Content warning: Old age, Alzheimer’s disease, assisted dying. This post touches on delicate subjects that some may prefer not to read about. Please feel free to walk away if it might upset you.
I contacted the funeral home today to have a discussion about a final resting place for my mother’s ashes. Not just hers but my father’s and my brother’s too. It probably seems a bit weird to have left it so long, but after three family deaths in 18 months and finding ourselves tied up with enquiries into our brother’s death, my surviving brother and I haven’t had the emotional bandwidth. However we have new births and weddings on the horizon and it feels right to seek closure to this series of small tragedies before throwing ourselves into more joyous events.
While having these thoughts, I’ve been listening to TV personality and certified national treasure Esther Ranzen talking about her imminent death from cancer and the fact that she might choose assisted dying as a way to manage the end to her life. There’s also been an extended Radio 5 discussion on the same subject this morning, hosted with great care and sensitivity by Nicky Cambell.
I’ve decided to revisit the post I originally wrote in what turned out to be the last few days of my mother’s life. In updating it, would I still feel the same way about how the end of her life played out, or would distance bring a different perspective?
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At four in the morning on the day my father died, the young doctor on duty called me from the ward and told me that his condition had deteriorated. Dad was having trouble breathing and the doctor was going to administer morphine. He warned me that he might not recover. Four or five hours later a nurse called me to tell me he had passed away.
That young doctor would have had to make a judgement about the amount of morphine to allow into the canula in my father’s arm. Had he perhaps had to recognise that, however carefully he calibrated the dose, my father was so ill that there just might not be a perfect answer; enough to alleviate his suffering while allowing him to wake up again? Had his call to me really been to ask my permission to let my father go, rather than to prolong his discomfort?
I’ll never know.
I’ll never know because the system doesn’t allow me to know what was really in the young doctor’s mind. He and I were unable to have a discussion about what was truly in my father’s best interest. I would have been ready for that discussion and would, I think, have been comforted by it. Instead, we were forced to skirt, with our carefully chosen words, around the ill-defined edges of a moral, ethical and legal pothole, around which successive governments had erected “keep out” signs, rather than attempt to deal with the real issues.
And now, two years after her death, I’m asking myself the same questions in relation to my mother. Her move from hospital to a home seemed so be a tacit recognition that medical science could no longer help. She was bed-bound, almost completely immobile, with barely any communication and seemed uncomfortable much of the time. After weeks like this, in a rare moment of lucidity, she communicated to her distraught granddaughter that she didn’t want to live any more. I believe she was trying to tell me the same thing, though less clearly, on one of my visits. Then she stopped eating and started refusing to swallow her pills, obstinately clamping her teeth tight shut, distressing the nurses (who would be considered to have failed if she didn’t take her medicines) and distressing us, who had to watch helplessly as she tried to do for herself what we and her doctors were unable to do for her.
Was there a stage in all this when the compassionate course might have been to accept that medical help was not prolonging her life, but merely delaying her death? Not only delaying her death, but forcing on her a much less comfortable and dignified end than the one she would choose for herself. Had my mother not reached a point where to provide her with a comfortable end, a good end even, might have been a better use of the doctors’ and nurses’ skill than what she was forced to endure?
Once again this issue is being covered in the UK, with podcasts and interviews exploring whether there should be a free vote in parliament to consider changes to the law. I’ve listened to emotional stories: the husband who accompanied his partner to the Dignitas clinic in Switzerland; the man who listened to his partner pleading to be aloud to die while approaching death in distress and discomfort. Opinion polls suggest the public are largely supportive of change, though it will be opposed by religious groups and others. Everyone accepts that any new legislation will have to come with safeguards, checks and balances.
For myself, I recognize the huge moral and ethical complexities raised by the subject of assisted dying. But the contrasting experiences of my father and mother have made me think about the kind of end I would choose for myself.
But I continue to feel strongly that I would want to have that choice and to be able to make it while my mental faculties were intact.