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An awkward topic

Life is finite – there’s no getting around it. I think it was in a self-written film scene that Woody Allen once quipped “I don’t fear death – I just don’t want to be there when it happens”, but it’s certainly the case that the approaching end of a life (and the surrounding issues thereto) is a difficult enough subject for dangerously-ill patients, families and friends to address in private, let alone raise for discussion in the media.

About a decade ago I sat next to an elderly family friend at a book launch dinner. We hadn’t seen each other for three or four years and (as you do), after we’d caught up with each other’s family news, we moved to chatting generally on a range of subjects great and small.

Suddenly he turned to me and asked if I would like to know his greatest fear. The evening was only about two-thirds through – I wasn’t going anywhere – so I admitted I had no idea, but added that I suspected he was about to tell me.

He did.

He said he was currently engaged in a campaign to amass enough pills (he didn’t go into the scientific details and to be frank I didn’t wish to know) to top himself and his biggest worry was trying to gauge just how many he would require to do the deed.

I should explain that over the perhaps fifty years I had known him, I had never thought of the gentleman as susceptible to stress, pressure, anxiety or depression – he’d certainly never exhibited symptoms, nor expressed any personal concerns, in that direction down the years – and, even as he spoke, he gave no sign of any.

He went on to say, almost as background information, that “in the old days” [by which he was perhaps referring to the 1950s through to 1970s?], when home-visiting GPs were the norm, one could simply have a quiet word with the quack and, no questions asked, he could then quietly slip anyone who had come – through terminal illness and attendant pain – to the end of their tether something that would do the trick.

Nowadays, unfortunately, (he continued) the rules and regulations regarding the Hippocratic Oath had been reinforced and tightened up – plus of course the law had got involved – with the result that no longer could someone who’d had enough and didn’t want to be a burden, or indeed cause stress to their family by expiring messily in agony and distress, obtain the easy exit they craved. Instead, they’d probably find themselves being treated beyond endurance, or given violent CPR for minutes longer than was humane etc. etc., simply to ensure that no medic in the room was going to be on the end of a legal charge of negligence or failure to do everything absolutely possible to keep them alive.

Thus, apparently, my dining companion was collecting a horde of pills, week by week, simply so that if the day ever came when he’d had enough – he could self-administer himself what can euphemistically be described as the knockout blow. He’d even been reduced to worry and stress about a future scenario in which he began taking the said pills and erroneously fell unconscious along the way, i.e. before he could imbibe the lethal dose he desired.

What kind of sense is there in such a situation?

I should add that I acknowledge there’s a ‘thin end of the wedge’ line of argument, often ably put by pro-life campaigners (religious or not), in relation to the disabled or otherwise vulnerable who – in a situation where ‘acceptable life-ending’ legislation had been passed – might be put under unfair pressure, real or imagined, to sign themselves up.

I don’t have a ready answer to resolving those complex and difficult issues.

Who can pronounce with authority when matters of personal choice and free will come into this sort of focus?

Who can judge that person A is expressing a considered and rational ‘free will’ choice to end his life, whilst B (apparently expressing the same view) is not – strictly-speaking – exercising proper ‘free will’ at all, e.g. because of the influence of depression, third party pressure or even temporary delusion, and therefore his expression of preference can/must be ignored/denied?

I’m no Solomon or fount of wisdom on this subject or indeed any other.

Which brings me to recommend this article written by Margaret McCartney which appears on the website of The Independent today – COMING TO THE END

About Wendy Lewis

A former GP in the Home Counties, Wendy’s busy life revolves around her husband, grandchildren and two Labrador dogs – though not necessarily in that order. More Posts