03\/webcast-archive-suffering-revisited\/","title":{"rendered":"Webcast archive: Suffering, revisited"},"content":{"rendered":"<p><iframe loading=\"lazy\" width=\"1180\" height=\"664\" src=\"https:\/\/www.youtube.com\/embed\/HcH-8k6G8S8?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen><\/iframe><\/p>\n<p>In this episode of <em>Euthanasia &amp; Disability<\/em>, Amy Hasbrouck and Christian Debray discuss:<\/p>\n<ul>\n<li>The topic of suffering, revisited<\/li>\n<\/ul>\n<p>Please note that this text is only a script and that our webcast contains additional commentary.<\/p>\n<p><strong>SUFFERING, REVISITED<\/strong><\/p>\n<ul>\n<li>Two years ago, we talked about suffering as the greatest motivation for assisted suicide.\u00a0 Since it remains at the centre of the debate, we thought it would be good to look again at what suffering is, and what it means.<\/li>\n<li>Although physical pain is often given as the main reason for allowing assisted suicide, pain is not always an important factor when people ask to die.\u00a0 Only 29% of people who asked for assisted suicide in Oregon in 2015 list \u201cpain or the fear of pain\u201d among the reasons they want to die.<\/li>\n<li>So far it is impossible to measure pain on an objective scale; all the ways to measure pain involve self-reporting about the intensity and quality of the pain.\u00a0 What can be measured objectively is the degree to which pain and feelings that go along with it interfere with a person\u2019s ability to function on a day-to-day basis.<\/li>\n<li>But even that measure isn\u2019t just about the intensity and quality of pain.\u00a0 It includes how the person behaves (bold or fearful), how it makes the person feel emotionally (sad or angry), and its impact on quality of life.<\/li>\n<li>Many people have watched a loved one die in pain without realizing that this outcome is dictated by the medical system.\n<ul>\n<li>Doctors have only a few hours of training in pain management in their entire medical education,<\/li>\n<li>Many doctors are unaware of the wide range of pain-control methods, and are afraid of using narcotics to ease pain.<\/li>\n<li>Illnesses and conditions that can\u2019t be \u201ccured\u201d are a problem for a health care system that is focused on concrete positive results.<\/li>\n<li>Finally, only a small percentage of the population has access to effective palliative care.<\/li>\n<\/ul>\n<\/li>\n<li>Pain isn\u2019t the only problem that comes with terminal illness and disability, but many can be treated with effective palliative care.\u00a0 Nausea, bruising, shortness of breath, communication problems, trouble eating, seizures, and other difficulties can be managed to improve the person\u2019s quality of life.<\/li>\n<li>When people talk about \u201csuffering\u201d they sometimes mean the grief that comes with any major loss in life, such as the loss of a spouse or child.\u00a0 With encouragement and support, it\u2019s possible to pass through this grief to feelings of peace and acceptance.<\/li>\n<li>As well, dealing with unresolved personal or family issues can bring relief from anxiety and grief.<\/li>\n<li>Another kind of \u201csuffering\u201d has to do with becoming disabled.\u00a0 Most people have very negative views of disability, as dependence, helplessness, and exclusion.\u00a0 So when they become disabled, they see themselves in that negative light.<\/li>\n<li>The person also sees these negative beliefs reflected all around her, from medical staff, family, friends, co-workers, and even in the media.\u00a0 She will have few realistic role models or positive views of disability unless she can interact with her peers, such as in the disability community.<\/li>\n<li>The real experience of disability (learning to do things differently and dealing with barriers and discrimination) becomes confused with the grief over the loss of ability, and negative beliefs about disability (that life isn\u2019t worth living, that it\u2019s a tragedy, that there will never again be any joy or fulfillment in life).<\/li>\n<li>Grief, loss, personal issues, mental health problems, family conflict, tasks left undone, the effects of discrimination and low self-esteem can cause depression and demoralization.\u00a0 These are often called \u201cexistential suffering,\u201d and such feelings can lead to suicide attempts and requests for assisted suicide, whether or not the person has a terminal illness or a disability.<\/li>\n<li>In Oregon, the reasons people give most often for asking for assisted suicide include: losing the ability to do favorite activities (90%), losing autonomy (92%), and fear of losing their dignity because they need help with personal care (79%).\u00a0 All of these are based on prejudiced beliefs about disability, and a lack of architectural access and self-directed home-based care.<\/li>\n<li>Disability rights activists worry that such disability discrimination-related \u201csuffering\u201d has become widely accepted as good enough to allow assisted suicide.<\/li>\n<li>What are some solutions to different kinds of suffering?<\/li>\n<li><strong>Pain management<\/strong>\u00a0is an expanding medical specialty that treats pain and its effects, using a wide range of techniques, from medication to meditation, from acupuncture to nerve-blockers, for chronic and acute pain.\u00a0 In fact, pain can alsmost always be controlled with effective palliative care.