I have been an emergency physician for 14 years. Like many people, I have followed the debate on euthanasia. I believe the project has been poorly explained and misunderstood. I also believe that, had it been otherwise, the majority of people today would be in disagreement with this project. Much has already been said on the subject. I will content myself here with providing a very personal response to some of these assertions, based on my experience as an emergency doctor who sees people struggling with great suffering on a daily basis, and hoping in the process to clarify certain things about of euthanasia.
First of all, I heard and read that to oppose the free choice of a patient who would like to anticipate and choose the moment of his death was a form of paternalism, because it was to want to choose in the place of the patient what is best for him. However, I believe I am in a good position to know that when it comes to end-of-life care, it is almost always the doctor who initiates the discussions and who proposes the solutions. And that it is almost always the doctor's opinion, when he expresses one, that has the greatest influence on the patient's choice. It should not be thought that things are different when the subject of the discussion is euthanasia, because this choice is often first proposed by the treating personnel. And this gesture represents in my opinion a shortcut which, in the long run, will take up more and more space in medical practice, always confronted with the lack of time and financial and human resources. Dutch doctors themselves admit that euthanasia is often practiced for primarily financial reasons.
The number of euthanasia practices is increasing rapidly in all the countries where it is legal, and the markers are always, by sliding effect, progressively transgressed, regardless of their number and their clarity in the law. The examples are numerous. Moreover, common sense tells us that where euthanasia is practiced, the interest in developing palliative care diminishes. Unfortunately, this intuition is confirmed by what is happening elsewhere, particularly in Belgium.
Compassion towards patients is also invoked to agree to perform euthanasia. What if we approached the question from another angle, that of the vast majority of patients with terminal or degenerative diseases? Those who have never, at least until now, considered the option of euthanasia? This would perhaps make it possible to understand what kind of pressure they are subjected to when euthanasia is an integral part of the therapeutic choices. As an emergency physician, I witness daily the fact that the seriously ill very often fear being a burden for those around them, for the nursing staff, and for society in general. I am convinced that this very strong and omnipresent phenomenon will lead many to choose euthanasia, not because they would have spontaneously wanted to have recourse to it, but because they feel that it is the only "responsible" choice. Isn't it sad to come to this? I feel uncomfortable that this is it, being progressive and acting out of compassion. The law on euthanasia, by wanting to accede to the request of a tiny minority of patients, threatens in my opinion a much larger number of patients, who would like to end their lives other than by having recourse to it. They find themselves faced with the following dilemma: continue to consume resources of time, personnel, money, continue to represent a “weight” for those around them, or resort to euthanasia.
I am firmly convinced that the choice, in these circumstances, is no longer a matter of the simple free will of each person, because it is influenced by a social pressure which, if subtle, is nonetheless extremely powerful, especially in a situation end of life where you already feel very vulnerable.
It is for these reasons that, if one day I am asked to euthanize my patient, I will refuse to do so.
