Dear Editor
I have worked as the only full-time doctor in a hospice, and for a much longer period as a GP. For the last few years I have worked largely for a service visiting unwell housebound patients registered with any of the practices in a particular city. I have long felt that palliative care doctors are some of the least qualified to comment on assisted dying. Their patient population is relatively small and suffers largely from well-defined terminal illness of reasonably predictable trajectory. When a desire for assisted dying arises it is often from specific symptoms of that illness and which are often reversible.
There is a far larger population of patients they do not see, who are largely suffering the overlapping effects of multimorbidity, age, frailty and/or loneliness. They may be confined to their bed or chair unless carers and/or specialist equipment is available, padded for bladder/bowels, and sitting alone in soiled pads except during carer visits three or fours times daily – the most the state is likely to provide. Even where circumstances are much better, for example, with a live-in carer or cohabiting younger relatives, many will admit to wishing they had not lived as long as they have. Specific and/or reversible symptoms may be entirely lacking, but they may exist like this for years, some literally praying every night that it will be their last. It is difficult to conceive of a healthcare service other than assisted dying which can remedy this. It might even be said to be modern healthcare, through treatment of reversible conditions such as infections and some cancers, and reducing risk of acute events such as MI, stroke and VTE, which contributes to so many people reaching a stage of life they would rather not.
Re: Assisted dying: MPs hear evidence from doctors as Westminster mulls changes – palliative care blinkers