BreakPoint: A Killer Bonus

Canada Weighs Paying Docs Extra for Assisted Suicide

Faced with doctors’ growing resistance to assisted suicide, some Canadian advocates are asking, “What if we just pay them more?”

Thirteen months ago, Canada legalized doctor-assisted suicide, or as Canada calls it, “medical assistance in dying.”

From the start, Eric Metaxas and I have said that our northern neighbors have placed their entire society on a slippery slope on which the “right to die” will eventually become the “duty to die”—just as it’s happened everywhere else.

Nothing in the past thirteen months suggests Canada will be an exception.

Elderly patients diagnosed with cancer are immediately asked if they wish to be euthanized; “ethicists” strongly urge that the organs of the euthanized not go to waste; and policy proposals to extend the “right to die” to “the mentally ill” are now being advanced.

Notwithstanding this parade of horribles, there’s one bit of good news: Many doctors who initially expressed a willingness to lend deadly so-called “medical assistance” have changed their minds. Unfortunately, the growing reticence of early practitioners to continue offering this lethal service is not because they now take the moral qualms seriously. No, the problem is that they’re not being paid enough to kill their patients.

I wish I were making this up but, sadly, I’m not.

An article in the July 12th issue of the Canadian magazine MacLean’s asked “Should doctors be paid a premium (for) assisting deaths?” The author tells us that as “staunch supporters of physician-assisted dying are avoiding taking up the work … advocates of the service worry it will exist in theory only, and not in practice.”

The solution, according to the author, is to pay doctors more. While she acknowledges that “medically assisted dying is still controversial in Canada,” and that “paying someone a premium to do this work can be construed as ethically compromising,” she still thinks the problem is one of incentives.

This notwithstanding a 2015 survey by the Canadian Medical Association, which found that “only 29 per cent of doctors would consider providing the service, and that was before they knew doing so could be financially detrimental.” (Emphasis added.)

Who knows whether the proposal to pay doctors extra for killing their patients will go anywhere. What is clear though, is the fanaticism and moral obtuseness of assisted suicide advocates. For them, the problem isn’t that the vast majority of Canadian doctors have moral qualms about killing their patients—it’s the pay is too low.

This reminds me of something Ben Mitchell of Union University said: “Whenever you put a price tag on something that is priceless, you cheapen it.” In this case two priceless things—the sanctity of human life and the duty of care doctors owe their patients—have been cheapened in the service of a false idea of what it means to be compassionate.

No, real compassion towards the sick and dying is on display in countless hospices, yet another gift of Christianity to the modern world. There, palliative care is combined with concern for the person’s spiritual and emotional needs. The result, as my friend from New Zealand, John Fox, has written, is a powerful witness to the fact that pain and death are “a team sport.”

The Christian alternative to bribing doctors to kill patients is, in Fox’s words, to surround them with “solidarity, the love of caring families, and the competence of medical professionals.” In doing so, “we can carry together the experience of suffering, find meaning and stillness inside it, say the things that should be said, and make and receive the peace we need.”

As what Pope John Paul II called the “culture of death” spreads through the culture, it’s imperative that Christians model and dramatically expand the sort of palliative care that Fox writes about. In his words in an email to me, “we must be the people who care for our sick and elderly—we must be the people who don’t kill their children or throw away grandma.”

In other words, we must show the world real compassion so that it can reject the cheap substitute currently being peddled.

 

A Killer Bonus: Canada Weighs Paying Docs Extra for Assisted Suicide

As John points out, believers are to model the compassion of Christ. We should be the first in line to care for those who are suffering and in pain. Hospice is a great example of this effort. Be proactive in presenting the alternative to doctor-assisted suicide–compassionate and competent palliative care.

Resources

Should doctors be paid a premium for assisting deaths?
  • Catherine McIntyre | Macleans.ca | July 12, 2017
Second Thoughts on Assisted Suicide: Canadian Doctors Balk
  • John Stonestreet | BreakPoint.org | March 15, 2017
Four Problems with Physician-Assisted Suicide
  • Ryan T. Anderson Heritage Foundation | March 30, 2015

August 3, 2017

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  • Phoenix1977

    “An article in the July 12th issue of the Canadian magazine MacLean’s asked “Should doctors be paid a premium (for) assisting deaths?” The author tells us that as “staunch supporters of physician-assisted dying are avoiding taking up the work … advocates of the service worry it will exist in theory only, and not in practice.””
    As a doctor who participated in several euthanasia cases I can tell you it’s one huge pile of extra work. In order to guide your patients and his/her family adequately, but also making sure everything is documented correctly to avoid legal problems, you need to clear your schedule. Which is, at least in the Netherlands, the major reason why doctors refuse to participate in euthanasia. However, I think it’s simply part of my job and extra money, no matter how welcome, shouldn’t be the incentive to convince doctors to perform euthanasia.
    So, although I agree with John Stonestreet in this case (which must be a first) I agree on very different reasons. I simply believe euthanasia is part of every day medical practice and if you cannot perform this medical procedure when wished by your patient you do not belong in medicine to begin with.

