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Euthanasia Tuesday, 28 November, 2000, 11:21 GMT
Alternatives at death's door
Hospices try to raise the quality of life
Advances in palliative care could eventually rule out one of the arguments given in favour of euthanasia - that it should be an option to patients whose quality of life is negligible.

Whereas euthanasia aims to end suffering, palliative care aims to alleviate it.

Specialists working in the field say modern palliative care is changing the face of medicine, as it seeks to relieve the effects of illness rather than cure the disease itself.

If doctors could guarantee a high quality of life up to the moment of "natural" death, euthanasia campaigners would lose their central argument.

But is it realistic to expect medicine to advance so far? For those who consider euthanasia, is modern palliative care a convincing alternative to ending it all?

"Euthanasia will always be an issue because people who've had a bad experience will see it as the only option," said Dr Richard Hillier, chairman of the Association for Palliative Care.

"These people will have seen a friend or relative receive sub-standard care - they will have seen them die appallingly probably.

"The vast majority of them will have been nowhere near a palliative care unit.

"They've got the wrong solution - the answer is not to then go around killing the patient. The answer is to get involved with a very good palliative care unit."

Expanding area of medicine

He said it was a rapidly-expanding area of medicine. Where there was nothing 30 years ago, there were now hundreds of units and thousands of teams, he said.

Current treatments could offer strong pain relief while allowing patients to live a normal life, he said.

He added that the success of terminal care was down to its realistic approach. Palliative care specialists were similar to euthanasia lobbyists in as much as they recognised death was inevitable, he said.

"Where we differ is that they're solving the problem by just getting rid of it - or so they think.

"If the patient has a pain they cannot cure, they would say 'kill the patient'. We would rather say kill the pain."

He said there was no simple answer to the euthanasia question.

"We need to keep talking to each other. The pros shouldn't be standing behind their mothers' skirts throwing mud at the antis or vice-versa, like children.

"We should be talking about it as openly and as honestly as we can, each seeing where the other is coming from and why we have these differences, rather than trying to polarise it."

Debating the issue

The Millennium Debate of the Age, organised by Bupa, Age Concern and Legal and General, is trying to evaluate the pros and cons of the issue.

In a discussion document it says: "Expansion of palliative care is a more appropriate response to the kind of discomfort which some believe can only be remedied through euthanasia or physician-assisted suicide."

However, it concludes: "We do not believe that palliative care is either inferior or superior to euthanasia.

"What matters most fundamentally, we contend, is that individuals be the ones to choose for themselves, under appropriate circumstances, how their lives are to end."

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26 Jun 98 | Health
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