We could do more to delve into the challenges that our colleagues face when forced to choose whether to participate in assisted dying, and better understand the longer-term impact of these decisions on family members.
Stephen Connor
Executive Director, World Hospice Palliative Care Alliance (WHPCA); clinical psychologist.
The views of palliative care professionals on this issue are very important and under researched, so thank you to the IAHPC for delving into this issue. As expected, palliative professionals have very mixed views on euthanasia and physician-assisted dying. Based on the survey results generally, most palliative care workers are opposed to—or think access to— assisted dying should be limited or restricted in some ways. My view on this topic is that we should not be legislating access to assisted dying (or euthanasia, which is part of assisted dying) before ensuring that all people have access to competent palliative care. I believe that palliative care takes a middle position between those who espouse the right to death and those who believe that the right to life is paramount at all times.
Palliative care professionals believe that we must first identify and address the causes of suffering, what is driving the desire for assisted dying, and provide competent palliative care. However, we also have a philosophical belief that people have the right to autonomy and agency in making all decisions about the care they receive or do not receive. Not all suffering can be eliminated in all cases, and I’ve seen enough patients we could not make whole despite our best efforts. So, if a patient decides they want to end life, despite all we can do, we must respect that choice if it is fully informed.
This survey is a good beginning to help us understand the problems we face as more and more territories legalize assisted dying practices. We could do more to delve into the challenges that our colleagues face when forced to choose whether to participate in assisted dying, and the personal, ethical, and moral impact of their decisions. We also need to be clear on the definitions of assisted dying, as palliative sedation is not, in my view, an example of assisted dying. Palliative sedation is solely aimed at relieving intolerable suffering. Also, euthanasia is not always “voluntary” at the person’s explicit request, as has been done not infrequently in the Netherlands.
We also need to better understand the longer-term impact of these decisions on family members, potentially either positive or negative. One of the arguments against legalization is the possibility that patients may face overt or covert family pressure to choose premature death. Very little is known about this potentiality. In any event, the trend toward legalization of assisted dying is growing, and we as palliative care professionals must find our way forward in this new environment.
Stephen Connor has spent close to two decades working on palliative care development internationally in Sub-Saharan Africa, Eastern Europe, Asia, and Latin America.
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How your gift supports the IAHPC mission
Achieved: $24,941
Goal: $30,000
83%
Education
Your gift funds the operational costs of our online courses taught by globally recognized experts who volunteer their time and provide educational resources relevant to palliative care topics. It also supports scholarships that enable palliative care workers to attend educational events and congresses, and allows us to maintain Pallipedia, the free, live, online dictionary.
The goal of this pillar is to implement strategies, resources and tools that will improve the competencies of the global workforce for appropriate palliative care delivery. We have two programs under this pillar plus many other resources for our members.
Your gift enables us to build and strengthen the partnerships that accelerate global, regional, and national advocacy for palliative care. We advocate for its integration into primary health care under universal health coverage and effective access to essential palliative care medicines and packages for people of all ages. Your gift supports our work to prepare delegates and participate in technical consultation meetings of the relevant UN organizations.
The goal this pillar is the integration of palliative care into primary health care within the spectrum of universal coverage to improve access to adequate care for patients in need. We offer the following to our members:
Documents on Human Rights and Access to Medicines and Care
Research
Your gift enables us to continue doing research that provides guidance and recommendations for action, based on responses from the global palliative care community. Such research includes our recent evaluation of the impact of euthanasia and assisted dying practices on palliative care workers and the use of essential medicines for palliative care. It also supports the costs of publications focused on research relevant to palliative care.
The goal of this pillar is to design and implement projects that lead to the integration of palliative care into health policies, resolutions, and key documents. Our studies help us provide guidance and recommendations, and take action based on the responses from the global palliative care community.
Your membership enables you to participate in IAHPC projects such as the:
Your gift enables us to continue our in-depth reporting and book reviews in Pallinews, as well as media campaigns that raise awareness about the need to increase access to care and support for patients and families.
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