The recent debate in the House of Lords concerning Lord Falconer’s private member’s bill to legalise the practice of assisted dying has led to great debate not only in the media but across society as a whole.
The proposed legislation would allow doctors to prescribe a lethal dose to terminally ill patients judged to have less than six months to live.
When I started out as a medical student, I was in favour of assisted dying but my own experience on the frontline doing a lot of late-night calls, often in a ward of cancer patients, changed that view.
I think palliative care and hospice care are invaluable and can change the mind-set of someone with a sense of helplessness that can be felt in the face of death.
I cannot see that we could make legislation on this without leaving people open to abuse. I do not doubt the good motives of most people but I think as a proposal it is too well-meaning, too detached from real life.
When I was training to be a doctor I witnessed cases which raised alarm bells about the motives of some relatives.
There was a case in which the husband of a woman with advanced multiple sclerosis seemed more concerned about protecting their assets, than about the care she received. From the kinds of questions he asked, we worried about his motivations.
The patient had relatively advanced MS - but she was not dying. We were optimistic she would recover and soon be able to go back home, yet his questions were about the assets, about what would happen after her death.
There is a great need for compassion. I myself have been involved in resuscitating patients, it is a very brutal experience to undergo, with a very low chance - two or three per cent - of success. There is a need for frank dialogue with a patient’s family to discuss the issues surrounding their treatment.
In one case a patient was in the advanced stages of pancreatic cancer. In her medical notes, consultants had given a prognosis of two to three months, yet during her stay in hospital, no one had informed her relatives that she was dying.
Her heart stopped and I had to attempt resuscitation, in order to ‘buy some time’ in which the family could attempt to be reconciled to her circumstances.
This patient was saved but she was left with cracked ribs, which made it incredibly painful for her to breathe. Afterwards the doctors who were involved in the case with me discussed their regrets about the way they had handled it.
I remember my consultant’s exact words. He said: “You would not treat a dog like that.”’
Medicine is failing these patients because we are not willing to have a proper conversation about death.