Heart failure, disabling polyarthritis, cancer…
“This group is becoming more and more important”observes the Commission. This percentage will continue to increase, because polypathology is associated with the aging process that patients undergo. The age graph confirms this: 70% of the patients concerned were over 80 years old and 32% over 90 years old.
In these people, the severity of the condition results from a combination of progressive, non-improvable and increasingly debilitating illnesses, which can lead to organ failure. While some of these conditions are life-threatening (56% of these patients are considered to die in the short term), others mainly involve quality of life.
Around 50% of these patients suffer from severe heart failure and disabling polyarthritis, and 30% have cancer that cannot be treated properly due to the polypathology, details the report.
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A chronic evolution that extends over several years
Renal failure, which can cause cardio-renal syndrome that is difficult to treat, is present in one in five patients. One in ten of these (very) elderly people suffers from a psychiatric disorder, mainly dysthymic disorder (a form of depressive state) or a complex grief reaction. In 5% of patients, the onset of dementia or memory problems is observed.
“The chronic course of these conditions extends over several years and constitutes the main cause of significant psychological suffering”indicates the Commission.
-This suffering has been evaluated on the basis of scientific research. It emerges that the feeling of despair, dependence on care, the fear of further degradation and that of increased physical suffering are determining factors in the request for euthanasia. “On the other hand, weariness of life and the feeling of an accomplished life only play a very limited role.underlines the report.
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The nonagenarian cannot bear her decline
To illustrate polypathology situations, the report presents a clinical vignette. This is a 93-year-old lady, blind, suffering from retinitis pigmentosa since she was 20, who suffered a serious stroke. After a second stroke, she had to be hospitalized. She suffers from left hemiplegia (paralysis). She is now unable to walk alone, feed herself, bathe or leave the house. She is no longer (and will no longer be) able to live independently but refuses to be placed. This situation causes him great psychological suffering.
Antidepressant treatment is useless: she is absolutely not depressed and has never had any history, but she cannot bear her decline. The resulting moral suffering is unbearable and without hope of improvement. All her loved ones accept her wish for euthanasia, confirming that what she is experiencing is extremely painful and unbearable for her, despite everything that can be put in place.
A general practitioner and an internist, specialized in supporting people at the end of life, both gave a favorable opinion. “From this analysis, it is clear that polypathologies lead to severe somatic and psychological suffering, meeting the criteria for serious, incurable and intractable illnesses.which authorize a request for euthanasia, concludes the report.
