Check Your Priviledge

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“Check your Privilege”[1] came to my mind one day last November as I listened to panellists discussing the status in Canada of physician-assisted suicide, or ‘medically assisted death’; the label currently in favour with the medical community.[2] I have watched the evolution of this debate since it emerged in the early 1990’s with the Sue Rodriguez challenge to the current law. At that time, the Supreme Court confirmed that it was illegal for a physician to assist a patient in suicide. Now over twenty years later, our government will move to make available assistance in ending one’s life, under carefully circumscribed conditions.

I am no longer willing to argue, as I once did, for or against. Moreover, in taking a step back, I see how this debate has emerged and developed, and this causes me to offer the opening phrase, “Check your privilege”. Here is why:

I started my professional health care career in 1970, but had been working in and around hospitals for 8 years before that. I have watched how over the last forty-five to fifty years technology and illness care have taken over the system, driven hard by pharmaceutical and business interests, at the expense and to the denigration of health and wellness care. Medically assisted death is a natural progression in a system where it has become hard to die. Inevitable disease processes are interrupted and prolonged by all manner of technological and pharmaceutical interventions.

While these can be beneficial and allow for extension of life, I believe it is the overuse of interventions that impels people to the notion that they must, or can only avoid illness progression by deciding the time and means of their dying. I don’t blame them. Interviewing doctors and nurses who work with dying patients in intensive care, I learned that the care they give is often driven by the availability of the technology, and that none wants such care for themselves. The lure of technology makes it easier to keep treating than to make the decision to stop. Patients and families, as long as the medical ‘experts’ offer more treatment, usually, in hope, are reluctant to refuse it.    So it is our wealth, our ‘privilege’ that has brought us to this place of needing to be able to stop the (advanced medical) process before it becomes unbearable.

While listening to the panellists, I couldn’t help but think what a wealthy first world issue this is. In many parts of the world and even among Canada’s First Nation communities, basic health care is not always available. As Syrian and other refugees flee for their lives, what would they think of this issue?

I realize that it will unfold in Canada as it has in other jurisdictions, and that assistance to end one’s life will be available through our medical system within a short time. But this will not begin to address the issues around the allocation of medical resources, or questions around the best ways to provide care to an aging population.

From my years as both a nurse and hospital Spiritual Care Provider, I find two things: Most people are not in a hurry to die, and even though we ourselves may think we would not want to live with certain limitations, when people have them, they still cling to life. I have known people who are confined to a chair and completely dependant on others, who feel life is worth living just to feel the sun and wind on their face whenever they manage to get outside.

Many people, regardless of religious beliefs, do not fear death itself; they do however fear the process – pain and suffering. Important also is that suffering is not limited to physical pain, but physical pain can be heightened when emotional and spiritual needs are not addressed.

The pressing question is this: How can we ensure appropriate support and care without either prolonging or adding to, a person’s pain and suffering? We just had an election in Canada. The many ’polls’ never failed to state that Canadians view ‘health-care’ as a priority. Our health-care system does not need more money, more resources allocated to the existing system. What we do need, is wiser use of the resources we do have, with more and better attention paid to research-based health and wellness support. Check your priorities Canada!

[1] Privilege is still the idea that society grants unearned rewards to certain people based on their race, gender, sexuality, etc — checking your privilege means acknowledging the role those rewards play in your life and the lives of less privileged people.

[2] This discussion follows as a consequence of the Supreme Court’s unanimous ruling in 2014, supporting, under certain circumstances, based in Canada’s Charter of Rights and Freedoms, a person’s right to decide to end their own life, and the right to not be opposed in this, by the medical system; rather, to be assisted by it.

4 thoughts on “Check Your Priviledge”

  1. You are a wise woman, Anne. I appreciate your perspective on this issue. It is, indeed, a first world debate – one that thousands, if not millions, less privileged people in our world would find incomprehensible.

  2. Thanks for this Anne. It adds another view for me in clarifying my own position – changing as it also is. In addition, I feel we may not see how selective we are about our attitudes to control of dying (perhaps there is a better way to say this), because we still think it is okay to kill people in war or to allow people all over the world to die of hunger or disease that we could help prevent. We do tend to focus on issues like abortion and physician assisted suicide – perhaps because it seems more immediate. It does seem a huge issue in any case, but one that requires us to try not to be so afraid of death (and, at almost 79 I find myself there sometimes) – we will die so we are in many ways trying to prevent the inevitable. As you say, not long ago someone my age would have been dead years ago.
    Nice to see you back at Rosedale.

    1. Thanks Judith for your reflection and honesty. I may not have been as clear as I might have. Years ago, you might still have lived to 79 and even longer. My concern is more the prolongation of the dying process when it is what is more or less imminently happening. Patients and families assume that treatments being offered will cure or improve the disease process, but often they simply prolong the suffering. In addition patients frequently told me they were not afraid of death – only the process and pain of getting there. I do not pretend to know what it is like to be dying even though I have spent hours at the bedside when it is happening. What I did gain from those hours was a sense of awe and wonder and very often deep peace. In my teaching work in this area I always encourage people to spend whatever time they can at the bedside of either family or patients who are in the process of dying. it is truly a gift. There is a Buddist saying passed on to my by a 25year old who was dying that goes something like this: When we are born, we cry and the world rejoices; when we die, we rejoice and the world cries. I like that. thanks Anne

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