White Mass speaker addresses true compassion at life’s end

By Linda Harvey
 
“We must kill the pain and suffering, not the person with the pain and suffering,” Dr. E. Wasley Ely told 80 people gathered for a dinner following the White Mass at Lexington’s Cathedral of Christ the King, on Oct. 29. The Mass, for health care professionals, was celebrated by Bishop John Stowe, OFM Conv.
 
Sponsored by the Family Life and Evangelization office of the diocese, Dr. Ely’s talk addressed “Maximizing Dignity at the End of Life: Insights from the ICU,” focusing on physician-assisted suicide and euthanasia.
 
Dr. Ely is the Grant W. Liddle chair at Vanderbilt University School of Medicine, with a subspecialty training in pulmonary and critical care. His research is focused on improving care and outcomes of the critically ill patients in ICU who are manifesting delirium and dementia.
 
“Medicine diagnoses and cures diseases by reducing suffering towards the end of life. Its goal is to preserve and improve self-worth and personal dignity,” Dr. Ely said. “However, let’s not confuse the ‘means’ with the ‘end’. How we navigate to natural death matters.” 
 
He noted the different reasons people ask to die: 1) Physical suffering where patients have pain, anxiety, and shortness of breath. 2) Existential suffering that amounts to 57 percent of patients where loss of independence, loss of dignity and burden to others are involved and euthanasia often addresses the latter group.
 
“Euthanasia is the deliberate, direct causation of a patient’s death to relieve suffering by a physician (or other healthcare practitioner) where the physician gives an injection to kill the patient. Ninety-nine percent of physician involvement globally use lethal injection,” Dr. Ely explained. “Euthanasia is against the law in the United States but there are 10 states where the patient can obtain a prescription and end their life at home.” 
 
He pointed out that there is a worldwide consensus statement with physicians. Eighty percent of 1,350 doctors in 32 countries said that “active shortening of the dying process with the intention to hasten death is not permissible even if allowed by law.”
 
For those in society who favor physician-assisted suicide, Dr. Ely noted, they have respect for the patient, favor autonomy or freedom to choose, and want to relieve suffering. But he countered: “One person’s autonomy or freedom must not undermine another’s. Medicine must heal and reduce suffering. Healing is the personal experience of transcending suffering and there is a distinction that lies in intent and causation,” he said. 
 
“On the other hand, as medical professionals, we should reject life-prolonging procedures that are insufficiently beneficial or excessively burdensome in the eyes of the patient,” he added. “To forego extraordinary or disproportionate means is acceptance of the human condition in the face of death. The person dies a natural death from her/his underlying disease.”
 
He clarified: “Withholding and withdrawing life support is not euthanasia. A patient can voluntarily choose to end life support. If a patient comes into the hospital and tells me he or she did not want life support such as a ventilator or dialysis, this would be respected,” said Dr. Ely. “Giving water and food is ordinary but the way it is given can be extraordinary. If you have to give it by surgical tube for example, it can be too burdensome for some patients. Sometimes you can give a spoon of honey, in a loving way that provides interaction with the loved ones.”
 
Dr. Ely is president of the Catholic Medical Association(CMA) in Nashville. It is for medical students and community physicians where bioethics, spirituality and formation of physicians are involved. Nancy Mullen, an internal medicine physician who is the president of CMA in Lexington, can be contacted at 859-533-4425 for end of life concerns.