The debate surrounding Lord Falconer’s Assisted Dying Bill has brought to the forefront a number of questions currently facing our society. The most important of these is: what are we doing to care for the dying in the last stages of their life? The existence of such a Bill suggests that we can’t be doing enough.
In a recent talk hosted by OSFL, Tanni Grey-Thompson made the point that legalizing assisted suicide would be a drastic step and should not even be considered without first attempting to improve end-of-life care. Rather than seeking to improve care, the Falconer Bill offers the last resort, death. Can we really say that our best option is “to be compassionate by eliminating suffering through elimination of the sufferer“?
The UK is the first country to have introduced purpose-built hospices, thanks to the work of Dame Cicely Saunders. These hospices underlined the importance of palliative care in modern medicine and offered holistic care to meet the physical, social, psychological and spiritual needs of its patients. As Saunders herself frequently emphasized, however, there is always more to be done.
Baroness Campbell, who has spinal muscular atrophy, said in her speech to the Lords on the Bill: “My long experience of progressive deterioration has taught me that there is no situation that cannot be improved.” She later went on to say: “We must put our energy into providing the best support, be it medical, social, practical or emotional, to disabled people and terminally ill people. We are nowhere near there yet.” Similarly, Baroness Finlay, a professor of palliative medicine, recognised that palliative care “does not have a magic wand to make everything right”, but insisted in her speech to the Lords that assisting someone to die “calls for good care, dedicated support and time, and not the quick fix of offering the medical equivalent of a loaded gun.”
Over the next 25 years, the number of people over the age of 65 will increase significantly and will take up a greater percentage of the NHS’s costs. This very vulnerable group is only going to grow and we must do all we can to protect them. We must make sure that they are cared for as well as possible at the end of their lives. So what is it that we can do to improve end of life and palliative care?
For a start, the problem of the ‘postcode lottery’ – where access to good hospices and care homes is dependent on where one lives – needs to be dealt with. We cannot have a situation whereby a person’s access to adequate end of life care is dependent on socio-economic background and address.
A huge amount of funding and research goes into finding the cures for diseases, but far less money has been put into the research to help take care of the physical and emotional pain. The medical community has new ways to understand the symptoms people experience, such as images of the brain to help study pain and depression. We can use these new techniques to see how different treatments help, and to develop new, improved treatments.
With regard to how we treat patients, there is a concern that we might come to value those at the end of life less than the rest of society. Yet it is crucial that we value their human dignity as equal to that of a physically healthy person. This means a consistent ‘ethics of care’, in which all patients are treated with the dignity and respect they deserve. This should include spiritual as well as physical support, ensuring that each person is cared for in the way they want to be cared for. We should remember Baroness Campbell’s affirmation that there is no situation that cannot be improved.
This is not to claim that it is a straightforward task, but rather that it is one worth committing ourselves to. The end of life is inevitably a difficult time, and if not addressed, suffering can be great. Nonetheless, this does not mean we should give up trying and settle for the last resort of assisted suicide. We can instead focus on ensuring that our society provides the best possible support for the dying, be it medical, social, practical, or emotional. It can safely be said that we have a long way to go.