by Barbara D.
In recent weeks, the newspaper Avvenire has given ample space to the debate on the end of life, regarding the discussion of the law on advance treatment declarations, the Dat. I followed the debate with attention and trepidation. Yes, trepidation, because for those who work in the healthcare sector this law is long awaited. Of course, I don't believe that a law can take away all the problems of conscience in the individual cases that we encounter every day, but at least it can direct and support us in certain difficult decisions.
I am happy that there are politicians and legal experts who are working to ensure that amendments are not approved that could in any way introduce passive euthanasia in our country; I thank them for their work because I would never want to have to find myself in the situation of having to, by law, accept the request for an assisted suicide. However, the term "end of life" is very broad and those who want to address it must, yes, know bioethics and the most up-to-date scientific notions, but also spend time alongside the many sick people in hospital wards, in retirement homes, in home, and listen to them.
I'll make a little introduction. I started my work as a doctor about 10 years ago, with two years' experience in Africa. There I experienced the profound sense of frustration in the face of deaths due to social injustice; how many lives could have been saved if only they had had access to the care of a more advanced country, I still remember their faces. I then returned to Italy to carry out my everyday job: hospital geriatrician. I assure you that the frustration that I began to experience here, where all treatments are available, was another, totally opposite: the therapeutic obstinacy, the loss of dignity at the end of life, a medicine that must always be victorious and therefore must do everything possible until the end (perhaps because we don't want to feel "responsible" for a death), without listening to the patient who, I assure you, "speaks" even in the terminal stages of dementia, if we only want to listen to him. Fortunately, in recent years palliative care is becoming increasingly important and many medical associations are moving forward with documents and guidelines to help us choose the best clinical path in the many forms of terminal illness that are increasing in number (think of dementia in the terminal, cardiac or respiratory failure in the terminal phase, etc.).
This is why I cannot accept putting "euthanasia" and "end-of-life care" in the same cauldron. By doing this you fall into ideology. It cannot be said that "hydration and nutrition" are "forms of life support that are necessary and physiologically aimed at nourishing and alleviating the suffering of the subject in a terminal state". We must be precise and say that the situation of a vegetative coma or a stroke in a stabilized phase is different from a terminal condition in a chronic degenerative pathology. Otherwise confusion will also be created among the families of the sick, who read these slogans and then find themselves having to face difficult decisions with many scruples. A terminally ill patient should certainly not be abandoned, but artificial feeding can be futile or even harmful in the terminal phase.
Likewise, hydration has even been shown to worsen symptoms in the last days of life. As a Christian, in my work, I feel obliged to help people in a terminal phase to face death with dignity, with the freedom to even say no to medical interventions that are disproportionate to them, not because they want to commit suicide, but because they have already carried their cross for a long time and with dignity and know how to understand when the moment has come for them to be called to leave this life. In a society where we no longer know how to deal with death (I assure you that more and more I find family members of elderly people over 90 having difficulty accepting the death of their relative, as if they had never thought that sooner or later this life has an end ), we must abandon the idea of a medicine that can do everything and save everyone at any cost and move on to a medicine that can accompany terminally ill patients with discretion and respect. We need a law that says no to euthanasia, but which also allows us to give dignity to people in terminal situations. On this occasion, I thank you for Avvenire, where I am always sure to find serious articles, the result of responsible journalism.
(from Avvenire)