A Dignified Death

Idignifiedf ever there is one.  Nobody likes to talk about dying but unfortunately it is something we all have to face.  Members of families speak about it but do they do the right thing to enable their choice of passing.

I know my family know that I have made, what they call a living will, and they know that my wishes are that it be carried out.  I have told them if I need resuscitation and will awake with a normal life, fine.  But if resuscitation is going to leave me in a vegetative state or a state where I immobile and bed-ridden for the rest of my days and my brain is still functioning as it should do… please let me go and don’t resuscitate me.

Last night I was reading an article in the Telegraph where they say some families are not told patients have been put on the Liverpool Care Pathway, the article said:

NHS doctors are failing to inform up to half of families that their loved ones have been put on a scheme to help end their lives, the Royal College of Physicians has found.

The article then went on to explain about the scheme.

Under the guidance, patients who are close to death can be placed on the Liverpool Care Pathway, so called because it was developed at the Royal Liverpool Hospital in the 1990s. It aims to ensure they die without being subjected to unnecessary interference by staff.

In addition to the withdrawal of fluid and medication, patients can be placed on sedation until they pass away. This can mean they are not fed and provided with water and has led to accusations that it hastens death.

To be perfectly honest I have never heard of the Liverpool Care Pathway before last night, so I read a related article from 2009, again written by the Telegraph, where it states the following:

Imagine you have just six hours to live. You’re wired to monitors, and have tubes all over your body. Nurses and doctors know you’re not going to recover, but they still keep changing your drugs and taking blood from your arm. Your spouse is trying to hold your hand and talk to you. But all you can hear is a machine that goes “beep”. It’s probably the last thing you’ll hear.

Ten years ago, that was how too many people reached the end of their lives – in hospital, as a failing body, plumbed into machines, with staff doing their best to cope, but with no guidance on how things could be better. But today the way in which many hospital patients are cared for has improved enormously – and death is being treated as the natural end of life, rather than a failure of medical technology.

Driving these improvements has been the Liverpool Care Pathway for the Dying – a model that takes the philosophy and practice developed by experts in hospices, where Britain leads the world, and sets out detailed guidance for doctors and nurses who care for dying patients in hospital. It ensures that the patient is comfortable, free from pain and distressing symptoms such as breathlessness.

Do you know what?  It wasn’t until this time last year, when I was having breathing problems, caused by bad reactions to medication, did I realise how frightening fighting for your breath was.

There is nothing worse than trying to get your breath and not being able to. The panic attacks that occur, because you feel you want more oxygen in your lungs and you can’t get it no matter how hard you try to breath, are frightening.  It was like having air-hunger (believe it or not it does exist). And it is scary.  And as the above article states it is very distressing, not just for the patient but for the family around them as they watch someone fighting for breath.

Luckily for me once the medication was changed, the symptoms subsided and I was back on the road to recovery.  But I can tell you no matter how many times, you try to tell yourself the feeling will pass and you will be able to breath properly in a minute, it still doesn’t stop that panic that ensues you.  The fear of perhaps I won’t get over this attack.

We all, during our lives, have to make decisions, some of them good some of them bad and we pay the price for those bad decisions.  But one decision that we should all be entitled to is how we die.

I am an animal lover, and no matter how much it hurts me and no matter how much I don’t want to have to do it, but when my little (well not so little) boy gets to the stage that his quality of life is not worth having, I will make that decision to relieve him of his misery.

Why? Because I love him and because I wouldn’t want to see him in pain and suffer a long distressing and agonising death.

We don’t make animals suffer, so why do we make human beings suffer.

The law will prosecute an animal owner for cruelty if they fail to put a sick dog down, whilst in the next breath the law would also consider prosecuting a person who helps a terminally ill person, who is begging them for help, to end their life.  It just doesn’t seem feasible that we are prepared to let human beings suffer.

I think a dignified death is want many of us wish for and it is a personal choice.  I am all for this type of scheme, if a patient views are known and if the patient receives a pain-free death, then surely that must be less stressful and less distressing for the patient as well as the family.

And given the options of a pain-free death and a painful one, pardon me for being a coward, but I will take the pain-free option, if you don’t mind.  Me and pain don’t get on to be honest and the less pain I can have the better.

It should be a personal choice and I don’t think any group, individual or Government has the right to say how each of us die.  And we should respect a person’s wishes, I hope and pray when my time comes, my family have the strength to respect my wishes.

Perhaps it is time for the whole euthanasia debate to be fully aired in public… because there is nothing worst than having your loved one ask you to help them die a dignified death and then face being prosecuted.

Who knows we might even follow in the footsteps of Switzerland and have a medical unit similar to Dignitas, but at the present moment in time,  the law is not clear and the whole debate of euthanasia is something that should be looked into.

Personally I am all for it.


Further Reading – From http://www.demos.co.uk/publications/thecommissiononassisteddying

The Commission on Assisted Dying, launched in November 2010, was set up to consider whether the current legal and policy approach to assisted dying in England and Wales is fit for purpose. In addition to evaluating the strengths and weaknesses of the legal status quo, the Commission also set out to explore the question of what a framework for assisted dying might look like, if such a system were to be implemented in the UK, and what approach might be most acceptable to health and social care professionals and to the general public.

The Commission, chaired by Lord Falconer, includes members with expertise in law, medicine, social care, mental health, palliative care, theology, disability and policing. The Commission engaged in a wide-ranging inquiry into the subject, including a public call for evidence which received over 1,200 responses, public evidence hearings, international research visits, and original and commissioned research on the issues surrounding assisted dying.

In this report, the Commission concludes that the current legal status of assisted suicide is inadequate and incoherent. While the current legal regime can be distressing for the people affected and their families, it is also unclear for health and social care staff, and lays a deeply challenging burden on police and prosecutors, which could be eased by a new statutory framework. A proposed legal framework for assisted dying is laid out in detail in the report, including strict criteria to define who might be eligible to receive assistance and robust safeguards to prevent abuse of any new law.

Based on the evidence received, the Commission considers that substantial improvements to health and social care services would be needed in parallel with changes to the law to permit assisted dying. It proposes that the role of any future assisted dying legislation must be to provide all people with access to high quality end of life care and protect potentially vulnerable people from any form of social pressure to end their lives, at the same time as providing people with greater choice and control regarding how and when they die.

To view the evidence submitted to the Commission, visit the Commission on Assisted Dying website.

The Commission on Assisted Dying Report – 5th January 2012


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