Dr Phil Hammond, GP and broadcaster

People sometimes ask me “Could I have a little blue pill, Doctor?” They’re not asking for sildenafil, you understand, but something that makes you permanently stiff.

It seems that there is a myth that a single magic tablet can give you a swift and dignified death if things become intolerable. In the absence of a Go Quickly Pill, the voluntary euthanasia movement has come up with some rather more basic solutions.

One voluntary euthanasia group runs what are known as “self-deliverance workshops” including the latest “how to die safely methods”.

I haven’t been to a workshop, but I have been sent some of their literature, which contains graphic photos and descriptions with the warning “Please do not leave it where it might be found by minors”.

It recommends several methods, each of which employs items that are readily to hand or available from all good hardware stores. Do we fail so dismally to offer people the choice of a dignified death that they have to resort to this?

At a debate in Scotland on voluntary euthanasia, some 80% of the audience were over 70, and 90% were in favour before the debate had even started. By the end, just about everyone wanted a choice in how they died.

We talk about rebuilding the health service around the needs of patients but far too many still suffer a painful, miserable, undignified and pointlessly prolonged death. And I don’t know anyone who’d choose that.

No one wants to be remembered soiling the bed in front of the children when their brain’s gone to putty. And I certainly don’t want to die with a junior doctor jumping up and down on my chest, cracking my ribs (and nicking my chocolates).

Indeed, I’ve already put my name down for one of those ‘Do Not Resuscitate’ tattoos should I make it to extreme old age. But whatever age I am, if I start putting CDs in the toaster I want out of here.

Now, if I’m lucky and I’ve still got something in the black bag, I may just be able to manage it. But most people need more than mere drugs.

Most of us want the end to be quick and painless after a great party – but can you have a good death if it’s slow and prolonged?

When I was a student, one of my most inspirational patients was an elderly woman called Jean who wasn’t frightened at all about her terminal cancer: “It’s not a bad way to die.”

She didn’t want to die quickly. She wanted time to say goodbye, time to put her affairs in order, time to reflect on her life – and time to tell as many people as she could that death was the most natural thing in the world.

Jean’s catchphrase was “the fear of cancer is worse than cancer”. Her refreshingly realistic approach to death was bolstered by an excellent GP, a supportive family and some great palliative care.

Alas, a recent report by the Commons Health Committee found that many thousands of people each year are denied “a good death”. This is often because of a lack of resources. For politicians, there are no votes in death.

Guidelines in Practice, September 2004, Volume 7(9)
© 2004 MGP Ltd
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