分类： health

During a dinner conversation with friends, the topic of Medical Assistance in Dying (MAID) surfaced, sparking a profound discussion on the ethical, medical, and societal implications of this controversial practice. My friends, echoing the sentiments of advocacy groups like Dying with Dignity Canada, argued that MAID is fundamentally a human rights issue—every individual deserves the freedom to choose a dignified death. However, as a practicing geriatrician, I found their perspectives overly simplistic and detached from the nuanced realities of end-of-life care. Having spent years in palliative care, I’ve witnessed the profound complexities of predicting death and understanding the wishes of those nearing the end of their lives. My friends’ black-and-white view of MAID suggested a lack of firsthand experience with the dying process. When asked if I would ever perform MAID, I responded with a resolute no. The act of intentionally delivering a lethal dose contradicts the very essence of why I entered medicine—to heal and comfort, not to hasten death. One friend argued that individuals with mental health issues should have the right to end their lives with dignity, especially as Canada plans to expand MAID eligibility to include those suffering solely from mental illness by 2027. Yet, I questioned how one could differentiate between suicidal ideation and a genuine desire for a dignified death. Another friend expressed a desire for MAID if they were to develop dementia, but I countered that such decisions are often made without truly understanding the lived experience of dementia. What troubled me most was their ideological framing of MAID as a human rights issue, devoid of the medical uncertainties inherent in such decisions. Medicine thrives on uncertainty, and reducing MAID to a slogan undermines its complexity. Furthermore, the term ‘medical assistance in dying’ is misleading. MAID is not about assisting the dying process but about facilitating death—a distinction that carries significant ethical weight. Palliative care, which focuses on comfort and natural death, is fundamentally different from MAID, which actively hastens death. The lack of robust social supports and palliative care access in Canada raises questions about whether legalized MAID is a medical solution or a Darwinian ideology in disguise. As a physician, I believe our focus should be on improving palliative care and supporting vulnerable individuals rather than prematurely embracing assisted death.

As World Occupational Therapy Day approaches on October 27, the Trinidad and Tobago Occupational Therapy Association (TTOTA) reflects on 20 years of transformative work under this year’s theme, ‘Occupational Therapy in Action.’ Khamara-Lani Tarradath, TTOTA’s chairman, emphasizes the importance of focusing on shared humanity and strengths rather than differences, advocating for inclusive and accessible environments where everyone can thrive. Occupational therapy, a healthcare profession dedicated to helping individuals of all ages engage fully in daily activities, has evolved significantly since TTOTA’s inception in 2004. Founded by four pioneers—Lesley Garcia, Neela Ojar, Rosemary Green, and Margaret Hussain—the association has grown into a national force, influencing health policies and promoting accessibility, rehabilitation, and community inclusion. Over the years, TTOTA has achieved milestones such as launching the first master’s degree in occupational therapy at the University of the Southern Caribbean, hosting regional conferences, and initiating community projects like Team HOPE, which raised over $200,000. Despite these successes, challenges remain, including financial barriers, limited public sector positions, and public misunderstanding of the profession. Shaianne Pemberton, TTOTA’s public relations officer, highlights the need for increased government funding, expanded public sector roles, and greater public education to strengthen the impact of occupational therapy. The association continues to advocate for its members while advancing national healthcare goals, focusing on improving access to therapy services and enhancing health literacy. To mark its 20th anniversary, TTOTA will host its first-ever awards ceremony on November 26, celebrating outstanding contributions to the field. Additionally, the association is supporting a Caregiver Health Fair at St Ann’s Psychiatric Hospital on November 1, empowering caregivers of individuals with disabilities. Looking ahead, TTOTA envisions a future where occupational therapy is widely recognized, accessible, and integrated across health, education, and community services, with growth in non-traditional roles such as corporate wellness, disaster relief, and sports rehabilitation. The public is encouraged to support the field by engaging with TTOTA’s outreach events, attending awareness sessions, or contributing through donations and volunteerism.

In the whirlwind of life’s challenges, finding effective coping mechanisms is essential for maintaining mental well-being. While some turn to traditional methods like therapy, exercise, or gardening, others discover solace in unconventional activities. For me, swimming has become a sanctuary—a place where I feel most like myself, even if my strokes resemble those of a beluga whale. It’s not about grace or competition; it’s about finding peace in the water. This personal reflection underscores the importance of identifying what works uniquely for you, whether it’s a long drive, painting a fence, or baking cookies. However, not all coping strategies are created equal. While some, like indulging in cake or other comfort foods, may offer temporary relief, they can lead to long-term harm if overused. The key is to find healthy, sustainable ways to manage stress without losing yourself in the process. For some, this might involve problem-focused techniques, while others may benefit from emotion-focused or spiritual approaches. The journey to mental wellness is deeply personal, and there’s no one-size-fits-all solution. As I reflect on my mother’s serene moment bathing a borrowed cow, I’m reminded that serenity can be found in the most unexpected places. Ultimately, the goal is to discover your own ‘cow’—a practice that brings calm without causing harm. And remember, seeking professional guidance from a doctor or therapist can provide valuable insights tailored to your unique needs.