Wednesday, 19 December 2012

Thoughts on assisted dying


This article was written by a friend of mine, Dr Duncan Stewart

Three elderly clerics are discussing the point at which Life begins.  The Anglican, slightly pompously, begins with “As soon as a newborn baby cries, Life has started.”  “Oh, No” responds the Catholic priest, who presumably has no firsthand experience of conception, “Life begins much earlier. It starts when the sperm fuses with the egg” They both look at the Rabbi who strokes his beard and slowly announces “In my opinion Life begins when the children leave home and the dog dies.” A very important debate about the end of life, with some equally whimsical moments, is swirling around the corridors and leather benches of our Parliament . The supporters of Assisted Dying are making progress in spite of sustained opposition to a change in our laws from senior religious figures whose predecessors obstructed the passing of more progressive social legislation than any group except the aristocracy.

It is generally agreed that life has ended and the undertaker can confidently be called when the heart beats for the last time .There is  less agreement about  those “not quite dead” states in which death is both inevitable and imminent , as  when other organs like the liver and kidneys fail or that “Old man’s friend ” pneumonia intervenes. Fortunately, in these forms of terminal illness, pain is not a prominent symptom so fewer ethical problems arise. We all fear uncontrolled pain but sufficient doses of  opiate drugs can control any pain and if the dose required causes a coma that is only ended by death , so be it. But what if you have a condition which is not only painful and terminal but has deprived you of speech, movement and continence? What then? If you could somehow summon effective help in such a situation, you would not request the presence a homeopath nor a priest, you require the help of doctor with a syringe driver full of Morphine .

  I can understand the importance to a   believer in an afterlife of being reassured  of this by the his priest but we live in an increasingly secular society so why does  religious thinking still dominate this territory? The opportunity to rob your neighbour, murder his noisy children or seduce his wife, has now passed.  In any case why do God’s earthly representatives object to doctors relieving pain and anguish  when all  the other  parties involved ; the patient, physician  and relatives , have all agreed after much careful debate that to end  life remains  the only humane act? I refuse to accept that anyone’s god is going to be seriously offended if a few souls smelling strongly of barbiturates reach him a few days ahead of schedule.
For myself, I imagine my final day lying in a comfortable bed surrounded by friends and family sorry to see me go but thinking, perfectly reasonably, about my last will and testament.  As  life slips  gently away I  will be reviewing my few successes , my many more numerous acts of timidity and unkindness and finally trying to compose a  witty last utterance. Maybe.

Forget the rising cost of living and ponder on the cost of prolonged dying.  I intend  to  vote for whoever wants to repopulate the House of Lords and legalize Assisted Dying and to  give more generously to our 2 superb local hospices, The Martlets and The Beacon to whose running costs our parsimonious government contributes only a miserly  30%. I will also check that my having made a Living Will, which lawyers refer to as an Advance Decision, is known to my family, solicitor and GP. This simply states one’s wish not to be resuscitated where this is clearly inappropriate and while it cannot override existing legislation it may help all who participate in that decision. You can download the paperwork very simply. I will also dust off my organ donor’s card in case any of my organs have a bit more mileage left in them.

You are probably aware that Switzerland, Holland Belgium and Luxemburg have succeeded in creating carefully crafted legislation which acknowledges the right of some, but by no means all, terminally ill and seriously disabled people, to decide when their life ends. Three states in the overtly God-fearing USA : Montana Washington and Oregon allow assisted suicide in similar situations. Simply wishing to die clearly does not qualify, it is suicide.

 Our 3 clerics would all have accepted the Paediatricians’ assertion that the first 12 hours of life, whenever it starts, are the most dangerous; but they are not as hazardous and uncertain as the last 12.  RIP

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