Dying With Dignity

[robbie bobby]

Of course death affects all of us, either indirectly ( loved ones, friends ) or – finally – directly. Dying with dignity is a laudable aim, which sadly can’t ever be realised for everyone.


Well done Arthur for raising the topic, rightly debated by some members ; understandably avoided by others ; and ultimately depending on society’s wishes, law, politics and finance.


Most doctors and other health workers have reservations about assisted suicide. They would prefer to diagnose early, and treat, cure or at least support patients to live as comfortable and long a life as possible.



The GMC has reminded us that encouraging or assisting suicide is a criminal offence. Some believe there’s a case for strictly controlled legalisation of assisted dying for terminally ill mentally competent adults. Already the “ Liverpool care pathway “ is standard practice in many UK hospitals and hospices – under this, doctors allow a dying patient ( or family ) to choose whether to prolong life-support or let them die ( with life-shortening pain killers ).


The first reported case of a UK person with early dementia choosing to end their life at “ Dignitas “ in Switzerland is in the context of an estimated 800,000 with various forms of dementia in the UK. The only estimate I have seen for the Philippines is 200,000 ( improbably low ). Only around 200 of all UK residents have travelled to Dignitas to die since 2002. The annual total assisted deaths in Swiss residents is around 300 ( 0.5% of all deaths ).


Dying with dignity is not, in my opinion, primarily about the minority who wish assisted suicide – although the debate about that seems likely to continue, with strong opinions on either side.


Most people, wherever they live, hope for a good life, and not to die prematurely ( aged less than 65 ), from whatever cause. In the UK, a majority ( 3/5 ) die in hospital, only 1/5 die at home, and the rest in care homes, hospices or elsewhere ( accidents, suicides etc ). More would prefer to die at home, surrounded / supported by family and friends ; but also with better community support. Many have said they want the familiarity and reassurance once taken for granted from their own doctor, not from an “ out-of-hours “ locum, or A and E doctor.


How different it is in the Philippines. Non-communicable diseases ( like cardiovascular diseases, cancers, lung ailments, and diabetes ) take their toll, as in the UK - but only 3/5 deaths, compared to 9/10 deaths in the UK . Communicable diseases ( like TB ), maternal and perinatal conditions account for the remainder. Implementation of the Reproductive Health Act would reduce avoidable deaths occurring DAILY, either in childbirth or in infants – LONG before they reach the hoped-for life expectancy of three score years and ten ( 70 ).


In the Philippines 3/5 of the population die without seeing a doctor / other healthcare worker. Most die at home, supported as best they can by family. How THEY must wish for a dignified death, only after receiving adequate health care ! The Philippine economy is healthy. It’s to be hoped more resources ( healthcare workers, drugs, infrastructure, etc ) are made available for care of its citizens.


“ Assisted living “ - improved comprehensive health care available to all, whether for dementia, cancer, heart disease or other illness – is what most health care workers would wish for, in the UK and the Philippines. That depends on how much the population want – and the respective governments can afford - to spend on resources.

Well done Doc.I was just leaving this one alone but you have brought me back with your post.Really thought provoking and Thanks for stimulating me.i do agree Death comes to us all and sometimes Its better to be ignorant when something like this comes up as we have all had some experience on this subject in a personal way.Having said that,it does need to be discussed and where better than a close knit forum like this.I bow to you and Arthur for creating this post

[Arthur Little]

Well done Doc ...

... ...

... I bow to you and Arthur for creating this post

... and we, in turn, thank you, for your appreciation of our efforts, Robbie.

[fred]

The Michigan physician they used to call "Dr Death" because of his record of helping over 100 patients escape terminal disease through euthanasia – before prosecutors finally put him in prison a decade ago – is back. More than that, he and the issue of assisted suicide will this weekend barge into the front rooms of millions of Americans.

[Arthur Little]

... suppose where there's a "will" there's "a way!"

[joebloggs]

... suppose where there's a "will" there's "a way!"

where's there's a 'will' there will be long lost relatives turning up