On Monday here in the UK, I watched a documentary about assisted dying. It was presented by Discworld author and person with Alzheimer’s disease, Terry Pratchett, and in my view it was an intelligent and uncomfortable film about a topic that we need to address. (Assisted dying is currently illegal in the UK, but legal in some parts of Europe and the US.) Although Pratchett is largely pro-assisted-suicide, I don’t think this was propaganda: the profound distress of many people on the sidelines of the process was heart-wrenching and spoke volumes for the anti-assisted-suicide lobby.
I’m not sure how I feel about assisted dying. On the one hand, I do respect the wishes of the people who choose to end their lives that way, and having seen close-up exactly what late stage cancers are capable of, I can see exactly how a cupful of barbiturates can start to look as appealing as a Mojito on a sunny Italian terrace. On the other hand, I am frightened by the implication of being allowed to make decisions about when I might die. Anyone who has suffered a serious depression and come out of the other side of it will know exactly what I mean.
Because of my own mixed feelings, I’ve been paying close attention to the follow-up in the media, which has largely been intelligently and respectfully argued by both sides. But one thing stuck in my craw. On Radio 4 on Tuesday morning, Bishop Michael Nazir-Ali told terminally ill cancer patient Christine Jackson that in her case “it is perfectly possible to manage pain, to give people a quality of life… last days are not lost days…[it's possible for you to] have a good death.”
This perception, I think, is the difficulty, and I saw it time and time again during my dance with cancer. The way that pain is experienced by the ill person and the doctor are two very different things. Those of you who have been around here for a while may remember that, on a day when I was in so much pain I could barely move, it took hours and hours to persuade the hospital that paracetamol wasn’t actually cutting it. Eventually – 12 hours on – we got some codeine. And the next time we saw my oncologist, she told us that she wouldn’t have prescribed codeine because it wasn’t necessary for the kind of chemotherapy I was on.
I hope that the bishop could see why I stood in the kitchen spluttering with horror at the thought of ever having a pain-free death under that oncologist. And it’s not just the thought of the pain: it’s the thought of being in the power of someone else, someone who doesn’t listen or understand what you are suffering, at the most vulnerable time in your life.
Advances in medicine and surgery are wonderful, of course, but what we also need are advances in empathy and emotional intelligence from our medical practitioners. Until we have achieved that – until anyone can go to see their GP, surgeon, or consultant, and be assured of being properly listened to, thoroughly understood, and having their views respected – we cannot even begin to think about managing assisted dying.
Not until we’ve properly mastered assisted living.