Three or so years ago our local
hospice ran an appeal based on the claim that some of their patients were dying
in pain because there was not enough money to buy effective medication. The
appeal letter could not be found when I asked for a copy a few months later.
And, of course, it was not entirely factual. A year or so later the then
Prime Minister asserted that “We don’t need Voluntary Euthanasia; we have hospice”.
That, too, was a bit naive. We know now—as I personally found out after surgery
a few years ago— that not all pain can be controlled. Indeed the World Health
Organisation suggests that up to 25% of pain may be untreatable. So the
palliative care movement cannot be expected to deal with all pain. And the
dilemma for the hospice movement is what can they do with patients who unhappily
fall into that category?
My answer would be that hospice
should think about embracing the medical aid in dying movement for such patients as wish to avail
themselves of it. I know all the traditional Hospice arguments against such
a course. It would involve a sea change of thinking. But studying the values
and aims of the hospice movement I can now point to a lot of hospice principles
that could be honoured by taking palliative care to its logical conclusion in
every case, instead of only in five out of six patients.
Respect, dignity and
compassion are values that apply as well to a good programme of medical aid in
dying as they do to palliative care. And, perhaps, at the end, for some people
for whom pain is uncontrolled and who choose for another option, they apply
more to the former than the latter.
Where could we find a more
appropriate organisation to offer the qualities of nursing and pastoral care, support and judgment
that will be required when Parliament has passed an appropriate law?
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