Update 22nd Aug Tony passed away at home surrounded by his family. I hope he and they find the peace they are looking for.
This brought back very painful memories of Eileen’s last few months, she had lost the ability to speak coherently, to write, her eyesite was failing and she had simply had enough. There was no hope of a cure, she was completely frustrated by the loss of control of her life to the tiniest detail. Dependent on someone else for anything and everything it was only a matter of time. The clock ticked slowly and painfully for those of us witnessing her decline, for Eileen it must have been interminable.
Eileen endured months of such frustration, Tony Nicklinson years and doesn’t appear to have even the slim hope of any immediate end in sight to end this misery for himself and his family.
It would be a heartless individual who could look at such suffering and not feel sympathy for a man who reached the end of his tether and just wishes to end his personal nightmare. That said I don’t believe it correct or fair to expect a single doctor to have the responsibility for such a decision and with much regret for the individual I think the court’s decision and the BMA’s standpoint is correct. A single Dr. deciding who should live and who should die is extremely dangerous, in fact we had one not long ago he was called Dr Harold Shipman.
The real issue is how do we give such people, who knowingly, willing and consciously wish to die, a means to achieve it when they are not capable of it personally. If you have a right to live then surely you must have a right to die when you consciously and coherently decide that that life is no longer tenable.
There are so many contradictions in our society, today (Aug 20th 2012) we read about another family fighting in the courts to maintain the life support of their loved one opposing the conclusion of the clinicians who believe he in a persistent vegetative state with no hope of recovery. Then there is the case of Ian Brady (moors murderer) who tried to commit suicide 12 years ago and has been force fed by the state ever since.
I don’t know what the right answer is for these different cases, a man who is at the end of his tether, a family too distraught to let go of their loved one or a suicidal multiple child killer. I do think there has to be a better way for all of them.
In many ways the Nicklinson case is the most straightforward, someone who has arrived at a particular conclusion after deep and careful thought. This is not someone who is having a “bad day” but has consistently expressed his desire over a long period and in a coherent manner. In my view he should be granted his wish, but how you design and enact such a process would need very careful thought but some sort of clinical tribunal would seem appropriate. I think it would need to be based on very specific medical conditions as it should never become a free for all for those so inclined. (Or an easy option for relatives a bit too keen to inherit and so forth.)
There is also a vey major question in who would perform such a task, having decided to abolish capital punishment it would be a contradictory scenario to have state conducted ending of life on request which brings us back to Ian Brady. Would it be right to allow him his wish – 12 years refusing food would seem a strong statement of intent – or should he be seen to serve his punishment? Would this be another right forfeited by criminals? There is the issue of possibly losing any chance of locating his victims versus the fact that he is being kept alive at vast expense to the state (taxpayers). Another major dilemma, should cost even be a consideration in this debate?
Which brings us to the last poor suffering family who want their loved one kept alive at any cost. Unfortunately the financial cost is being borne by everyone else. Is this fair ? For how long ? 1 year, 5 years or forever? I don’t know, I do know it is in none of our interests to want clinical decisions made on the basis of cost only.
So sorry no answers, only more questions. The only certainty: current arrangements are inadequate in all these cases and there simply has to be a better way. As surely, collectively, we are better than this.
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