<\/li>\n<li><strong>Palliative care<\/strong>\u00a0is a medical specialty that includes pain and symptom management to improve the physical and mental state, especially at the end of life. \u00a0Good palliative care also includes counselling, social work and spiritual support to help the person deal with grief and other issues, family conflict, and the larger questions of life such as \u201cwhy me?\u201d and \u201cwhat is the purpose of my life?\u201d<\/li>\n<li><strong>Parity in mental health services\u00a0<\/strong>means society allocates funds for mental health care on an equal basis with physical health care, so that people in emotional or psychological distress can get the support and treatment they need in a timely fashion.<\/li>\n<li><strong>Peer Counselling<\/strong>\u00a0can help people adapt to the onset of disability, offers role models and peer support to learn to do things differently, helps people navigate the social service system, and teaches skills of self-advocacy that are so important when one is disabled.<\/li>\n<li><strong>Self-directed personal assistance services,<\/strong>\u00a0by giving a person control over when and how help with activities of daily living is provided, can relieve a sense of powerlessness.<\/li>\n<li>Obviously, it\u2019s impossible to relieve all suffering.\u00a0 The hope is to identify the social, economic, spiritual and psychological sources of suffering, as well as the physical ones, and address all of these problems, to steer people toward a better quality of life and away from assisted suicide and euthanasia.<\/li>\n<\/ul>\n<p><strong>THE LETTER WE SENT TO OUR MP<\/strong><br \/>\nMember of Parliament, House of Commons, Ottawa, Ontario\u00a0 K1A 0A6<\/p>\n<p>Dear (MP):<\/p>\n<p>I\u2019m writing to urge you to incorporate the vulnerable person standard in any legislation governing medical aid in dying.<\/p>\n<p>In the\u00a0<em>Carter<\/em>\u00a0decision, the Supreme Court expressed deep concern about protecting the lives of \u201cpersons who may be vulnerable to inducement to commit suicide in a time of weakness.\u201d\u00a0 This statement does not set apart a particular group of people.\u00a0 Rather it signals a set of circumstances that can befall any person, which would render them vulnerable to social, medical, psychological, or economic pressure to request assisted suicide even if that is not the best solution for that person.<\/p>\n<p>The\u00a0<strong>Vulnerable Persons Standard<\/strong>\u00a0is a series of procedures to identify those problems that lead to an assisted suicide request, and ensure that they are solved, to put the vulnerable person back on an equal footing with others who have more resiliency.\u00a0 These measures include:<\/p>\n<ul>\n<li>Requiring a vulnerability assessment to determine what social, medical or psychological factors may be putting pressure on the person to request assisted suicide\/euthanasia.<\/li>\n<li>Requiring a detailed analysis of voluntary, informed consent<\/li>\n<li>Requiring before-the-fact, independent approval by a judge or administrative tribunal;<\/li>\n<li>Ensuring that communication accessibility (neutral and qualified interpreters) will be provided.<\/li>\n<\/ul>\n<p>A copy of the Vulnerable Persons Standard is attached to this letter.<\/p>\n<p>The Vulnerable Persons Standard is an invaluable analysis for persons with disabilities, who experience higher rates of poverty, isolation and discrimination which can compromise their resilience.\u00a0 The Standard provides important procedural and substantive safeguards to ensure that Canadians requesting assistance from physicians to end their lives are not vulnerable to inducement and will not jeopardize their lives because they may be subject to coercion and abuse.<\/p>\n<p>I\u2019m hoping you will act to ensure that federal legislation regulating physician-assisted death incorporates these safeguards.<\/p>\n<p>Thank you very much for your consideration.<\/p>\n   ","protected":false},"excerpt":{"rendered":"<div class=\"entry-summary\">\n<div class=\"entry-summary\">\nThis week, we discuss the connection between pain, suffering, and assisted suicide.\n<\/div>\n<div class=\"link-more\"><a href=\"https:\/\/tvndy.ca\/en\/2016\/03\/webcast-archive-suffering-revisited\/\" class=\"more-link\">Continue reading<span class=\"screen-reader-text\"> &ldquo;Webcast archive: Suffering, revisited&rdquo;<\/span>&hellip;<\/a><\/div>\n<\/div>\n<div class=\"link-more\"><a href=\"https:\/\/tvndy.ca\/en\/2016\/03\/webcast-archive-suffering-revisited\/\" class=\"more-link\">Continue reading<span class=\"screen-reader-text\"> &ldquo;Webcast archive: Suffering, revisited&rdquo;<\/span>&hellip;<\/a><\/div>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[92],"tags":[121,351,283,97,98,101,118],"class_list":["post-1729","post","type-post","status-publish","format-standard","hentry","category-webcast-archive","tag-euthanasia-disability","tag-grief","tag-oregon","tag-pain","tag-suffering","tag-suicide","tag-webcast","entry"],"_links":{"self":[{"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/posts\/1729","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/comments?post=1729"}],"version-history":[{"count":4,"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/posts\/1729\/revisions"}],"predecessor-version":[{"id":3715,"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/posts\/1729\/revisions\/3715"}],"wp:attachment":[{"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/media?parent=1729"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/categories?post=1729"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/tags?post=1729"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}