The fear of dying badly

Most journalists covering Swiss news will eventually be confronted with the issue of assisted suicide, legal in this country as long as the person helping does not benefit from the other’s death. This week assisted suicide organisations claimed that a state-funded research programme exploring the theme of death and dying was biased against their activities (a claim swiftly denied). I’ve written about this controversial subject before and it always makes me think, and wonder. Will this ever come close to home?

Last year I attended the World Right-to-Die conference in Zurich – as well as popping in to the protest counter-conference across the street, convened by a Canada-based pro-life & anti-euthanasia group. It was a long day. Around that time I also interviewed a woman who had helped her elderly mother pursue her wish to die.
You can read about that case here http://bit.ly/Mc8mAJ .

One speaker at the right-to-die conference made a strong impression on me and I grabbed a few minutes with him later in the hotel lobby. A palliative care doctor who looks after 300 terminally ill patients a year, he has more experience than most of the wishes of the dying. Up to 20 of his patients per year express the wish to avail of assisted suicide but only one or two of them actually see it through.

What makes a person who knows they will die soon want to intervene and end their own life? According to the doctor, there are two types of terminally ill people seeking assisted suicide. The first type is a strong willed, usually successful person who is used to controlling their own destiny. They reject the decline and suffering facing them and decide to end things on their own terms.

But for most people this doctor deals with, the main motivating factor is fear – fear of suffering and fear of being a burden to others. Terminally ill patients are not afraid of death, but of dying badly. They are terrified of dying in awful pain, gasping for breath – a fate that modern medicine can spare us. When this fear is taken away, by informing the patient about pain management and sedation on the one hand and reassuring them that professionals will be in place to care for them when the time comes, the suicide wish usually goes away too.

Assisted suicide now accounts for one in four Swiss suicides. Most of the people who go down this road are suffering from long-term rather than terminal illnesses. Suicide is usually carried out by taking a lethal dose of barbiturates procured with the help of an assisted suicide organisation.

As our population ages and excellent health care means people can live for much longer (but not necessarily well) with multiple illnesses, investing in the provision of good palliative care is one way to make sure assisted suicide remains a minority choice. But for those who decide they can’t take any more, there is comfort in knowing that there is a safe, humane and legal way out.

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