Guest column: As a pharmacist in the longevity concoctions business, I prefer to keep my 'oldies' alive

As Canada's Parliament debates Bill C-384, why are more pharmacists not rising up in protest over possible legalization of euthanasia and assisted suicide? Is it because we ought to remain neutral? Yet if this debate is supposed to be all about choice, then, as a pharmacist, I choose not to remain neutral on an issue that could impact my livelihood.

I'm in the business of health and wellness; longevity concoctions, my specialty. I believe it is more lucrative to keep my oldies alive and kicking longer; eliminating them is against my mission statement, and it would surely kill my business too. Unless, of course, I could charge a hefty sum for how-to-exit kits, including arsenic, asphyxiation bags, and other death paraphernalia.

But then comes another dilemma; as the elderly get knocked off, replacements will be needed -- so I can continue to offer my services. Yet most pharmacies are also in the birth control business; sooner rather than later, my clients will largely come from overseas. Time to brush up on my Arab and Cantonese.

Are health-care providers prepared for the impact a euthanasia law could have on their day-to-day practice? If, for moral or ethical reasons they find themselves unable to comply with such
a law, would they risk being fined or put in prison? Would I be accused of imposing my morality were I to dissuade sweet Ms. Jones from being euthanized by her inheritance-ravenous offspring? Yes, they will all claim it was her own choice, and really, in everyone else's best interests.

How about the lady with the severe arthritis or the man with the club foot? How about the child with the MS or the severely depressed teenager? Will our answer to their pain be their death too? If the Right To Die movement has its way, it will all boil down to "personal" choice. But whose choice will it really be? For example, as a pharmacist, I had no choice over the following briefing which states that everyone should have a choice.

In 1994, a government brief was presented to the Senate Committee Studying Euthanasia and Assisted Suicide by the Canadian Pharmacists Association. This brief clearly shows that pharmacists, like the Canadian population as a whole, are "largely divided on the issue [of euthanasia] and cannot make a strong recommendation on the legalization of euthanasia or
assisted suicide." The briefing statements make it appear as though everyone involved will have a choice, but the reality is there will need to be a balancing of rights; the right of the
patient to receive what he wants, versus the right of the health-care professional not to participate in the patient's demise. For many, referral will not be a viable option.

So if such a law should pass, I want to make something clear; I want two choices; the choice not to kill off my business by concocting death potions, and also the choice not to refer my oldies or disabled youngsters for liquidation elsewhere.

But, with all our "rights and choice" talk, are we not neglecting the underlying issues causing the euthanasia debate in the first place? And why are we not learning from the Netherlands? According to Dr. Herbert Hendin, American author of, Seduced by Death, the broad "safety" guidelines to prevent people from being euthanized against their will have been largely ignored, to the point where the doctors who help set euthanasia guidelines will privately admit that euthanasia in the Netherlands is basically out of control.

What we really need to be asking ourselves is: How did the patient reach the decision to put an end to his or her life in the first place? Was there any pressure? Was there fear of pain, of loneliness, or of the unknown? Has our society become so cold and ruthless that a sick person would rather die than be subjected to humiliating treatment by those who ought to care?
The reality is that were euthanasia to be legalized in Canada, we would be embarking on a "social experiment" of great magnitude.

Once the experiment is unleashed there will be no turning back. Your "choice" and mine may become somebody else's.

Alarcon is a Vancouver pharmacist with a masters in bioethics.
Published in Vancouver on October 29, 2009 in The Province

Pharmacists must have Freedom of Conscience

I met Martha a few years ago, a beautiful young woman. She started frequently visiting the pharmacy, nearly every month, just to purchase a home pregnancy kit. Her hands always trembled, and there was fear in her eyes. Finally I decided to ask her whether she was okay, if not, what was the matter. She looked at me tearfully and confided, “I don’t want to go through another abortion and if I get pregnant I know he will leave me.”......(click on title to read more)


Read more: http://network.nationalpost.com/np/blogs/holy-post/archive/2009/10/08/cristina-alarcon-trusted-professionals-must-have-freedom-of-conscience.aspx#ixzz0Tg8uMRRG
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Cristina Alarcon in National Post: Right to die? How about right to live

I had just returned from Washington, D.C., where I attended the Second International Symposium on Euthanasia and Assisted Suicide. The theme: “Never Again.”

The night before, I had mused over the intense weekend in Washington, the moving testimonials and the lively plane ride where I had become engulfed in conversations that betrayed the pervading culture of confusion surrounding assisted suicide and euthanasia. No, euthanasia is not about withdrawal of life support so as to allow a terminally ill person to die, I had explained to the lady on the plane. No, physician-assisted suicide “guidelines” are not always strictly enforced.......

LETTER IN RESPONSE TO JULIE CANTOR (NEJM)

Re: Conscientious Objection Gone Awry---Restoring Selfless Professionalism in Medicine

Dr. Cantor maintains that those who disagree with her perfectly contestable philosophical and ethical viewpoints ought to remain neutral, while she herself cannot. Accussing others of selfishly telling half-truths, while she falsely implies that a woman’s right to birth control is Constitutionally protected and self-servingly stomping on the truly Constitutionally protected rights of freedom of conscience and religion of healthcare providers, Dr Cantor betrays her own lack of impartiality.

True, Church and State are autonomous; yet this is not to say that religious believers within a secular society ought therefore to be treated as second-class citizens. .

Cantor’s obvious intent is to promote greater access to a variety of options for women, yet this cannot be done at the expense of relegating professionals to function as automatons or fragmented individuals who live via different mores in different settings.

Just as Dr Cantor has a right to live via her own beliefs and her own conscience, so do those who oppose her beliefs have the right to live with integrity as truly responsible moral agents.

Cristina Alarcon , Bpharm, Masters Bioethics


Longer version of letter:
Re: Conscientious Objection Gone Awry---Restoring Selfless Professionalism in Medicine


Unmatched is the candor of Dr Cantor in “conscientious objection gone awry…”. Not only is she transparently unfair to those who would disagree with her perfectly contestable philosophical and ethical viewpoints, but she also dares to insinuate that healthcare providers ought to remain neutral while she herself cannot.

While it is true that Church and State must each maintain their autonomy, it is false to conclude that religious believers (as opposed to non-religious believers) ought therefore to be treated as second-class citizens. She dares to accuse others of selfishly telling half-truths, while falsely implying that a woman’s right to birth control is Constitutionally protected and self-servingly stomping on the truly Constitutionally protected rights of freedom of conscience and religion of all citizens, those of healthcare providers included.

Cantor’s obvious intent is to promote greater access to a variety of options for women, yet this cannot be done at the expense of relegating professionals to function as automatons or fragmented individuals who live via different mores in different settings.

Furthermore, her myopic views on women’s health issues, which reduces women to the sum of their reproductive organs lacks vision and imagination. It is an insult to the women who, as patients, may not all share her views, and to the professionals who selflessly care for them. To compare the non provision of abortion services to non provision of lifesaving treatments such as blood transfusions and diabetic medicines shows a further lack of deep reflection on the fact that pregnancy is not an illness, and premature delivery is rarely a therapeutically lifesaving intervention. On the contrary, abortion takes the life of an innocent bystander.

Finally, just as Dr Cantor has a right to live via her own beliefs and her own conscience, be it religiously informed or not, so do those who oppose her beliefs have the right to live with integrity as truly responsible moral agents.

Cristina Alarcon
Bpharm. Masters Bioethics