This is a subject close to my heart. I experienced death with dignity in 1994, when my Father lost his long battle with cancer. Right up until his last few days, he fought against multiple myeloma and cancer of the oesophagus.
After diagnosis, and a little research, Mum and I knew Dad had a maximum of two years to live. Yes he smoked, hence cancer of the oesophagus. The multiple myeloma, his primary cancer, was a different matter - no-one knew what had caused that. Some specialists even asked if he’d been anywhere near some of the atomic detonations during the 1950s. He’d been a soldier during that time, right up until the early 70s. As far as we knew, he hadn’t, and that’s what he said too.
Although Dad slowly became visibly weaker during his last few months, he was still active, and through the pain, still tried to maintain as normal a life as possible. As a proud man, it was beyond him to ask for help, unless it was really necessary.
Like my Father, I also chose a role in the military, albeit in my case, part-time. I joined what is known as the Territorial Army here in the UK, very similar to the US National Guard. On returning home to my parents’ house after a training evening, I found Mum struggling to help Dad to the toilet. She wasn’t strong enough, and was relieved at my arrival.
My Dad looked at me and said “I’m knackered son”, he was clearly in distress, and needed assistance in order to get to the toilet, which I was able help him do.
By the following morning, a Thursday, it was clear that his life was coming to an end, the words he spoke to me the night before, were the last I would hear.
He slipped into a coma, and his body slowly started to shut down.
The Doctor came to visit that day, and said quite clearly that it wouldn’t be long now. He also left a large bottle of diamorphine, in order to relieve any pain, stating that we should administer a dose as and when needed.
For most of the day, Dad lay in bed peacefully unconscious. By the evening however, things began to change, his breathing became shallower, and he lost all bowel and urinary control. Thanks to a neighbour who worked in a care home, we were able to keep him clean, and to a degree, comfortable.
Diamorphine was administered throughout the night, when needed, as he slowly began to slip away.
The following morning, his sister came to visit him, and sat with him for about an hour.
After I’d taken her home, a short half mile drive away. I went back, and checked on Dad. His pulse was slow and weak, and his breathing shallow. I called Mum in, and said that I thought he was about to go.
As we stood there with him, I felt his last two pulses, and then he left us. He left this world in the company of the two people he cared about most - Me and Mum. We were with him at the very end. Just the way he would have wanted it to be. That’s death with dignity. He didn’t want his sister there - and just hung on until the time was right.
Yes it hurt, but in a strange way, it wasn’t just a relief for Dad. I felt relieved. His suffering was over, yet there was something else. The moment of death and sharing it with him made it so much easier to accept. Mum and I had a big hug, shed a few tears. But we knew he was now at peace, and would suffer no more. We had shared in his life, and at that vital moment we shared in his death. Something I can still celebrate. Yes, celebrate!
My Dad died in such a way that it made it easier for Mum and me to accept it, and to remember, still vividly, the moment he passed away.
That brings me on to the next part of this post – assisted dying. Should it, or should it not be legalised?
Personally, I have pretty strong views on this subject, and that is thanks to my Dad.
As stated earlier, we were able to administer diamorphine to Dad, as and when he needed it, in order to relieve pain. That is what we did. Yet, diamorphine can have a secondary effect - it can also assist in the dying process. This secondary, or double effect, is legal in many countries around the world. So long as pain relief is the primary aim, if death is a “side effect” then that’s acceptable.
There are of course other methods of “accelerating” death, many methods of which are also regarded as perfectly legal in many countries. Many care pathways, including the somewhat controversial Liverpool Pathway here in the UK, allow for the withdrawal of vital medicines, fluids and nutrients when someone is judged to be approaching end of life, or that the person concerned is in a vegetive state. Often the problem here is who actually makes the judgment. Clearly, the patient by this time - is no longer able to make that decision for themselves.
As individuals, as long as we’re able to make such a decision, whether we live or die, should be our choice. If assisted dying was legalised it would enable perfectly healthy people to state quite categorically what should happen if they were suddenly, through illness, or accident, placed in a situation where their life would be unsustainable without extreme medical intervention.
Here, I’m not talking of life changing events, where initially the casualty may feel they have lost the will to live because the psychological trauma of dealing with a life changing injury is too much. This is about whether there is a life to be lived or not. A life without pain, a life without suffering, a life that is not cruel. Where someone feels their life, through such traumatic events has become unbearable, and unliveable, they should at least be given an option, a simple yes or no scenario. Their personal choice will be based around many factors, and any conclusions or choices should not be taken lightly.
Life is a gift, but sometimes that gift can be too much to bear. Many people take their own lives each year, for a whole variety of reasons. Able bodied people can take their own lives whenever they want. Why condemn someone who feels life is no longer worth living, yet through disability or inability through mental or physical factors, is unable, thanks to outdated laws, to make that decision.
For some, death is a release. A release from the suffering of this world, a relief from pain. Many of us are strong enough to face many things, including death. A rifle barrel in your face could mean impending death – how would you deal with it? Some would fight, some would collapse in fright, yet others would calmly accept the outcome.
Death is never far away, and those close to it should be given the choice of whether they wish to continue to live, or not.
Personally, I believe that where a person is at the end of life, and that life has now become unbearable, through pain and suffering, they should be allowed to make that choice. Or, be given the choice to make that decision in advance.
We have donor cards, why not have an end of life card, stating quite categorically that person’s wishes when that time comes? It can still have an opt out clause, if needed. This would help alleviate many problems currently encountered between relatives and physicians, when deciding which treatments to continue and which to withhold. Even without legalised assisted dying, this would still work with care pathways and double effect scenarios.
Just a thought!