On Pain

- Christopher Wang, 2nd Year Medical School Student, University of Toronto

As second year medical students at U of T, we participated in a large, interdisciplinary event called “Pain Week”. While the title seemed rather gruesome at first, it turned out to be a great opportunity to interact with students from various disciplines (pharmacy, nursing, OT, PT…) in order to tackle the important health problem that is chronic pain. As the week progressed, I soon realized that patients’ belief systems often play an important role in how they experience, and therefore cope with, pain. So, throughout the week, I spent a lot of time thinking about how Christianity can bring meaning, and possibly even relief, in the midst of pain. Here are some of my thoughts.

C.S Lewis wrote in his book (conveniently titled “The Problem of Pain”) that “God whispers to us in our pleasures, speaks in our conscience, but shouts in our pains: it is his megaphone to rouse a deaf world.” And indeed, it is unfortunate that, all too often, we turn to God in moments of brokenness but forget about Him in moments of restoration. But to use that as a justification for the immense pain that our patients go through is also, I believe, unfair. Furthermore, if pain is the best way to point people to God, then isn’t our job as healers counterproductive? While I definitely do not have all the answers to these questions, allow me to share 3 steps that have helped me resolve these competing interests as a Christian medical student.

1. First, I found out that I needed to rediscover what it feels like to be in pain. The medical education system had such a focus on teaching me how to heal that I forgot what it felt like to be broken. I needed to become comfortable around vulnerability again, which I soon realized was something much easier said than done.
2. The next step, I recognized, was accepting that I could never fully understand the pain that other people were going through. We talk a lot about empathy in class but I firmly believe that empathy is overemphasized in the medical curriculum (perhaps the topic of another blog post). In many circumstances, it is simply impossible to fully understand the pain our patients are going through. It is only by coming to this realization that I was able to set the stage for the final and most important step in dealing with the problem of pain.
3. As Christians, we believe that though we can never fully understand the pain that another person is going through, we have someone who does. Hebrews 4:15-16 reads “For we do not have a high priest who is unable to sympathize with our weaknesses but one who in every respect has been tempted as we are, yet without sin. Let us then with confidence draw near to the throne of grace that we may receive mercy and find grace to help in times of need.” While not all of our patients will appreciate the comfort that this truth provides, it does not make it any less true. We must acknowledge their suffering, but also be ready when the time is right to direct them towards true restoration. In the meantime, I have found this verse to be incredibly helpful in my own journey through medicine. It has allowed me to look into the eyes of the suffering and see not only pain, but also perseverance, strength and even a subtle hint of hope. 

“It would be as much complicit in the action as actually doing it”

The National Post wrote an article last month on the effect decriminalizing physician assisted suicide would have on physicians who are morally opposed to the practice of euthanasia, 

“This is a question of whether people who have certain creeds or religious beliefs should be protected in law from the desire of a regulator to basically drive us out of the practice of medicine,” says Larry Worthen, executive director of the Christian Medical and Dental Society, which represents more than 1,500 doctors across Canada. “We’re simply saying there’s certain procedures we cannot participate in because of conscience and religious freedom. That’s in the Charter of Rights and Freedoms.”

For their part, some physicians may have already had enough. Mr. Worthen said he knows of several doctors who plan to retire early in order to avoid having to carry out procedures that conflict with their beliefs.

Others are pouring their concerns onto the college’s online forum.

“Faced with a request for assisted suicide from a patient, I would be required, by this college policy, to refer them to a physician who is ‘non-objecting, available and accessible’ to facilitate the assisted suicide. This in conscience I could not do,” wrote one doctor on Jan. 23.

“It would be as much complicit in the action as actually doing it,” wrote another on Jan. 5.

(Read the full article: http://news.nationalpost.com/2015/02/04/if-supreme-court-decriminalizes-physician-assisted-suicide-doctors-may-be-obligated-to-help-with-euthanasia/)

‘This is moral genocide’

From LifeSiteNews.com,

CMDS’s Worthen is sure that the new policy does something new—it requires doctors to co-operate with actions Christians consider immoral—and that violates the Charter of Rights and Freedoms.  He told LifeSiteNews, “The Charter protects individuals from the state and the College of Physicians and Surgeons is an arm of the state.”

What is more, said Worthen, last week’s landmark Supreme Court decision in the Carter case permitting assisted suicide contained specific directions from the judges ordering lawmakers to protect the freedom of consciences of doctors unwilling to assist suicides. 

Read the full article: https://www.lifesitenews.com/news/this-is-moral-genocide-canadian-doctors-blast-plans-to-force-them-into-help

What happens to doctors who refuse to help kill their patients?

The Globe and Mail weighs-in on what they call "four issues surrounding the Supreme Court ruling on assisted death":

"The ruling is clear that doctors cannot be compelled to help people die. But the court acknowledges that legislators and medical regulators will have to find a way to reconcile the rights of patients and physicians in response to the judgment. 

'There is an issue that remains,' said Paula Rochman, a lawyer who works with Dying With Dignity. 'Do you have a duty to refer the patient to somebody else?' 

That question could be left to the self-regulating professional colleges that govern physician behaviour in every province. Some – but not all – already have broad policies that require doctors to provide referrals if they refuse to provide a legal medical service on religious or moral grounds." 

"Euthanizing God? Theism and conscientious objection to physician-assisted death"

From CMAJBlogs.com written by Ewan C Goligher and Stephen W Hwang,

Physicians and healthcare institutions committed to theistic belief systems therefore face an important challenge: is it reasonable to base conscientious objection to physician-assisted death upon belief in God? This question has become critical in light of recent proposals to curtail physician autonomy and conscience rights in Ontario by requiring physicians to make referrals for procedures in violation of their ethical commitments. We argue that it is eminently reasonable to base such objections on belief in God, because theism is a rationally defensible belief system that provides coherent grounds for upholding the ethical values central to this debate, namely human autonomy, well-being and the incalculable worth of human life. (Read the full article at: http://cmajblogs.com/euthanizing-god-theism-and-conscientious-objection-to-physician-assisted-death/#more-1459) 

#MDsHaveRights2

Join the conversation on Twitter. Use the hashtag, #MDsHaveRights2 to take about conscience protection in Canada. 

"Do you want a doctor with moral integrity?"

Our doctors maintain professional, respectful and compassionate relationships with their patients. This includes accompanying patients as they make difficult choices, understanding fully that the final decision is always the patient’s.  Our doctors simply ask that they be respected as professionals in return.  Forcing doctors to violate their moral integrity is not only damaging to the doctor, but to the patient and to medical services as a whole.  It will inevitably mean that many doctors will be forced to leave patient care, leaving Canadians with less access to the medical care they want and need.   The choice is yours. Will you tell the College of Physicians and Surgeons of Ontario (CPSO) what you think about conscience rights? The deadline for comments is: Feb 20, 2015   http://policyconsult.cpso.on.ca/?page_id=5165  The College of Physicians and Surgeons of Ontario (CPSO) have a draft policy that would demand that doctors participate in morally controversial procedures like birth control, abortion and even euthanasia (if it becomes legal). Participation means making referrals and actually performing these procedures when the regulator (CPSO) considers them to be “urgent or otherwise necessary to prevent imminent harm, suffering, and/or deterioration.” This as a very broad requirement and will be open to abuse. Doctors who cannot participate due to deeply held moral or religious commitments will be vulnerable to punishment from the regulator, even though their fundamental freedom of conscience and religion is guaranteed by the Canadian Charter of Rights and Freedoms.  This is a form of discrimination.  If you are not already receiving CMDS updates and want to find out more about this issue: