Good morning!

When Jane pulled back the curtains this morning, I looked out on a clear blue sky and the houses over the road lit up by sunshine.

When I turned on the radio, there was an item about the report on end of life care provision by the CEO of Marie Curie Cancer Care, Thomas Hughes-Hallett. He was talking about it at 7.10, and then, an hour later, there was a discussion about it with Care Services Minister, Paul Burstow, and the palliative care consultant at St Thomas' and Guy's hospitals, Rob George, introduced by a clip of Tony Bonser, describing his son, Neil's death at his home, "He died peacefully, where he wanted to be" - thanks to a Macmillan nurse's intervention, asking the right question at the right time. It was a brilliant example of how dying can be managed well - so different from the many scare stories that are peddled too often. You can hear it half way down this article. The report seems to be saying that more widely available palliative care at home and in hospices would actually save on hospital budgets and therefore not cost the NHS more. Refreshingly, the minister welcomed the government-commissioned report without reservation; unsurprisingly he wouldn't be acting on it straightaway - examining implications, pilot projects etc. But it was good to hear something really positive about end of life care.

Perhaps the most encouraging point in the Today programme was the very end when John Humphrys said: "Just before we close, we've had a huge response to our item on palliative care, the care of people who are dying... very warm praise from an awful lot of listeners for Tony Bonser who spoke so passionately and with such dignity about the death of his own son, who was terrified of hospitals and did eventually, in fact, die at home. One email in particular caught our attention, Marian Nash whose father died just on Sunday. She arrived at the care home just as they were calling the ambulance, even though he would not have wanted to go to the hospital, and in the end she says, 'she fought her corner' and he died at home. She says he had a beautiful death surrounded by two of his children and with his favourite music playing in the background. 'I dread to think what his end would have been in hospital.' And that's what so many people have been saying. And every single email we've had,... from people who've had experience of hospices , says how wonderful they have been and how great care workers have been at home." Maybe the BBC is learning to give the silent majority its voice - or maybe the silent majority is finding its voice.

That wasn't all. The Chief Rabbi, Jonathan Sacks, a good argument for Judaism, was giving Thought for the Day. He was reflecting on the prevailing mood of pessimism and on actually how blessed we are. We may be preoccupied with cut-backs and pensions, but in a global and historical perspective (he mentioned his parents and grandparents who, I guess, were in mid 20th century Europe) "The lot has fallen to me in a pleasant place," he quoted from the Psalms, "I have a goodly heritage." Amen, that's true.

A couple of hours later I was reminded of the Burmese pro-democracy leader, Aung San Suu Kyi, who gave the first of this year's Reith lectures on Tuesday morning. What a brave woman! 21 years under house arrest, refusing to leave Burma for fear of not being let back in - even at the cost of seeing her two sons and not being able to see her dying husband. We take so much for granted, and we gripe about such insignificant things. 

The sublime and the ridiculous

On Saturday night I listened to the third of the Reith Lectures, given by the professor of government at Harvard, Michael Sandel. (Incidentally he's the model of Mr Burns of The Simpsons.) The over-all title is A New Citizenship, and he's looking at whether morality has a place in modern politics, now that religion is unfashionable. Saturday's was about genetic enhancement. He talked about 'the one-sided triumph of wilfulness over giftedness', if I remember right. And I was struck how apposite that was to the suicide debate. It's part of a culture which asserts the supremacy of choice over the fact that life is a gift. Clearly from a Christian perspective there are theological flaws in that view, but he was proposing general moral reasons why it's flawed. It's a symptom of the tendency to resist 'openness to the unbidden'. It will transform three key features of our moral landscape, humility, responsibility and solidarity. Far from choice bringing greater freedom, 'Changing our nature to fit the world is the ultimate in disempowerment'. He advocates the reverse: changing the world. Of course he was talking about liberal eugenics, but I was struck by the transfers to the end of life debate. (Lecture 3, about 20 minutes in.) And his analysis seemed to me to contain profound truths, which are often eclipsed by the more utilitarian arguments. Issues so fundamental, it seems to me, have to be discussed on this sort of level, even though it's not easy to package them for popular consumption - which is why TV sound-bite debate is so inadequate.

This morning Jane rang the wheelchair service about my manual chair. Its footplates keep falling down, which is a real nuisance when I'm trying to get into it, and its handgrips keep slipping off, which means Jane is in danger of losing me going downhill. There used to be a nice local firm, Keeps, which looked after the wheelchairs in Oxfordshire; but last year the Health Trust gave the contract to a London-based firm. Anyway, they were helpful when Jane rang, UNTIL she asked could they give us some idea of the time they might come tomorrow, because it helps plan the day. 'Oh yes, madam, anytime between 8 .30 and 5 pm.' Jane laughed. 'Thank you; most helpful!' It's not often, in our experience, that the NHS fails to live up to the Service part of its name, but this was one occasion.