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Wednesday, September 24 2014 13: 13

Right to die or freedom to live?

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by Mario Melazzini

Illness, pain and the role of the doctor

As a doctor and as a patient, I read with great dismay the testimony of the Sardinian doctor who admitted having «put thousands of people to sleep, in a hundred cases I went further. I did this whenever necessary, but I don't have a list. I have never regretted it, also because it was the patients who asked me to intervene. In all situations there was no other way out. This is a consolidated practice throughout Italy." How can you argue that certain behaviors are consolidated throughout Italy: I say very firmly that this is not the case! Faced with these statements, I wonder what the meaning of our role as doctors is?
What is our code of ethics for? In particular, what meaning would articles such as: 16 «disproportionate diagnostic procedures and therapeutic interventions», 17 «acts aimed at causing death», 20 «care relationship», 33 «information and communication with the assisted person» have? , 35 "informed consent and dissent", 37 "consent or dissent of the legal representative", 38 "advance declarations of treatment", 39 "assistance to the patient with a poor prognosis or with definitive impairment of the state of consciousness"? 
How is it possible not to ask ourselves in the face of all this: who are we to decide on an alternative end-of-life path to the natural one, even with illness, of another person? Are we sure that in "all situations" unfortunately that sense of abandonment and loneliness which favors defeatist decisions in the face of life has not prevailed? I believe it is unacceptable to endorse the idea that some health conditions make life unworthy and that every action turns into fury and a useless ordeal, forgetting that effective management and the continuous development of technology also allow those who are been affected by highly disabling pathologies to continue to look at life as a gift full of opportunities and unexplored paths before the illness.
In these times in which we talk more and more, with little clarity, about the right to death, about the principle of self-determination, about patient autonomy, we must instead work on the recognition of the dignity of the existence of every human being which must be the point of starting point and point of reference for a society that defends the value of equality and is committed to ensuring that illness, and everything that follows from it, and disability are not or become criteria for social discrimination and marginalization. Pain and suffering (physical, psychological), as such, are neither good nor desirable - I say this as a doctor, as a man and as a patient - but this does not mean they are without meaning: this is where the commitment of medicine and of science must concretely intervene to eliminate or alleviate the pain of sick or disabled people, to improve their quality of life and avoiding any form of therapeutic obstinacy. Right to die or freedom to live? Euthanasia or therapeutic fury? Self-determination or clinical relationship? Faced with these questions we must not lose sight of the core of the problem: human life, the human being, the person. We should look at human life as a mystery that cannot be reduced to its biological level and cannot be manipulated by anyone. It is a totally and radically 'secular' issue that has concerned and concerns each of us. Enough statements like nutrition and hydration are therapeutic acts, no, they are simple life support tools. We, doctors, should also contribute, together with the institutions, to strengthening the certainty in our country that everyone will receive adequate treatments, care and support. The patient, the person with a disability and his family must be guaranteed every possible, proportionate and adequate form of treatment, care and support as our legal system already provides. So the tools exist, but it is necessary to use them, make sure that people are aware of them and that the medical profession implements them in the most correct way possible. 
 
* Councilor for productive activities, 
research and innovation of the Lombardy Region 
and president of Arisla, Italian Foundation 
of research for Amyotrophic Lateral Sclerosis
 
Read 1410 teams Last modified on Wednesday, 24 September 2014 13:14

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