When we have no choice #114

End of life

Last week the Assisted Dying bill (The Terminally Ill Adults (End of Life) bill) ran out of time in the Lords. A private member’s bill bought forward by the MP Kim Leadbeater. Passionately and intelligently endorsed by the broadcasting legend we all grew up with, Esther Rantzen, herself terminally ill with lung cancer.

Filibustering

The bill was intended to allow those over 18 with a terminal illness - meaning they have less than 6 months to live - the choice of an assisted death. The recommended safeguards included oversight and ‘sign off’ by an ‘expert panel’, the members of which were under debate.

The unwhipped ‘free’ vote passed the Commons, 330 for to 275 against on its second reading. It then went to the Lords where over 1,000 amendments were tabled by a minority of Lords. Claims of filibustering have been made - the practice whereby a proponent talks and talks and talks essentially to prolong the debate such that the debate runs out of time.

Thoughts, experiences and observations

I don’t claim to know the intricacies of this debate, so I merely comment as a member of the public, who’s lived a bit of life, including a stint as a nurse, and years talking to clients about their plans for dying. Including one lovely guy, who, aged nearly 50, was diagnosed with a rapid form of Motor Neurone Disease – the same that took the life of Doddie Weir. My client knew he was going to die a distressing death, sentient to the end, having lost his ability to perform even the most basic of bodily functions. And all he could do was wait…

I also comment as a daughter having discussions with her mother. My mum, a woman who is 100% cognitively sound, certain that if she is unable to live a life of independence and knowing, she would rather not live. A statement I believe to be true. The reality though - macabre family jokes aside about my brother’s fishing pond, a small boat and a pair of concrete wellington boots - a decision such as this does not currently sit with the individual nor the family. In fact, by the time someone might wish to invoke such a right, they may have already lost the capacity to do so, a cruel irony.

Of course, we have Lasting Powers of Attorney, which can cover Health and Care decisions. This allows the ‘donor’ (the person who is appointing others to make decisions on their behalf) to direct their attorneys to make the decision whether to consent to life-sustaining treatment.

Yet an individual cannot choose the time they wish to die. And should another individual assist in anyway, such as a trip to Switzerland, they can be found guilty of assisted suicide which is illegal and punishable with up to fourteen years in prison. Incidentally, have you seen the Pedro Almodovar film The Room Next Door with the luminous Tilda Swinton and Julianne Moore? Watch it. Thought provoking, beautifully acted and stunningly shot.

It’s complex yet…

I can of course see the risks of such a bill becoming law. Potential abuse from relatives perhaps keen to receive an inheritance or relieve themselves of heavy caring duties. Dependant individuals feeling they don’t want, or shouldn’t be, a burden to relatives. Some may not have the mental capacity to understand the implications of a life ending decision not to mention those suffering from severe mental ill health or depression who might not take such a decision were they in receipt of effective treatment. All need to be protected, without doubt. Of course there must be safeguards.

There will be some who disagree with euthanasia or assisted suicide on religious grounds. Views which also need to be respected.

There are many who would argue if our End of Life and Palliative care services were properly funded and more robust, those facing these heart-breaking decisions might have different options.

And then of course there is the Hippocratic oath taken by our doctors, the commitment to cause no harm - an undeniable tension with assisted dying. I believe our medical profession does its best to manage this in close discussion with family members or next of kin but, in my experience, this happens right at the end, the end of life. When it’s too late to make any other choices.

Like so many decisions in life this is not clear cut. It’s complex. The tension clearly exists. And right now, I have never had to make this decision personally, or in collaboration with someone I love. Yet I can’t help but think, as an advanced society, the option to manage this most important choice should exist.

Kim Leadbeater has vowed to bring back the assisted dying bill in the next parliamentary session. Let’s see what happens.

You

As ever, I’m interested in you. What are your views on Assisted Dying? And what experiences may you have to share. Pour yourself a thoughtful brew and drop me a line, I’d love to hear from you.

It’s a tough one this week. But, as Esther would have said way back when, ‘That’s Life’. Life at any age, and not least when you’ve entered your 1000Weeks. Which reminds me, you’re never going to be any younger than you are today, do you need to have a conversation with someone about your or their end of life wishes? Not easy but I’m sure you won’t regret it.

Until next week my friends,

Ruth x

ps photo, Abney Park Cemetery, Stoke Newington this morning, worth a trip.

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