I never thought it would be such a happy place - a personal view by Elizabeth A. Burroughs
By Elizabeth A. Burroughs, MA MD (Cantab), retired GP and hospice doctor
According to the pressure group, Dignity in Dying, “The vast majority of the public support a change in the law on assisted dying for terminally ill, mentally competent adults. This includes the general public, people of faith and people with disabilities”.
However, there is a world of difference between being asked a theoretical question when we are fit and forty and being the patient who is told that s/he has less than six months to live. In my experience, when the situation arises, most of us wish to cling on to life for as long as we can. In 30 years as a GP, just two terminally ill patients asked me to help to hasten their deaths - and neither of them was imminently dying. In over 15 years working in hospices I cannot recall ever having received such a request from a patient although I have had some from relatives. Whilst I am sure that the majority of relatives believe they are speaking in the best interests of their loved ones, the worry is that patients may feel pressured to agree to assisted dying to save their family extra worry, inconvenience or expense.
I have had many discussions with dying patients who have told me they want to go on living but whose main worries have been about the effect of their illness on close family members.
Dignity in Dying seems to imply by its very name that there are but two alternatives: a dignified and clean assisted death or an undignified, painful, messy natural one. In fact, there is a third way which I am sure most people would want both for themselves and for their loved ones: high quality palliative care.
High quality palliative care consists of holistic care with attention being paid to all the needs of the patient – physical, psychological, social and spiritual – and his / her family, by a multidisciplinary team including (amongst others) medical and nursing staff, therapists, chaplains and family support workers. The quotation which forms the title of this piece is from a patient who was admitted very reluctantly to our unit for help with troublesome symptoms but who left a few days later a changed woman.
Sadly, despite increased funding and a great deal of charitable giving, we have at present in this country the resources to offer this type of care to only a fraction of those patients who would benefit from a palliative care approach. This is particularly the case with respect to patients with non-cancer diagnoses such as end-stage heart, lung or kidney disease, and degenerative neurological conditions. A health needs assessment carried out in Cornwall a few years ago demonstrated that a minimum of 40 beds was necessary to meet the specialist palliative care needs of the community. Currently there is a maximum of 16 beds available.
But quality palliative care costs money; assisted dying is a considerably cheaper option. If an Assisted Dying Bill became law, terminally ill people who chose to kill themselves would be doing the country a favour – saving us money! Is this really the sort of society in which we wish to live? Surely a truly compassionate society is one whose hallmarks include palliative care, greater support for carers and enhanced end of life services - to enable all of us to die in God’s good time with comfort and with dignity?