Earlier this afternoon, I listened to an item on BBC Radio 4's PM programme. Featuring Baroness Meacher and Robert Winston, it discussed reasons for and against proposed legislation to allow assisted dying/euthanasia. If you are reading this within 29 days of my posting, you will be able to listen to the item on BBC Sounds, here. The item occurs immediately after the news summary at the beginning of the programme.
In two distinct ways, it was the references to suffering and burdensomeness in the discussion that have prompted the following thoughts.
What does it mean if I suggest that "I do not want to be a burden on others"?
For a person who experiences an illness that is, to a small or to a greater extent, life limiting, there is merit in keeping as much independence and self-sufficiency in daily living as long as that is possible. But, as with those who have good health, that independence and self-sufficiency is nevertheless lived in a relation to others and not in an individualised bubble - it encounters bus drivers, shop staff, etc, the people of daily living. Our lives are shared with others, even when we are in good health.
There is nevertheless a graciousness in accepting assistance when that becomes necessary, be that social care or medical care. This graciousness has a reciprocal dimension - it does not just exist from the point of view of the person experiencing illness but also finds a reflecting mirror in the people who provide care. And it does not extend just to those who might provide care to a particular patient but extends to wider society too.
The recognition of this reciprocal graciousness is sadly absent from our society's conversation about end of life care and so, for some, the conversation is framed in terms of being a burden to others. That framing is often exclusively voiced from the point of view of the patient who is ill, which is to neglect the place of those who are potential carers. Surely our society needs to be much better in encouraging this reciprocal graciousness in our care for those experiencing serious illness.
Experiencing illness as you approach the end of life.
Perhaps we could all do well to think to some extent about what it means to experience serious illness and come to the end of our lives. What it does do is create a very special - and that does not mean that it is easy - time for a patient and their relatives/friends to have together. Clearly, different people will experience this differently, depending upon their individual situations; some will find it more difficult than others. But, at least for many, there is an opportunity for a specially shared time together with the patient who is coming to the end of their life. [This isn't theory on my part, but something I have been privileged to see a number of times.]
What would happen to this time if, because assisted dying/euthanasia were legally permitted, that possibility were admitted to the conversation? Or if, as has happened with legalized abortion, the offering of the opportunity for assisted dying/euthanasia comes to be seen as a normal practice of health care on the part of medical professionals?
It really is not good enough to say that people would have a freedom to choose assisted dying/euthanasia or to not choose it; so why not permit it for those who would choose it. With legalised assisted dying/euthanasia, everyone is put in a position where they have to make a choice, even if that choice is implicit. Everyone's experience of the end of life is affected, and that special time is irretrievably altered for everyone.
Unnecessary suffering.
I believe that it is entirely possible with proper end of life care for a patient not to have to endure unmanageable pain. And, with sufficient commitment to pastoral care, both the patient and relatives/friends can be supported through what might be termed the anguish that accompanies the end of life. If relatives/friends are worried about unnecessary suffering by the patient, that is a result of poor care both for the patient and for the relatives/friends. And it is not unusual for an end of life patient to "let go" when they are ready, and a key element of their care is recognising when that can come about. In the mean time, that privileged time that is the end of someone's life deserves to be respected rather than curtailed.
My two thoughts above, of course, do also feed in to this third thought.
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