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A WISH
with Agustina Claramonte, Amparo Espinosa, Ann Neumann, Cristina Villarreal, Elena Carrillo, Sergio Huidobro, Frances Kissling and Ariel Gutiérrez
Third Dialogue
ETHICAL PERSPECTIVES ON EUTHANASIA, PART 2
with Peter Singer, María de Jesús Medina Arellano, Amparo Espinosa Rugarcía, Frances Kissling, and Cristina Villareal
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ETHICAL AND LEGAL PERSPECTIVES ON EUTHANASIA
with Peter Singer and María de Jesús Medina Arellano
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FACING THE CHALLENGES OF SUFFERING, COMPASSIONATE AND PALLIATIVE CARE
with Margarita Araujo Navarrete and Bernardo García Camino
IN CASE YOU MISSED IT
Intelligent awareness of Life and Death with intervention
(Conciencia inteligente de la Vida y la Muerte con la intervención)
Specialists in the field who speak of the state of Palliative Care in our country; of pain, compassion, and solidarity in the final stages of life.
IN CASE YOU MISSED IT
Aprendiendo a Envejecer
What Mexicans think about dignified death and palliative care?
The Death of the Other
Amparo Espinosa Rugarcía
We are born among kisses and smiles.
Our parents welcomes us with gifts and a welcoming-space arranged to make our arrival in this world as kind as possible.
The grandmother weave a little jacket for us and the aunts take care of the stuffed animals.
The same does not happen when we leave toward eternity (that is, death).
At least in Mexico.
Too many Mexicans, mostly old or terminally ill, are said good-bye from life without the adequate space or care to make a good transition; without anyone daring to speak to them about the obvious, leaving them alone with their suffering and their fears; without the proper legal framework to opt for a medically assisted death if so they wish.
Ours is a culture that celebrates the dead, but that neither thinks nor talks about death, about the process of dying, about the dying.
When they are asked, ‘How often do you think about death?’, 46% of the population says they never think about it, and only 13% replies that they frequently think about it; but if the issue concerns talking about death, almost 47% never talks to anyone about death, and less than 1% talks about it with their doctor or a priest (2016 DMD National Survey on Dignified Death6).
This is how things had been going on for a long time, although quietly, without making too much noise… until the fierce pandemic caused by the Covid 19 took us by surprise. Then death came out of its hideout and looked at us in the eyes, showing up in a ruthless way. It seems that today all we can do is to look back at her in the eyes and become friends with her.
What else can we do when we have seen—wide-open and in full color—the shameful health system of our country, the immense suffering that this causes to so many Mexicans, and the countless deaths that occurred in a chilling solitude and without the proper care due to the lack of medical equipment and of trained staff to use it?
What else can there be when we also know that the flaws in our health system go far beyond its inability to care for patients in a pandemic situation? Already before, during the past normality, the attention and care of the defenseless persons—such as the terminally ill and the elderly—was far from adequate.
If we want to be able to experience a dignified death the entire population must have access to drugs that allow them to live through the process of a long illness without pain; they must have available the necessary legal resources to opt for medically assisted death if so they wish; propitious spaces are needed so we can live our last moments without being coerced by the circumstances to act in a certain way).
A few weeks ago, perhaps the topic with the greatest media presence was who should receive primacy if available respirators were not enough for all sick persons requiring them. At some point it seemed that anyone… except the elderly who had to be sacrificed for the benefit of the younger generations.
It was as if the Covid-19 circumstances were asking the elderly the same thing that wartime circumstances usually ask the young: to sacrifice their lives for the sake of the survival of others. If in wars young people are sacrificed for the sake of the other citizens; in times of the coronavirus, the elderly are the ones who must sacrifice themselves.
The approach was paradoxical: normally, old Mexicans are not well treated and cannot opt for euthanasia or physician-assisted suicide because those are illegal practices; but, on the other hand, they could be asked to sacrifice themselves for the sake of the young.
Death is the moment to seal our lives, and that is not just anything.
Just as society is in charge of providing the appropriate conditions for our arrival into this world, it should also be responsible for providing us those same conditions to ensure that our departure turns out as kind as our birth.
Tips on Mourning for the Death during the Pandemic
Source: Reforma
By: Eugenio Torres
At any moment, the death of our loved ones is painful. But nowadays, in times of pandemic, it has been even sadder and more frustrating for those who have not been able to say goodbye, with their usual rituals, to their relatives or close friends who have died.
That’s the way the psychologist Gina Tarditi explains it and addresses the subject in her most recent book Mourning in the Middle of the Pandemic.