    • Lauren

      I am truly not meaning to combat in an aggressive nature, though through typing, that is hard to convey. I am not in the medical profession, but am wondering if doctors still take the Hippocrates oath? “…I will give no deadly medicine to any one if asked, nor suggest any such counsel”. How is this reconciled amongst doctors participating in euthanasia? Thank you!

      • Phoenix1977

        The original Hippocratic oath has been rewritten in the 1980s / 1990s because it no longer suited modern medicine. The part you quoted was one of the things removed from the oath in the new version. That had nothing to do with eurhanasia, by the way, but with doctors refusing to assist in executing prisoners who had received the death penalty. Doctors stated assisting in the death penalty, as American law requires, violated their oath. So the violated part was removed.

        • Steve

          You have just described moral relativism. Doctors stated that assisting in the death penalty violated their oath. So the violated part was removed.

          Below is a translation of the original oath:

          I swear by Apollo the Healer, by Asclepius, by Hygieia, by Panacea, and by all the gods and goddesses, making them my witnesses, that I will carry out, according to my ability and judgment, this oath and this indenture.

          To hold my teacher in this art equal to my own parents; to make him partner in my livelihood; when he is in need of money to share mine with him; to consider his family as my own brothers, and to teach them this art, if they want to learn it, without fee or indenture; to impart precept, oral instruction, and all other instruction to my own sons, the sons of my teacher, and to indentured pupils who have taken the physician’s oath, but to nobody else.

          I will use treatment to help the sick according to my ability and judgment, but never with a view to injury and wrong-doing. Neither will I administer a poison to anybody when asked to do so, nor will I suggest such a course. Similarly I will not give to a woman a pessary to cause abortion. But I will keep pure and holy both my life and my art. I will not use the knife, not even, verily, on sufferers from stone, but I will give place to such as are craftsmen therein.

          Into whatsoever houses I enter, I will enter to help the sick, and I will abstain from all intentional wrong-doing and harm, especially from abusing the bodies of man or woman, bond or free. And whatsoever I shall see or hear in the course of my profession, as well as outside my profession in my intercourse with men, if it be what should not be published abroad, I will never divulge, holding such things to be holy secrets.

          Now if I carry out this oath, and break it not, may I gain for ever reputation among all men for my life and for my art; but if I transgress it and forswear myself, may the opposite befall me.[

          Essentially the original oath forbade abortion or euthanasia.
          Of course, that cannot be tolerated in today’s society so the oath must be changed.
          Rather than adhering to longstanding principles of preserving life, as was the original intention of the oath, the oath and other human beings are discarded when they become inconvenient.
          I too am a physician. Your comment of “if you cannot perform this procedure when wished by your patient then you should not be in medicine to begin with” is shocking, especially coming from a physician. Not only does it show your lack of tolerance for others’ beliefs but it shows that you are completely abdicating your responsibility to the desires of the patient. We physicians are not here to merely deliver what a patient wishes but are there to guide them towards better health, if possible. Never, however, are we to end their life intentionally. I often will tell patients that a surgery is not indicated for them, even if they want the surgery. They look for our guidance.
          Your comment that it is “one huge pile of extra work” shows your attitude toward the dignity of human beings.

          • Phoenix1977

            “Essentially the original oath forbade abortion or euthanasia.
            Of course, that cannot be tolerated in today’s society so the oath must be changed.”
            Actually, it was the United States government that pressured the AMA to rewrite the oath, so doctors could no longer call upon their oath to refuse to participate in the death penalty.

            “Your comment of “if you cannot perform this procedure when wished by your patient then you should not be in medicine to begin with” is shocking, especially coming from a physician.”
            As a professional you are required to act professionally. That means to leave your personal believes and opinions at home and abide the principles of your profession. If you cannot do that that means you cannot act professionally.

            “I often will tell patients that a surgery is not indicated for them, even if they want the surgery. They look for our guidance.”
            There’s a difference between refusing a procedure because it will not benefit your patient and refusing one because of your personal believes. The first one is your job while the second one, in my opinion, is unacceptable.

