I began practising palliative care in the community in the mid 1970's
and retired nearly 25 years later, having been involved with the care of
thousands of dying patients. We were evangelical in our attempts to teach
and spread the 'gospel of palliative care' to professionals, students and
lay people, in the UK and around the world. We thought it was the answer
to enabling people to have a good death....
I began practising palliative care in the community in the mid 1970's
and retired nearly 25 years later, having been involved with the care of
thousands of dying patients. We were evangelical in our attempts to teach
and spread the 'gospel of palliative care' to professionals, students and
lay people, in the UK and around the world. We thought it was the answer
to enabling people to have a good death.
It was a large part of the answer, but not all of it. Alison
Twycross points out that the need is to provide good end of care life so
that people do not want/need an assisted death. I would have agreed with
her in the past, but it is obvious now that with diminishing financial and
professional resources and increased bureaucracy, that the goal of
'perfection' will never be achieved, and in my opinion specialist
palliative care will become increasingly side-lined.
Alison Twycross feels that good end of life care would be more likely
were there, for example, better education about whether or not to
administer antibiotics to someone who is terminally ill. That is actually
an excellent example of how we have failed, after 50 years or so of trying
to educate everyone appropriately, as Dame Cicely Saunders first taught
about that topic in the 1960's. Incidentally, she always used to say "the
patients are our teachers", and my addition to that was "while we learn
they suffer"!
The provision of palliative care (and pain control is probably easier
to deal with than some other symptoms a patient may have) will never be
perfect however much we would like it to be.
We should have the option of an assisted death. For many, just
having that option would be sufficient to cope with their death. But a
small percentage of people would want to be able to end to their life when
it became intolerable. Suicide is not illegal any more. We should
therefore, with all the safeguards proposed in the Faulkner bill, enable
those people to bring an end to their distress and suffering.
Perhaps if we could really feel another's suffering, rather than just
empathise, we might have changed the law years ago.
Dear Editor,
I began practising palliative care in the community in the mid 1970's and retired nearly 25 years later, having been involved with the care of thousands of dying patients. We were evangelical in our attempts to teach and spread the 'gospel of palliative care' to professionals, students and lay people, in the UK and around the world. We thought it was the answer to enabling people to have a good death....
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