A Human Choice? I think so...

Medic999 has written about his thoughts on euthanasia, a controversial subject with so many implications. These opinions are entirely my own and I understand that people have very different views on this subject. It is largely a grey area, but I have my own thoughts as well that I would love to share.

I turned up on the A&E ward to work my late shift where I met a patient who I'll call Frank. Frank was in his late 70s or early 80s, he didn't talk much, but I was told he didn't have dementia. It was his silence that caught my attention, old people tend to be quite chatty. A carer was sitting by his bed, reading a magazine. I did wonder why she was there, she didn't seem very connected with him and we were quite capable of looking after him, so why was she visiting? I didn't think much more about it until it came to checking his blood pressure. The carer looked up and said she thought his pad needed changing, and she was right. I lifted up his bed sheet, and he was soaked in urine. So much that it was soaking his shirt right up to his chest. It was obvious that no-one had checked his pad at all that day, and possibly all night. He was bed bound, so he couldn't get up and go to the toilet. I was so angry, it wasn't even busy. I don't know if the nurses had assumed that the carer was doing it, but some nurses turn a blind eye and don't think it is their job to change a patient. I went to get some clean clothes and bed sheets for him, and while I was up I thought I should look in the notes and see what was wrong with him. There's nothing worse than moving an elderly patient who you didn't realise had a broken hip. I looked at the board to find his name, when I noticed underneath it read 'DSH'. Surely not? I read the notes, '?overdose, intent to end life'. I was lost for words. I went back to him and drew the curtains. 'We're just going to freshen you up Frank'. He didn't say anything, he just looked blankly ahead. We took off his wet clothes and the carer helped move him while I used warm soapy water to bathe him. You could see the humiliation in his face. He hated every minute of it, and his eyes started to well up. We got him into some clean clothes and changed his bed, and I offered him a cup of tea. He shook his head. Frank is competant. He doesn't have dementia, he knows what is happening around him. He is a normal person, trapped inside a body that he can't control. He can't move or do anything by himself. He has no family, he suffers alone. I can understand why he wants to die.

I have mixed feelings when it comes to the subject of euthanasia, but I do know that I would certainly rather die than become unable to move or communicate and suffer the intense pain that I have witnessed in others. In some cases with the heavily demented, they can only scream and wail, and if it wasn't for their agony they would be silent. They lash out at you when you are trying to help them, because they simply don't understand what is happening and they are frightened. It is often difficult to believe that they were once human beings with real lives and careers.

People diagnosed with degenerative diseases will sometimes become incapable of doing anything for themselves, just staring into blank space in front of them, trapped. Knowing this, some people would rather end their lives while they still have the capacity to make that decision, rather than prolonging their inevitable death, as they slowly get further and further away from the person they used to be, and turn into… well… I can’t think of another word for it… a vegetable. When they have deteriorated so much that they are only existing, nothing more. Such people have got in touch with a suicide clinic in Switzerland, but only a fraction have actually gone through with it. I think this is because people want to know that they have the option. Once they know that they have a little control over when they might die, they can put it to the back of their mind and just know that it is there if they should need it.

Dr. Anne Turner ended her life in January 2006. She was diagnosed with progressive supranuclear palsy (PSP), an incurable degenerative brain disorder. She had looked after her husband who had a similar condition, Dr. Jack Turner, a GP, and decided that she did not want to die in the same way. There was a drama made by the BBC called ‘A Short Stay in Switzerland’ about her story, I would definitely recommend it to anyone. She ended her life in Zurich, Switzerland, accompanied by her three children. I find the story compelling and although I still have mixed feelings about euthanasia I feel that this was the best option for Dr. Anne Turner. This is just my opinion.

The BBC agreed not to publicise any of the interviews until after her death;

http://news.bbc.co.uk/1/hi/health/4625538.stm

Frank will undoubtedly never have this option, especially as he does not have a degenerative disease (although I think depression is debilitating in itself). It seems he is destined to live and die bed ridden and unable to do anything for himself, depressed and alone. I would love to think that maybe one day his depression will end and he will learn to appreciate his life just for what it is, but realistically I don’t think this will ever happen. He may try to commit suicide again, but it is unlikely that he will be successful. I know what I’d want if it were me.

Maybe euthanasia could be incorporated into palliative care one day? It could be considered on an individual basis for anyone who wants the option to end their life before they lose the ability to speak/communicate/understand/move/everything else that these conditions deplete over time. There are of course strong arguments against assisted suicide, but I do feel that in a small number of cases it could be the best thing for the patient.