Sunday, July 26, 2009

End-of-life care - the English dilemma

Earlier today I posted some remarks about the proposed US State medical health system with regard to the elderly. Today, an article in the Daily Mail points out that in England, precisely the same implications have already come to pass, with pressure to allow assisted suicide mounting and care options declining. A few extracts:

... the law is there to protect the vulnerable. And the awful possibility now looming is that we may make those who desperately need such protection more likely instead to be exploited or manipulated.

They may come under pressure to end their lives by relatives who are either unscrupulous or simply unable themselves to cope with the pain and distress of seeing their loved ones suffer.

In such a situation, very sick people may well want to end their lives; but crucially, with better care and support they may discover a purpose in continuing to live.

That is what happened to motor neurone disease sufferer Sarah Ezekiel, the central figure in a charity appeal that is controversially deemed too harrowing to be transmitted on TV.

Leaving aside the rights and wrongs of showing the advertisement, the point is that Ms Ezekiel changed her mind about wanting to die.

Even though her disease is so far advanced that she has no capacity for movement and can now communicate only through a computer, she has movingly observed that whereas once she wanted to be 'put down' like an animal, better care helped her out of this depression and to realise that she could have a productive life that would give her enjoyment and satisfaction.

This is not to minimise the impact of this awful disease. But people's feelings about their predicament do change.

. . .

It is the assumption that such people cannot be helped that is so shocking about the attitude taken by the Royal College of Nursing, where 49 per cent of those who voted were in favour of assisted suicide compared with 40 per cent who were opposed.

This suggests that something has gone very badly awry with the ethical foundations of nursing, with the majority of nurses apparently now putting individual 'rights' above the overriding duty to care for the vulnerable and help them cope with their lives.

That's why Lord Falconer was also terribly wrong. While compassion dictates that any prosecutions should be rare, the law prohibiting assisted suicide is an important signal that it is wrong. It is a line in the sand that prevents us crossing into a culture of death-dealing.

We should also stop talking about 'helping someone to die'. People don't go to Dignitas to die but to be killed. And killing can never be a therapeutic act.

This distinction has been muddled ever since the Tony Bland case in 1993 legitimised the withdrawal of feeding and hydration tubes from patients in a persistent vegetative state.

The slippery language has itself helped erode protection for the very ill. Baroness Campbell, a Commissioner of the Equality And Human Rights Commission, suffers from spinal muscular atrophy, a degenerative disease that means she is immobile without help.

When she fell victim to a serious chest infection and lost consciousness, her doctors decided it would be kinder not to resuscitate her and 'allow her to die'. It was only because her husband told them very firmly that she didn't want to die that her life was saved.

Speaking powerfully against Lord Falconer's amendment, Lady Campbell warned: 'Those of us who know what it's like to live with a terminal condition are fearful the tide has already turned against us.'

Assisted dying, she said, was 'to abandon hope and ignore the majority of disabled and terminally ill people'.

It would also send us down a slippery slope, which could lead all the way from assisted suicide to euthanasia by lethal injection, from helping the terminally ill to end their lives to killing people suffering from Alzheimer's or depression.

The law is there for a purpose. It marks a boundary against intentional killing that we cannot cross without the most fateful consequences. To do so would brutalise our entire approach to the vulnerable and the physically imperfect, and to life itself.

Arguably we have already crossed that boundary - and, as public pressure mounts, are sleepwalking relentlessly into barbarism.

There's more at the link. It's worth reading, and thinking of the same thing happening over here. Think it won't? Think it can't? Guess again . . .



Anonymous said...

The Germans running the camps were just a few years early...

Anonymous said...

Dear Mr Bayou Man
I have come to Sarahs point of view. I to have MND and consider myself very lucky to have very good palliative care from my local hostice.Here in the UK only about 15% of terminley ill people have access to good palliative care, I have no figures for the US. But as Hostpice care here is paid for mostly from charitable donation I guess the US is no better?.My point is most writers in news paper,on the web etc etc.Only write adout death or dieing when it comes to assisted suicide not a bout your local hostpice.Or the bad death, so many people experience or fear at there local hospital.It is good to know so many people out there think all us terminaly folk are going to get our wifes or husbands to push us of the nearest cliff in our wheelchair, just as soon as we you realy care about us or it, or is it that your god says it is a bad thing?. this story shoud be about good palliative care and more of it for every one, not just the few lucky people like Sarah and myself. and the suicide one will all but diappear.
Best wishes Jeff

Anonymous said...

Think it won't happen here? Guess what, buddy...due to the way the slimebag politicians have ruined MediCare AND Social Security, it HAS to happen here...the only question is when...and will the American people do something about the thieves running the system...

Old Squid

Dirk said...

"Think it can't?"

I know it *will*, if this steaming pile they're trying to shovel down our throats as "reform" gets through. There *will* be strong pressure to euthanize the old, the incurable, so that the young and curable can have more access to more resources - which they still won't get anyway!