Doctor: Pain Care Refutes Case for Euthanasia. (Nation)

Article excerpt

Those who argue in favor of the "humanity" of killing patients through euthanasia typically cite a person's unrelieved pain as the primary rationale for taking life, but the argument is "absolutely not true," said a San Diego physician.

"Our ability to end pain is more powerful than at any time in the history of human experience," said Dr. Charles von Gunten, medical director for the Center for Palliative Studies at San Diego Hospice.

Palliative medicine--intensive multidisciplinary treatment of the pain and symptoms of serious illness--is a prime example of a new, patient-centered trend in health care.

Von Gunten, a widely published authority on palliative medicine, is a trustee of the American Board of Hospice and Palliative Medicine and a consultant to the National Board of Medical Examiners in the area of end-of-life care. He also leads a project to train physicians in palliative care and is associate clinical professor of medicine at the University of California-San Diego.

To some people, "palliative care" implies the absence of care, an indication that "there is nothing more that we can do," he said in an interview with The Southern Cross, newspaper of the San Diego diocese. "To the contrary, it means there's a lot more we can do."

Palliative care goes beyond pain control, he said, because pain is not the sole component of suffering. It is a physical experience, endured by the patient, but there are additional components endured by both the patient and the family, he explained. The components of suffering are physical, emotional, social and spiritual.

"The field of palliative care has developed as an interdisciplinary approach to relieving suffering in all four dimensions," said von Gunten.

Medication can relieve the pain, experts say, but the drug will not end the suffering because the patient may still suffer from worry, guilt, fear and uncertainty. Once the pain is under control, however, doctors, nurses, chaplains, social workers and family members are better able to work on the other aspects of suffering.

"Palliative care is so much more than simply pain management: It's explicitly a team approach for ending all suffering," he said.

Although strides have been made in heightening both physician and public awareness of relieving pain in advanced stages of disease, palliative care researchers believe that many physicians do not take pain seriously enough. …