The progress
of the Assisted Dying Bill through parliament is a ponderous one. Lord Falconer’s
bill intends that ‘competent adults who are terminally ill be provided at their
request with specified assistance to end their own life; and for connected purposes’.
It passage
seems unlikely to be easy or straightforward, and will be further hampered by
the fact that in this country we have the somewhat arcane system whereby
members of the established church (bishops) sit in the House of Lords. Hasten
the day when that lot will be booted out. Yet it is hard to see how, in the
end, some sort of facility for assisted dying will not be enshrined in law.
Unfortunately it may be a very watered down one. Already sufferers from
Alzheimer’s Disease and other progressive dementing processes are virtually
excluded as a consequence of so many not being deemed to be competent to make
such an informed request in their circumstances.
The medical
profession has proved itself adept at prolonging life to an ever greater
extent. I know, from having worked many years in the National Health Service, that
quantity – length of life – has a far higher value set upon it than its
ultimate quality among those who determine treatment regimes for patients. When
it was suggested to me, in my late 60s, that taking a statin would reduce my
risk of stroke or heart attack I asked the question ‘so, what would be my
likely mode of dying in the end?’ The response, from a nurse who was acting
upon the directive of a protocol on her desk, was a vague answer that was
little more than a brush-off. No matter – from my experience of caring for
people in extreme old age I had a pretty good idea of it in any event. Pneumonia
if I was lucky, recurrent and chronic urinary infection from an indwelling
catheter if I was not – indeed were I actually to be permitted to die of these
illnesses rather than have yet another course of unpleasant antibiotics, quite
probably administered intravenously.
But I want
none of it. Not if I were afforded any choice in the matter, which seems
unlikely.
The
counter-arguments to assisted dying are several and include the wonderful
quality of terminal and palliative care. Tosh. Or at least in far too many
situations (not all, I grant you) - tosh. But this is what the public is fed in
the press and the other media. So long as people are condemned to die ‘naturally’
there will always be suffering to one degree or another, and far too often
appalling suffering in terms of pain and other symptoms, and loss of dignity.
Worse – as we all know – deliberate and callous abuse by those charged with
their ‘care’. People may try to tell you otherwise but they are either deluded
or less than truthful.
Another
powerful argument is the claimed potential for abuse of the law – as has
happened with the Abortion Act which was never intended to create a facility
for abortion on demand as has certainly happened in most parts of England. But
that is a consequence of laxity, and collusion between health service workers
and their patients. The demand for assisted dying is going to be far less than
that for termination of pregnancy, and the decision could quite properly
involve a judge as well as a medical expert, the family and – most importantly –
the patient her/himself. So the fear that granny will be bumped off in order
that her bungalow may be sold and the family go off round the world on a cruise
ship on the proceeds should hardly be taken seriously.
When I was a
GP I lost count of the number of times I was asked by people in extreme old age
to be helped to die, or at least not to be treated in the event of serious
illness. They had lost all their friends. Their families might be hundreds, if
not thousands of miles away. And they lived constantly in the fear of ‘being
sent to a home’. Of course I could not – and would not while the law does not
exist – do anything that could be seen as acceding to their request, and I
gently told them so. But they were very special patients to me and I gave them
my best, which I know might have made their predicament a little more easy to
bear. Yet still they longed for it all to be over. And almost always their
parting took place in when they were alone, or – worse – in a busy hospital
acute ward or on a trolley in A&E.
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