Professor, Palliative Medicine, University of Navarra, Spain; Director, Department of Palliative Medicine, and specialist in radiation oncology, University of Navarra, Spain
As palliative care professionals, our aspiration is for the end of life to come peacefully and with effective relief from suffering, in a natural and respectful manner with minimal intervention or technology. The fear of intolerable suffering at the end of life is something that is present in society. Beyond fear, the desire to die without suffering is a legitimate one that, fortunately, has an effective medical response in what we know as palliative care. If we witness intolerable suffering in the last days of life, we can turn to palliative sedation, a sedation that is not related to euthanasia but to good medical practice.
As health professionals in general and palliative care specialists in particular, we do not remain indifferent to unrelieved suffering. On the contrary, we strive to the fullest extent possible, organize a team around the patient, gather resources, seek the help of others, give our best, and, always, are there. We stay there, next to the patient, because we feel that our presence is a vehicle of relief. We could say that healing, relief from deep suffering, comes through us, as long as we stay there, present with the patient and their loved ones.
Watch with Me: Inspiration for a life in hospice and palliative care1 is the title and subtitle of a wonderful little book that recounts the beginnings of the modern hospice movement. When we talk about euthanasia or assisted suicide, we are speaking a different language. Euthanasia implies violence, lack of relief, and intervention. With euthanasia, we do not speak of "staying there," we do not try to watch over anyone: we speak of ending abruptly, of making a quick exit. That is not palliative care. Palliative care allows us to remain with the patient, without rush or pressure, offering relief and companionship. In short, palliative care not only relieves physical and emotional suffering, but also provides comfort and spiritual support at the end of life.
Saunders C. Watch with Me: Inspiration for a life in hospice and palliative care. Observatory Publications, UK, 2005.