Sunday, 8 March 2009

If it's not broke, don't try to fix it

I see that The Times of London had a leader on Saturday calling for Parliament to debate Assisted Suicide again in the wake of the couple from Bath, Mr and Mrs Duff, both of whom had cancer and who had killed themselves in the Zurich clinic last week. The argument of the leading article is that because 'around 100 Britons' have availed themselves of the clinic's services the silence of Parliament on the issue is 'deafening'. It's a very odd argument in that neither house of Parliament has been silent on the subject, as anyone who follows PMQs or Yesterday in Parliament knows. What the Thunderer (as Trollope called the Times) seems to be after is legislation to permit assisted suicide in this country, though of course it purports merely to be calling for a full public debate.

What I find most disturbing about the Times' (which of course is not alone among the media) covert campaign is that it feeds on fear and it fuels fear. People are naturally afraid of dying, and they're afraid of not being in control. Personally I know both fears. MND has the popular reputation of having one of the most unpleasant conclusions of any disease. The first time I expressed this fear in print I received a letter from someone who visited many MND patients. She said, as I remember it, 'It really doesn't have to be like that, Michael. Palliative care practitioners are very good at managing the final stages.' The MND Association gives similar reassurances. I've certainly seen the last stages of cancer well and peacefully managed. That's not to minimize the pain and distress. However, they are universal experiences, which don't need compounding with fear. The fact is that millions of Britons have their last months and days and moments made dignified and bearable by Macmillan nurses, hospice staff and carers. Their concern is to minimize suffering which is a world apart from the aim of expediting death - even though its effect may be indistinguishable.

The 19th century poet, Arthur Clough, wrote a satirical poem called 'The Latest Decalogue'. Some reckon it's a blaphemous mocking of the Ten Commandments, but I agree with the chap who described it as a 'salutary warning against hypocrisy and self-righteousness'. Sometimes people speak more truly than they think. So Clough wrote:
'Thou shalt not kill; but needst not strive
Officiously to keep alive.' I haven't asked any doctors, but it seems quite a neat working formula in medicine, bearing in mind that the stress falls on the word 'officiously'. And I believe it's the approach of the vast majority of the medical profession, and the one that's eased millions into the next world. If it ain't broke, don't try to fix it. And woe betide those who try to pile up fear for a society that's already running scared of so much.

Incidentally isn't it ironic that a side effect of the credit crunch is that some hospices (who rely on voluntary donations) are having to cut back on the services they offer. I heard of one recently which was stopping its home care service; so that they were no longer able to offer people the option of dying at home. I raised in 'My Donkeybody' the possibility of assisted suicide being legalised for economic reasons. The cutting back of palliative care could be the first step.


  1. This comment has been removed by a blog administrator.

  2. Michael, I so agree with the "not striving officiously to keep alive" principle. I have worked as a nurse, midwife and health visitor over the past fourty plus years and am convinced that there is profound difference between caring for the dying and striving to keep alive. The latter often has more to do with the medical professions fear of death and discomfort in its presence than the comfort and wellbeing of the dying.

  3. Thanks, anon. You raise the big issue of our whole society's attitude to death and dying. I suppose without faith there's neither a reason for holding life sacred NOR for not fearing death.