Ooooh, the pain!

I’ve just had my quarterly Zoladex implant. Having taken quite a few of them “cold turkey” in recent years, I must be getting soft. I made up a patch with some Emla cream and stuck this onto my skin in the approved area and the implant went in with less pain than usual. But I could have used more cream.

While waiting for the nurse practitioner to punch the Zoladex in I studied the notices on the walls, especially the one that states a patients’ rights. It’s a lot different from what I might have seen twenty years ago. Over and over again it says I have a right to make decisions about my treatment. It’s pretty impressive and inspires quite a bit of confidence. My views are, apparently, quite important.

All very fine, until the time when I get into that last stage of care where nothing anyone can do for me will make any kind of difference or relieve the waves of pain that may be washing over me. Then they will have to say, “Oh, sorry, your Patients’ Rights have just run out. We can’t do anything to ease the intolerable pain we know you are suffering. You just have to put up with it. We just hope it won’t be too long...”

It ought to be a terminal patient’s right to ask for  - and be assessed for - physician-assisted death. It ought to be the first principle of hospice therapy that an easy and comfortable death, one way or another, is the right of every terminal patient. We must change the law. 

My Submission

Some months ago, I wrote here -

Members of Parliament, hear me: I have terminal prostate cancer.... I believe it is a human right for me choose to die a dignified, planned death when I feel the time is right. Make it legal!

Well, after a lot of work, my submission on Physician Assisted Dying has gone off to the Parliamentary Health Committee. I am supporting legislation to permit choice of some form of assisted dying in New Zealand. Having been active in pastoral care of people in the last stages of their life many times I have had some experience of some very harrowing and undignified deaths, I have a little first-hand knowledge of the issue.

However, the intensity of my feeling arises as much out of the possibility of having such a bad death myself. Of course, everyone with prostate cancer is told “But you probably won’t die of it”. See here for my half-humorous commentary on that theory. But, at my age, and with my PSA velocity, I need to be aware of the prospect of a somewhat unpleasant death.

So I have produced a substantial submission. There’s not much new ground in my argument. I think that most of it has already been said by other people. But I have tried to set out what I have come to feel about the negative personal and theological implications of deaths that have been punishing and cruel. In my own case, I feel I should not have to suffer when palliative care is not able to take the pain from me. What some sensitive medical people are now calling “ultimate palliation” should be available to me to bring about the end of an intolerable existence, should that occur. Such action must be at my request, and in the context of proper precautions and reviews. But I need to have the choice. 

No palliation that does not reach out to this extent satisfies my understanding of the compassion of Jesus. To stop short of properly assisted death when untreatable pain has reduced living to mere existence is to disrespect one of the central tenets of modern medicine. It's found on the wall of every hospital these days: the wishes and needs of the patient must be taken into account in all treatment. 

I submit that it's time we followed that principle to its logical conclusion. 

But the Parliamentary Committee on Health is receiving a large number of submissions from those who disagree with my position. Some offer the most bizarre arguments, based on assumptions that are not part of any responsibly drawn up proposal. The Committee needs to hear from more of the silent majority who appear to support change in the law. Just a simple letter with your name and address will do. If you can include a personal experience of a bad death, that would add weight to your contribution. But just getting something on paper will strengthen this vital cause.