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Bioethical Practice: What is the right thing to do in palliative care, euthanasia?


On 8th April 2021, the Institute of Family Studies and Ethics (IFS), in conjunction with Fanusi Study Centre, held a highly informative, thought-provoking webinar entitled Palliative Care: Euthanasia, moderated by Dr. Yvonne Bwikizo, resident of paediatrics and child health, Makerere University. Dr. Pamela Mandela, ENT surgeon and public health specialist, University of Nairobi, and Dr. Veronique Dinand, consultant and head palliative care and supportive care, Bai Jerbai Wadia hospital for children, Mumbai, were at hand to take the audience through the session.

How often do we look into the quality of life we live, rather than simply going through the never-changing life cycle? More often than not, healthy people view it as the norm to get through life at ease. There is hardly any struggle with the thought that they are quickly reaching the end of life. It is not the case, however, for people in need of palliative care. The discussion held aimed to sensitize people on respecting patients’ dignity and shedding some light on euthanasia.

The dying patient

Cessation of life can never be fully discerned; at times it happens unannounced. Those with worsening conditions showing a system that is slowly shutting down and ending the life cycle are usually in dire need of special care, better known as palliative care. It is crucial to recognize that these patients have unique needs as well as special rights. According to Dr. Dinand, palliative care is simply ‘helping one live as good as possible, for as long as possible.’

The patients have fundamental rights, including confidentiality and privacy, autonomy and choice, a caring environment, a good death and, most definitely, information.

Is there such a thing as a good death?

Human beings are dignified beings. Regardless of the state at which one is, dignity is paramount. The actual definition of dignity is complex. It relates to showing the patient that they are worthy of honour and respect, which is Dr. Pamela’s view of the dignity that patients deserve. We should always consider that a patient’s age, ethnic diversity and religious beliefs/preferences are fundamental to have the patient at peace during their end-of-life care.

According to the Catholic Church Catechism (CCC 2278), withdrawal or withholding of treatment to hasten or cause death is euthanasia by omission: Discontinuing medical procedures that are burdensome, dangerous, extraordinary, or disproportionate to the expected outcome can be legitimate; it is the refusal of “overzealous” treatment. Here, one does not will to cause death. The decision should be made by the patient if he is competent and able or, if not, by those legally entitled to act for the patient, whose reasonable will and legitimate interest must always be respected.

Please note that the “do not resuscitate (DNR) notification” is legally binding and should be respected.

Bedside manners

How aware are you of your conduct around ailing people? Ensure the patient does not feel distanced or non-existent while in their presence. Talking over the patient is rude even though they may be semi-comatose; try to treat them as normal as possible, and remember ‘we cannot change the outcome, but we can affect the journey’ ~ Ann Richardson.


This article was written by Anna Jessica Munya.  


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