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Quebec will soon teach the rest of Canada

In his post for DWD Canada’s blog, Quebec nurse Nathan Friedland writes with passion about how healthcare providers in his province will soon become Canada’s go-to experts on how to help patients die with dignity and in comfort. Quebec is preparing to implement Bill 52, an end-of-life care law that includes provisions for assisted dying, by the end of the year:

Unknowingly, Quebec has given doctors across the entire country an incredibly valuable teaching tool to aid them as they begin to learn about how to go about the process of assisting patients to die. This seemingly inexhaustible homegrown resource has been helping ease the suffering of dying patients in a province that so far can only provide palliative care for one third of those who need it, in the often difficult setting of an overcrowded hospital ward. As part of that training, I have seen patients die right in front of me and have, for the most part, been able to eliminate their discomfort as they’ve slipped away.

At this very moment, nurses across the entire province are doing what I’ve done. They are giving narcotics to ease their patients’ suffering, they are talking to their family members and, when the time comes, they will wash their patients with the utmost care, wrap them in a shroud and bring them to the morgue.

Oddly enough, doctors are rarely present when these difficult moments happen because they are trained to save lives and not to ease death. With Bill 52 and the Supreme Court of Canada’s recent decision, that is about to change.

If and when a dying patient requests euthanasia, that patient’s doctor must remember but one factor that relies on empathy, humanity and integrity: trust. There will be many questions that doctors must be prepared to answer. “Will you make sure I don’t suffer? Will you be available and ready when I wish to die? How will you give me the drug and how does it work? Can my family be there? Will you hold my hand as I die? When I’m gone, what will happen to my body?”

Nurses have been answering these questions since the days of Florence Nightingale, as we have used our somewhat limited resources to help patients die as comfortably as possible. “I WILL be there for you, and your suffering will end. I will give you morphine so you can sleep through your final hours. Your family can be right there with you, next to you. It will be an honour to hold your hand as you die. And when the time comes, I’ll wash you, wrap you and take you to the morgue personally.”

I once gave these answers to a patient’s family a month before their son died. He was in no condition to ask them but the process worked nonetheless because his family trusted me. I gave him morphine in very small quantities, just enough to keep him peacefully at rest for the nearly 24 hours it took his body to pass away. He was one of the lucky ones.      

In a very short time, Quebecers and Canadians will have more choice in how they wish to die and doctors must begin to understand that death is not necessarily a bad thing. Helping a patient die is just as important as helping them live. And since nurses seem to already have grasped this concept, we can help doctors to understand it as well.      

Every night before I go to sleep, my five-year-old Golden Retriever hops into the bed between my wife and me. He loves to push his back between us like he did when he was just a puppy trying to keep warm with his brothers and sisters when they were first born.

Each night I kiss his forehead and pet his back knowing that sadly, he probably will only live another seven years or so. I tell him “I will not let you suffer” because he trusts me and it helps me to fall asleep. It is now time for doctors to provide the same kind of options and love to their patients as we give to our pets.

(with thanks from DWD Canada Blog)

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