“During the pandemic, mourning is experienced in a very sad way, even in those cases of people not dying of Covid, but who die in this context. It is being tremendously difficult because they cannot carry out the usual rituals: funerals must comply with the healthy distance, and, with all the measures we are taking to control the pandemic, people are left with the feeling ‘I couldn’t do what he/she wanted’, the hug, the physical cuddling to which we are accustomed.”
This specialist from the National Cancer Institute, who has dedicated herself to the area of palliative care and the care of terminally ill patients and their families, stresses the importance of performing certain rituals, even during the contingency.
“You must be flexible enough so that they can say goodbye to their loved one, in some other way, but one equally valid for both the person who passed away and the one who stays here. Each person, together with his/her closest circle, will have to reach an agreement on how to say goodbye to their deceased loved one,” also recommends the thanatologist.
Another of the effects that Tarditi has noticed during the current health emergency is a great anxiety in the elderly, or in those who have comorbidities, because, although they are taking care of themselves, they feel a hint of sadness because they were not able to be with their loved ones and they don’t know when normality will return. All this causes them fear and uncertainty.
DMD presents new quantitative and qualitative report on palliative care
about Palliative Care
in Mexico City
of knowledge, the perception of current status, main needs and
future perspective of Palliative Care in Mexico.
Exploratory Study
its current status and availability, its progress, challenges / obstacles
and possible evolution.
To think
An Initiative to Prevent Suicide →
El Semanario
On July 29, the Senate unanimously approved two draft bills amending the General Health Law in order to take the necessary steps to prevent suicide, help persons who failed in their suicide attempts and those who are affected by the loss of a relative who died from this cause…
Bioethics: Is there Autonomy in a Pandemic? →
Prodavinci
Would you accept a confinement due to the fact of being a COVID-19 suspect case without being offered minimal humane conditions? Would you be willing to receive drugs having a doubtful or marginal benefit but a proven risk of side effects?…
Palliative Care
What is palliative care?
It is the branch of medicine defined as the integral and interdisciplinary care that is provided to the patient and his family when a life-threatening condition is diagnosed, regardless of the outcome.
In the case of the patient’s death, the palliative caregivers keep helping the family through the grieving process.
What is its purpose
Palliative care purpose is to improve the quality of life of patients and their loved ones when they face the challenges typical of a life-threatening diagnosis. It prevents and alleviates suffering through the early identification, evaluation and correct treatment of pain and other problems, whether physical, psychosocial or spiritual.
What do the palliative caregivers do?
- They provide a comprehensive and interdisciplinary care to the patient and his family, when there is a condition endangering life.
- They contain, accompany, listen, translate the language of the healing team to the patients and their loved ones; they advise them to making decisions; they coordinate the logistics of the patient’s care; and they are intermediaries between patients and their loved ones.
- They eliminate the taboos of the patient and his family as to the disease, the pain, the death, the farewell and the grieving, thus allowing to create a loving end of life.
Articles about Palliative Care
Palliative care and dignified death in the Mexican Constitution →
El Semanario
Last July 1st, a reform promoted by Senator Miguel Ángel Mancera was approved unanimously by the Senate to incorporate palliative care and the use of controlled medicines for it in Article 4 of the Political Constitution of the United Mexican States…
IPN promotes palliative care speciality →
Instituto Politécnico Nacional
To improve palliative care in terminally ill patients, the National Polytechnic Institute (IPN) seeks to promote a specialty in that area, so it works on the design of the academic program that it intends to implement together with the Mexican Institute of Social Security (IMSS)…
he should have the option of
the Association for the Right to Die with Dignity A.C. Mexico 2016
he should have the option of
the Association for the Right to Die with Dignity A.C. Mexico 2016
Glossary
Advance Will
It is a way allowing a competent person to put in writing his will concerning the treatments he would want or he would not want to receive if he were to find himself in a situation where he could not express his will himself. The advance directive comes into force when the person becomes unable to make those decisions.
Assisted Suicide
It is the help that a doctor gives to a patient in response to his request, and it consists in providing him with the means to put an end to his life. The help may be to give him a prescription for a lethal dose of a drug or the drug itself. The patient himself executes the final action that causes death.
Euthanasia
Etymologically it means “good death”, and it refers to the action that a doctor performs to induce the death of a patient who has freely requested it because he is enduring an intolerable suffering for which there is no relief, and that is caused by a disease or a medical condition for which there are no healing options.
Palliative Care
It is the active and total care of those patients who do not respond to a healing treatment, in which it is a priority to provide relief through the treatment of pain and other symptoms, as well as to care for the psychological, social and spiritual aspects.
