“With the birth and death of my first son, my baby, God spoke to my heart,” is how 82-year-old Jean Echlin explains her careerchoice — caring for people as they face death.
Echlin was a nurse-in-training when her first baby came. She went on to complete a master’s in nursing, teach at the University of Windsor and founded Hospice of Windsor — an institution that ensures 70 per cent of Windsorarea residents have access to palliative care when they need it, compared to less than 30 per cent throughout the rest of Ontario.
Because Echlin is one of Ontario’s pioneers in palliative care, and because Canada is mired in a confused, emotional and critical debate about assisted suicide, euthanasia and end-oflife care, the deVeber Institute for Bioethics and Social Research has instituted the Jean Echlin Award for Ethics in Palliative Care. Nominations for the new award closed July 31 with 10 nominated for the award.
Echlin couldn’t be more pleased that the award will draw attention to the effectiveness of modern palliative care.
“I’m anxious for this to go outwards now,” she told The Catholic Register. “I’m laughing because I’ve been saying, ‘At least it’s not a memorial.’ ”
The repeated argument that patients should have a right to die on their own terms, that patient autonomy trumps the moral qualms of doctors, nurses, friends and strangers, infuriates Echlin.
“People think you’ve got to answer to the person’s autonomy. I think we exist for the common good, not for one person,” she said.
Still teaching the occasional class at the University of Windsor, Echlin is deeply troubled when nurses or doctors soften their commitment to care and open up the possibility of assisted suicide.
“Listen, I say. Hold on everybody. What happens to the minds and the hearts of those who could kill, those who are designated to kill somebody?” she asked. “Does anybody care? A doctor or a nurse designated to kill another human being? Give me a break. I think it’s horrible.”
Echlin didn’t end up in palliative care nursing because she was obsessed with death. As she struggled through the death of her baby son in 1955, she became obsessed with life.
“I looked for, as we Christians do, we look for meaning in loss and suffering. At least I do,” she said. “What is the meaning here? I don’t believe it’s a God-inflicted thing at all. The world has evil in it, and has disease in it, and so on. What is the message when we’re confronted? What do we take away from something that hurts us so much?”
In 1955 Echlin had a big extended family and a loving, attentive husband to help her through her grief. She had all the love and support any person could hope for.
“But I thought, what do people do who haven’t got that? How do they face end-of-life?”
In the 1950s and ’60s Echlin didn’t have anywhere to go with these questions. She just kept running up against the reality of how people died in hospitals.
“I thought it was horrendous the way we let people die,” she recalled. “They were in pain. We weren’t really allowed to medicate. It was just assumed you would die in pain. I disagreed. I found it unacceptable.”
After finishing her masters and beginning her teaching career, an opportunity to tackle these issues directly came up in the late 1970s.
McGill University’s Dr. Balfour Mount, the father of palliative care in Canada, offered a course in palliative care. Echlin took an unpaid leave-of-absence from the University of Windsor and headed to Montreal. She learned basic principles of palliative care and formulated a medical argument for care, comfort and pain relief leading up to natural death. But it was a field in its infancy in 1979. When she came back to Windsor to establish Hospice of Windsor, now the Hospice of Windsor and Essex County, she had to grow up in the practice of palliative care. “I kid you not, we were flying by the seat of our pants,” Echlin said. “We had nothing even to chart on at the Hospice of Windsor. It was that new.”
With support from Windsor’s newspapers, radio and TV stations, Hospice of Windsor built a profile in the community and support for the hospice and the idea of palliative care.
“When there is good palliative care, physical pain is controlled. We attend to the social and psychological pain that people suffer — the losses, the emotions and the fear. Once you’ve managed a lot of their physical suffering they (patients) have time to attend to their spirituality. And there also we come front row and centre in support,” said Echlin.
The deVeber Institute expects to announce the first winner of the Jean Echlin Award for Ethics in Palliative Care at the 20th International Congress on Palliative Care, Sept. 9 to 12 in Montreal.