End of Life Choices

I have written here before about assisted suicide and choices around the end of life Assisted Dying – A Duty too Far and Better Dead Than Disabled and it seems that the subject just isn't going to go away until we have a proper debate about it, rather than skirting around the issue and allowing high-handed medics to take unilateral decisions by default.

Ironically, I suspect that many people who might instinctively support a classic British “fudge”, as a practical way of allowing commonsense to prevail in this complicated area, will have been jolted out of that viewpoint by the attitude of retired GP Howard Martin, who seems to have been worryingly sure of his own ability (and right) to assess the quality of an individual's life, and the amount of suffering they might be experiencing. Invoking “Christian compassion” as a justification for his actions adds another controversial ingredient to the toxic brew, given the often-quoted Christian regard for the sanctity of life.

Reactions from those most closely affected by his decisions - the relatives of his patients, for of course the patients themselves are no longer in a position to give their opinion - make the situation no clearer, ranging as they do from describing him as an “angel of mercy” to somebody “lacking in compassion... so arrogant, so cruel”.

It seems, as always, that there are no rules or yardsticks that can be universally applied to judge the quality of a life: what one person perceives as intolerable suffering may not appear so to another. Which brings us back round to an individual's right to decide for themselves when/if their life is no longer endurable, and to be helped to end it if they are not able to achieve this themselves. Like it or not, we are a consumer society and have grown accustomed to choice: in everything from education to health care, insurance to banking, we are encouraged to believe that there are multiple options for us – why should we not feel the same about the way in which we approach the final event of our lives?

One choice that is not as widely available as it should be is good palliative care: perhaps some people who think they should be helped to commit suicide would be less disposed to this solution if they were confident that their final days would be managed in a way that removed pain and respected their dignity. And we must never lose sight of the risk that a right to die might morph into a duty to die, when an individual starts to feel that they are becoming a burden (financial or emotional) for their family or friends. You might be interested to read about a new book that has just been published "End of Life – the Essential Guide to Caring" which looks at both the practical and emotional issues around dying and bereavement.

No easy answers, but I don't think that takes away our responsibility to discuss the options, and try to reach a consensus, rather than muddling along as before, and allowing the Howard Martins to make the decisions for us.

What do you think? You can share your ideas by leaving a comment here, anonymously if you prefer.