Dealing with processes euthanasia It is not an easy task and it can “generate doubts at times”. The doctors have perceived, after more than a year applying the law, that participating actively in the aid-to-die processes It is very hard”. They say that they have faced it as “brave”, but that psychologically have detected that they need help to overcome it, a support that is not contemplated in the legislation and that many hospitals clean up by including it in their internal protocols.
respond to a euthanasia request it can be difficult for the doctor. The right of patient Asking for assistance in dying can trigger emotional problems among the healthcare workers involved that must be treated to overcome the moment. Nuria Masnauintensive care physician Doctor Josep Trueta University Hospital of Gironaes euthanasia reference of her center, a position that places her as a support person for those professionals who receive the requests for assistance in dying from the patients.
Since the law was approved in the summer of 2021, with an annual balance of 180 euthanasias According to data from the Ministry of Health published in June 2022, Masnau has participated in these processes from different perspectives. She has been linked directly on five occasions, but she has also been linked indirectly in another 20 processes due to her role as transplant coordinator from the hospital where he works.
Despite the fact that Masnau has been familiar with the processes of assisted dyingacknowledges in statements to Medical Writing that it has been “a tough year”. The doctor assures that “they were so immersed in making everything go well and responding to the patients” that they were not “aware of what it meant on a personal level.” “However, when we have taken stock of the last few months, we have realized that emotionally it has been hard,” he adds.
In this process, the doctor comes to “question many things and the limits are very weak, so it creates doubts at times.” He confesses that “it is not the same to help someone die than to put a medication and that death is almost immediate, that is something that must be worked on”. Despite the personal crossroads that it may entail, the law does not contemplate a psychological help for these health professionals, so hospitals are organizing their own internal protocols in which a response is given to this need that they have detected.
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Masnau: “It is not the same to help someone die than to give medication and death is almost immediate, it is something that you have to work on” |
“We started as brave. Our objective was to respond to a need that existed” and, in the midst of this process, “we supported each other a lot.” The doctor explains that all this unofficial support they have had has been thanks to the creation of the figure of the “euthanasia reference”. However, they are aware that in order to deal with euthanasia it is necessary to have specific professional support, both before and after. “Now we are organizing everything in a better way. We are immersed in a request for euthanasia and since December we have already started with psychologist sessions because it is a very special case”. Usually in the case of toilets, “in the blacksmith’s house, a wooden knife”.
Previous preparation to face euthanasia
Josep Soler, psychologist of the Euthanasia Commission of the Doctor Josep Trueta University Hospital of Girona, claims in statements to this newspaper the importance of this figure as support for the health care provider involved in providing help to die. “Professionally they are prepared, but sometimes there are doubts or concerns, and that is why we work beforehand to normalize the sensations they may have.” He assures that some of the professionals who have participated in these processes report “stomach problems or insomnia, although others do not suffer at all”, for this reason prior preparation is important. “We give them guidelines so that if anxiety arrives, they know how to assume the situation without blocking themselves. To do this, we offer self-healing guidelines and guide them to normalize emotions.”
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Soler: “There are professionals who, although they are preparing to respond to the provision of help in dying, suffer from stomach problems or insomnia. Prior psychological preparation is important” |
How to deal with the situation also depends on the experience of the health worker himself. “If they are used to palliative care, they know how to handle the situation better. In other cases, doubts arise about what to do, where to go (near or far from the family)… their concerns are more of a physical nature or what to say in front of the lack of practice in dealing with death”.
Aware of the need that arises in the health workers involved in the processes of euthanasiahe General Council of Psychology (COP) pleads because the figure of psychologist It is contemplated, within the Euthanasia Law, in the development of the legislation, although they clarify that there is currently no open procedure to claim its inclusion.
Josep Villajoanafrom COP Division of Health Psychology explains that “there is no formal process to request a change in the law. What interests us most, those of us who direct the strategies of the profession, is that in practice the role of the psychologist is considered and that the experience of the autonomous communities that have psychology professionals in the evaluation commissions”.
He confesses that the role of these professionals is “assessed as fundamental by the doctors” involved in providing assistance to die and, although the Council has not yet discussed whether or not it is necessary to “propose an amendment to modify this law in the one that contemplates psychological assistance to participating health workers, there is an interest in that in the development of the same it is contemplated in this way”.
Health workers bear the responsibility for euthanasia
Despite the difficulties and the fact that processes have had to be improved internally along the way so that healthcare professionals have the support they may need in the exercise of this service, Nuria Masnau makes a positive balance all of it. “We have had the opportunity to demonstrate that it was possible. The work has been done well and in silence, because in the end the noise distorts. In the midst of all this, I have realized that there are very good people among health professionals who have shouldered this responsibility and have assumed it, despite the fact that each one has a way of thinking”. For this reason, he asks his fellow conscientious objectorsto those who respect and understand, who consider that “there are red lines that should not be crossed”, who “do not leave a request from a patient unanswered. A medical objector It doesn’t have to be a problem, you have to give an answer and look for someone who can manage it”.
On a personal level, he highlights how euthanasia has ‘helped’ to “recover the profession”. “We live in a world, at least in hospitals, that is very technological. Now, we have returned to people and with it, to recover the essence of our profession.”
Although it may contain statements, data or notes from health institutions or professionals, the information contained in Redacción Médica is edited and prepared by journalists. We recommend to the reader that any health-related questions be consulted with a health professional.