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Posts Tagged ‘Living Will’

So, with the announcement that the Government is to allow MPs a free vote on Lord Falconer’s Bill introducing assisted suicide, legislation on this highly contentious issue moves a significant step closer.

Baroness Butler-Schloss, someone for whom I have enormous respect, feels this is a step too far. In an article in the Daily Telegraph (15/12/2013) she argues that “allowing doctors or others to give active assistance to people to end their lives would cross a vital legal boundary. Laws, like nation states, are more secure when their boundaries rest on natural frontiers,” she writes.

“The law that we have rests on just such a frontier. It rests on the principle that we do not involve ourselves in deliberately bringing about the deaths of others. Once we start making exceptions based on arbitrary criteria like terminal illness, that frontier becomes just a line in the sand, easily crossed and hard to defend. The law is there to protect us all. We tinker with it at our peril.”

However, the law as it currently stands doesn’t go far enough for certain individuals such as Jane Nicklinson, the widow of Tony Nicklinson, the “locked-in syndrome” sufferer who starved himself to death last year after a long battle for assisted suicide, Paul Lamb, a quadriplegic who describes his life as ‘unbearable’ and a man named only as Martin who also suffers from locked-in syndrome.  They are seeking to sweep aside a prohibition on assisted suicide contained in the Suicide Act, using human rights laws.

I can sympathise with arguments on both sides of this case and understand the genuine concerns of the Butler-Schloss camp. However, on balance, I think I’m more inclined to the side of those seeking the right to die. Maybe I’m just not cynical enough to believe that this will lead to an onslaught of doctors ending people’s lives for some arbitrary reason, be it their own or someone else’s.

What I find totally unhelpful in all of this is the attempt of some commentators to introduce a hysterical tone to the whole debate, such as the comments made by Wesley J Smith, a senior fellow at the Discovery Institute’s Center on Human Exceptionalism, who on hearing the news stated:  “UK MPs need just look a short distance across the English Channel to see what your “strict guidelines” will get you; doctor-facilitated killing for the mentally ill, the elderly “tired of life,” a depressed transexual unhappy with a botched sex change operation, euthanasia for children, and a psychiatric patient euthanized because she had been sexually predated by her own psychiatrist. And that’s just scratching the surface.”

Towards the end of my dad’s battle with Alzheimer’s I knew that he had very little quality of life and I also knew that, if he could have seen himself, he would have hated what had happened to him. However, he was in no pain and life was comfortable for him. I was more worried about my mother, herself in her 70s, who was coping with him at home, albeit latterly with the help of a fantastic, private carer. But there would have been no question of us opting to go down the road of assisted suicide for my father even if this had been available to us. Putting aside, for the sake of this argument, his Catholic faith, we could assume that he wouldn’t like what he had become and how he was living but we couldn’t ask him and he was totally comfortable. Fortunately for us, nature did take its course before things become any worse and he contracted a very serious chest infection which, in the end, was what ended his life.

However, I remember when my grandmother was in a nursing home in the 1990s, there was a lady in her room who had all manner of things wrong with her, including Alzheimer’s. She was very thin and her body seemed always to be contorted. I remember she was in a heavy duty canvas cot as she used to thrash around so much she couldn’t be in a normal bed as she would have hurt herself, either by falling or by knocking herself on the rigid raised sides which would have been essential to prevent her falling. When she was very distressed she used to shout out and wail. It was heartbreaking.

On the wall above her cot was a series of black and white portrait photographs of her when she was in her 20s/30s and then a variety of family photos. She had been beautiful: film-star beautiful. The family had put the photos up to remind those looking after her that within this now shell of a human being there had once been a stunning, vital woman who had loved and been loved, had raised a family and had had a life full of meaning which she’d lost in the dementia lottery that we all face. In those days there was no question of assisted suicide and I have no way of knowing whether this would have been her or her family’s wish. What I do know is that, for myself, I would not want to live like this, even with the argument that I wouldn’t know anything about it.

The thing is, Tony Nicklinson was and Paul Lamb and Martin still are in charge of their mental faculties so can tell their families, doctors and lawyers what they want. People who have become mentally incapacitated don’t have this luxury.

With the possibility that the right to assisted suicide could become legal, it’s more important than ever that people think about what their own breaking point might be in the deterioration of their quality of life before assisted suicide becomes a consideration, or if it should never be an option for them, and make sure this is recorded in a living will or in a Lasting Power of Attorney and preferably both.

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I watched Channel 4’s ‘24 Hours in A&E’ recently. I didn’t catch it all but it featured an 85 year old man who had apparently suffered three heart attacks. Now I’m not sure what the time lapse was between each heart attack – years, months, days, minutes – but the third one was the one that killed him.

He spent his last minutes on this earth being rushed into A&E, having tubes inserted into him, having doctors trying desperately to get his heart going again. Did he want this? Who knows? He was 85. He’d had a long life. Did he want more time or was he accepting of the fact that, at 85, he’d reached the end of his time on this earth?

One thing, the doctor who tried so hard to save him knows that this isn’t what he wants for himself. He felt that this was no way to die and I’m with him on this, but without any instructions to the contrary the doctor was duty bound to try everything within reason to save this man’s life, no matter how invasive, aggressive and ultimately futile.

Would I want that for myself? Probably not; not at 85. Now at 75, if I was unfortunate enough to suffer a heart attack or a stroke or something equally as serious, assuming I’ve been relatively fit and healthy up to that point and the doctors believe that I have a good chance of resuming a reasonable quality of life for another five, 10 or even 15 years, then I probably would. If, however, they feel they can get me going again merely to ‘exist’ then, frankly, at 75, 65, even 55, I’ll pass. There comes a time when we have to accept that we’re not going to be able to cheat death forever; it’s going to catch up with all of us in the end and we must think about this and decide what we’re prepared to settle for if we ever find ourselves in this situation. Now your number and your threshold for an acceptable quality of life will be different from mine but the point I’m making is that if no one knows your number or the quality of life you’re prepared to accept, you could find yourself subjected to the same life saving procedures experienced by our doomed 85 year old, even though you had reached the point where you had made peace with the inevitability of your own death and would not have wanted this kind of intervention.

So, how do we avoid this? By making an Advance Directive (commonly known as a Living Will) and giving copies to your family, your doctor, your local hospital, your solicitor – anyone who might need to know your wishes at such a time. Doing this means that, even if you’re in a coma, people are left in no doubt as to what you would have wanted had you been in a position to communicate your needs and will hopefully inform any decisions being made regarding your treatment. It will also relieve your family of the burden of having to make what could be a truly untenable decision that even they may not be able to agree on.

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