Fu Daren, a famous Taiwanese celebrity and sports anchor, suffered from pancreatic cancer in his later years and chose to euthanize in Switzerland. From the public video footage, it can be seen that the family accompanied the whole room throughout the process, and Fu Daren's death process was calm and peaceful.
Some media have called Fu Daren "the first person in China to choose euthanasia." Whether it is really the first one, in fact, it is impossible to verify, but his family admitted frankly afterwards: "Our family is very relieved that he is walking safely and happily." ”
Such a "happy" death seems to be the choice of every terminal cancer patient who is tormented by illness, especially those who have no way to seek medical treatment. But since "euthanasia" is not legal in our country, we can't help but wonder, for patients with advanced cancer, is there a better option than "euthanasia"?
I. The "Last Straw" that Crushes Cancer Patients
In 2019, a U.S. cancer research team analyzed more than 8 million cancer patients between 1973 and 2014 and found that people with cancer had a 4.4 times higher risk of suicide than the general population. The reasons that prompt cancer patients to finally choose "self-determination" are basically inseparable from the following 3 points:
1. Fragile mind
After many patients are diagnosed, the mental pressure is huge, and emotions such as irritability, anxiety, and fear occur, resulting in continuous deterioration and aggravation of the condition. Another part of the patient will also worry that their illness drags down relatives and families, there is guilt, bad emotions if not released, it is easy to accumulate in the hearts of patients, deplete their will, and eventually "force" them to go to the end of the road.
2. Pain
The pain caused by cancer is also one of the reasons why patients are not eager to live. Pain is the primary symptom in patients with advanced tumors, including pain caused by the cancer itself, pain caused by treatment, and pain related to cancer and exhaustion.
For example, large amounts of ascites and intestinal obstruction in the advanced stage of colon cancer cause intestinal colic; bone pain and pathological fractures caused by bone metastasis in lung cancer; and advanced cervical cancer with rectovaginal fistula. Long-term chronic cancer pain will cause patients to have anxiety, depression, irritability, guilt, despair, these emotional changes will aggravate the patient's perception and experience of pain, and eventually lead to patients lose confidence in life and prognosis, choose to "solve" the pain in an extreme way.
3. Economy
Cancer is a chronic, long-term disease with long treatment cycles and expensive costs, but the effects may not be satisfactory. It can be said that the cost of treating cancer is like a "bottomless pit", draining the savings of the patient's family and easily "stealing" the patient's will to survive. Patients are afraid of dragging down their families or adding that cancer will recur, metastasis, and poor treatment results, feeling that they have become a heavy burden on their families, and often take extreme approaches to seek relief.
Second, there is no "euthanasia" in China, where do patients go?
Cancer patients are so tormented that they don't want to die, so some people think of "euthanasia". However, at present, there is no legislation for euthanasia in china.
Combining the standards set by several countries that have legalized euthanasia, the following conditions need to be met for "euthanasia": the patient has a defined terminal illness; the suffering suffered by the patient is "intolerable"; the necessary procedures are reviewed and agreed; the patient needs to be conscious, carefully considered; the method must be humane, etc.
The time is not yet ripe for euthanasia legislation in China, not only because of the conflict between the different legislative values of "right to life" and "dignity of life", but also the low level of medical care and social security in our country, if euthanasia is legalized, there may be cases where the elderly apply for euthanasia due to economic pressure, do not want to burden their children, or children apply for euthanasia on the grounds of getting rid of burdens.
In addition, "euthanasia" can also become a "temptation to die", and death is a serious and non-regrettable process. It is both simple and difficult for people to really want to die. In fact, many cancer patients want to live, but the pain and financial burden of their families make them have to choose "death". And if "euthanasia" is really legalized, it may be easier for patients to give up their lives.
Three, 2 methods, or can make you "happy"
While "euthanasia" may be able to free cancer patients, it is not the best option. In the face of practical reasons, we should actively pursue how to "live in peace". With today's medical technology level, it is not difficult to continue life with equipment and equipment, but what we need to realize is how to complete this last stage with dignity when life reaches the final stage.
1. Analgesia
Pain treatment for patients while treating cancer can reduce pain in patients.