            “Your comment that it is “one huge pile of extra work” shows your attitude toward the dignity of human beings.”
            You want to talk about human dignity? Fine.
            At the moment I have an 81 year old woman in my ward. Last year she went on safari in Kenya and when she was 75 she walked the entire length of the Great Wall of China. Her hospital room is filled with pictures of her at pretty much every place in the world, as well as lots and lots of pictures of her with her children, grandchildren and great-grandchildren. To say this woman is loved, would be an understatement. Her youngest great-grandchild (age 7) asked me a few days ago if I could spare a few minutes of my time for her. She wanted me to promise to take good care of her “Nana”.
            A little over 6 weeks ago this woman suffered a small stroke. She barely had any symptoms after 48 hours but it was the beginning of the end. At the head CT the neurologists found a small intra-cerebral mass. Further diagnostics revealed metastasized ovarium cancer, not susceptible for hormone treatments. And even though she did not want treatment she allowed her children and grandchildren to persuade her to go for chemo.
            Unfortunately, after her first round of chemo she started to experience shortness of breath at the lowest possible level of exercise (and this was a woman who had been rafting in the Grand Canyon only a few years earlier). Ultrasound showed a severe cardiomyopathy, most likely due to the chemo. Despite the odds comparable with winning the lottery she got the one side-effect of her chemo we hardly ever see. Of course, chemo was stopped and we started treatment for heart failure immediately. And for a while she seemed to be improving.
            Unfortunately, this is not where it ends. During a follow-up ultrasound a clot in her left ventricle was found. And as if the **** thing had been waiting to be discovered it broke loose at that same moment so our cardiologist could see it float directly into the aorta, straight to the brain. Result: massive stroke with complete paralysis of her left side, aphasia, inability to eat or drink due to dysphagia and complete incontinence for both urine and feces.
            So within 6 weeks this strong, vibrant woman has been reduced to a paralyzed cardiac cripple with no way of communicating who soils her bed every few minutes. And when her family presented me with her living will, in which she declared in a condition like this she wanted euthanasia I couldn’t help her because she signed the document almost 6 years ago and Dutch law limits the validity of a living will at 5 years. And because she cannot talk she cannot ask me, with witnesses present, to perform euthanasia. And now we simply wait to see which complication will kill her first and how horrible her death will be.
            If that is your definition of human dignity I must agree we have very different views on that subject. Because I cannot think of a more inhumane way to be forced to live you last weeks to months of your life.

          • Scott

            This is a good reply Phoenix and it is a tragic story… my heart goes out to this woman and her family!

            Defining dignity is important to this discussion. Nobody wants to see a loved one suffer. A couple of years ago I watched my mother-in-law battle bacterial meningitis. She spent the entire summer in the hospital and miraculously survived however she didn’t recover completely. She is a shell of what she was, her memory has been reduced to spotty at best, once an extremely intelligent woman now she struggles with simple concepts, she has no feeling in her feet and has to use a walker to get around. She fell and broke her femur last winter and while doing physical therapy fell again and broke the metal plate supporting her broken femur (still not sure how on earth that was possible)… she can still function but needs assistance for many things and her capacity to live life has been greatly reduced. She has been through quite a bit in the last few years to say the least. She has not given up though…

            None of this however affects her dignity. In fact, her perseverance only enhances it. If our dignity is defined by our honor/self respect, then no amount of physical reduction or suffering can take that away. How we handle such things is actually a testimony to the nature of our dignity. My mother in laws unwillingness to quit (and she very well could have) was an inspiration to those around her and has positively affected the lives of her loved ones.

            I would not advocate life support when there is no hope for recovery… but a natural death is far more dignified than the alternative in my opinion. Our job in supporting our loved ones at the end of life is to eliminate as much pain and suffering as possible. But as my mother in law has taught us, suffering can be quite dignified.

          • Phoenix1977

            Also a tragic story. And I must say I admire your mother-in-law for pushing through.

            “She fell and broke her femur last winter and while doing physical therapy fell again and broke the metal plate supporting her broken femur (still not sure how on earth that was possible)”
            Osteoporosis, aggravated by the meningitis and the recovery afterwards, combined with the reduced mobility due to the polyneuropathy in her feet. In fact, the correct treatment would have been a hip prothesis, not a metal plate, although I don’t know how old your mother-in-law is.

            “If our dignity is defined by our honor/self respect, then no amount of physical reduction or suffering can take that away. ”
            I don’t agree. If you are lying in bed, drooling because you can’t even swallow your saliva, while laying in your own stench because you soil yourself every few minutes and you can even call for help because you can’t speak and the alarm to call for a nurse is positioned on the wrong side of you (due to paralysis) which cannot be moved there is absolutely no dignity in that.

            “But as my mother in law has taught us, suffering can be quite dignified.”
            I think this is, once again, an area where we must agree to disagree. But even if we agreed, it’s not up to us. It’s up to people like your mother-in-law and my patient. I cannot speak for your mother-in-law but my patient put in writing she considered living like this nothing less than torture and not a way to spend her final days/week/months. And I would have acted on that living will if it had not been outdated. But if I would act on it now, 1 year past expiration, I would face legal trouble and I’m not willing to risk my license, not even to help a patient in her final days.