Monday 25 January 2010

hope for the dying

My brother-in-law is a G.P. who specialises in palliative care and he has conducted extensive research on the subject both in this country and overseas. One of the frustrations with this area of medicine is the way in which the expertise and resources available to the terminally ill get little publicity, while the news is dominated by stories of demands for assisted suicide from lobby groups including the British Humanist Association and the work of organisations like Dignitas.

Over the weekend the Financial Times carried an excellent article A tradition of excellence in palliative care by journalist Adrian Tempany who spent last September and October with members of the Camden and University College London Hospital palliative care team and some of the 1500 new patients they care for each year. The report includes moving accounts of some of those being supported as they come to terms with a terminal condition and offers a helpful insight into the work of the palliative care team. Tempany writes about one couple:

To read the papers over the past 12 months, you’d be forgiven for thinking that Shelagh and Michael faced an agonising dilemma: fly to Switzerland, and bring Shelagh’s suffering to an abrupt end at Dignitas, or leave her helpless, to a painful, bewildering death. Assisted suicide was the biggest health story in Britain last year, after swine flu. But of the estimated 300,000 people who died of a terminal illness in Britain in 2009, only 27 bought a one-way ticket to Zurich. Most were nursed through the end of their lives by loved ones or by care teams. And many of those nursed by palliative care teams would not only die with minimal suffering, they would experience one of the most emotionally intense and even rewarding periods of their lives.

The article draws attention to the easily overlooked record of Britain in the area of palliative care:

Britain leads the world in palliative care, a discipline that owes much to the pioneering work of Dame Cicely Saunders, who founded the modern hospice movement in the 1960s, and the NHS commitment to care from cradle to grave. The hundreds of specialist nurses at work in the home, in care homes, hospices, hospitals and prisons are joined by 100,000 volunteers in hospices alone. They don’t reach everyone (nor are they expected to), but no one is excluded from the caseload. And while many are educated to degree or postgraduate level, what their patients value above all are compassion and understanding.

There are no happy endings to the stories reported by Tempany in the sense that most of the patients featured are now dead and being mourned by their loved ones and friends. What the report does highlight, however, is that these people were able to face their terminal illness with dignity and a sense that their life had real significance and value.

One piece of information mentioned in the report that has received little publicity in the British media is that the Swiss government is considering a significant tightening on the rules regarding assisted suicide and a possible ban on assisted suicide ‘tourism’. At the same time the government has expressed its desire to promote palliative care and suicide prevention.

The debate about assisted suicide has been dominated by the opinions of a few articulate commentators in the media pushing a particular agenda. The FT report is a timely reminder of the dedicated work going on day by day, bringing compassion, care and relief to those who are terminally ill.

Related post: assisted suicide – a relative issue?

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