In this regard, the World Health Organization proposed a three-tier drug principle for the treatment of cancer pain in 1986: the first ladder is mild pain, preferring nonsteroidal anti-inflammatory drugs, represented by aspirin; the second ladder is moderate pain, preferring weak opioids, represented by codeine; the third ladder is severe pain, preferably strong opioids, represented by morphine.
In addition, patients can also choose surgery to relieve pain. For example, pancreatic cancer patients face far more pain than other patients. Sensory conduction of upper abdominal organs such as the pancreas, bile ducts, stomach, and duodenum is mainly innervated by the abdominal plexus. At this time, the protocol to suppress cancer pain can be through the celiac plexus destruction technique, so that the pain signal emitted by pancreatic cancer does not pass to the brain. The patient's pain will be well controlled, the dose of opioids applied will be greatly reduced, and even painkillers can sometimes be discontinued, and symptoms such as nausea, vomiting, and constipation will be greatly reduced.
2. Hospice care
The data shows that 93.75% of patients are eager to reduce unnecessary rescue and treatment at the end of life, try to avoid too many invasive operations and treatments, and expect a comfortable and decent death. Thus, hospice care came into being.
Hospice care belongs to a new type of nursing model, which implements targeted nursing intervention for patients and their families through the application of professional nursing methods and scientific psychological intervention methods, so as to minimize the negative emotions of patients and their families, not only can effectively maintain the final dignity of the life of terminal cancer patients, but also make patients feel respected for their self-worth, and at the same time allow patients' families to obtain psychological comfort, alleviate the pain of their loss of relatives and negative life attitudes, and improve the quality of life of patients.
The service content of hospice care, in addition to the above-mentioned analgesic care, also includes nutritional support, daily nursing, psychological counseling and so on.
The first is nutritional support. Most patients with advanced cancer have poor appetite, accompanied by different degrees of malnutrition, and the dietary nursing staff will try to choose foods that are high in protein, high in calories, easy to be digested and absorbed, to ensure that the patient's diet is diversified and eats less and more meals, and at the same time asks the patients what they want to eat, as far as possible to meet their dietary needs.
In terms of daily care, patients with advanced cancer have low immunity and are often accompanied by behavioral impairment. At this time, the nursing staff in the hospice service can do oral hygiene for the patient, excrete hygienic care, and often wipe the patient's body with warm water to improve the patient's comfort; most patients with advanced cancer do not sleep well, and the ward needs to try to arrange the ward environment as warmly as possible on the basis of keeping it clean and tidy, adjust the light softly, and ensure that the temperature and humidity are appropriate to improve the patient's sleep quality.
In addition, psychological counseling is also essential. Advanced cancer patients will have some anxiety and depression due to the pressure of death and the torment of illness, at this time to give full understanding, with a sincere, caring attitude to communicate with patients, encourage patients to express their emotions and pain, as far as possible to meet their needs.
It can also relax the patient's body and mind through relaxation training and music therapy, and help the patient face death squarely; guide the patient's family to strengthen the escort and care, so that they feel the warmth and care from the family, and at the same time instruct the family to face the patient with an optimistic attitude as much as possible, and try not to show sadness in front of the patient, so as not to increase the patient's psychological burden.
Patients with terminal cancer who have received hospice care have shared their feelings: "The pain is relieved, the discomfort is relieved, the emotions are eased, and the soul is soothed." He believes that it is precisely because of the hospice care that his last trip in the human world can be regarded as "happy", even if it is difficult to escape the advent of the god of death, it can be regarded as a dignified departure.
Death is an eternal theme of life, and although most people in the world avoid talking about death, death is inevitable. Receiving hospice care and death education reflects respect for life. In the last days of the patient's life, which is accompanied by great pain and pressure physically and psychologically, hospice care reflects the sublimation of the spirit of medical humanitarianism and is a respect for the basic rights of human beings.
Resources:
[1] "The Effectiveness and Reflections on the Legalization of Euthanasia in the Netherlands and Belgium". Chinese Medical Ethics.2014-08-25
[2] Palliative care and euthanasia: differences or synergies. Medicine and Philosophy.2021-05-20
[3] "A Brief Analysis of the Possibility of Euthanasia in the Field of Hospice Care in China". The Rule of Law and Society.2020-07-15
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