The coronavirus pandemic has highlighted the reasons why we should all consider recording our end of life wishes. This is now known as an Advance Decision, sometimes referred to as a Living Will.
Dying is the one thing no-one can avoid but it is generally considered morbid to mention or discuss it, which can lead to distressing consequences.
Why we need an Advance Decision
If families are able to have a rational discussion, when they are well, clarifying how they feel about illness and dying, it is so much easier for their next of kin and the medical team, if there comes a time when decisions have to be made about treatment. Before the advances in medical care now available, many patients died peacefully at home, with appropriate medication administered by their GP. Others suffered a painful prolonged illness in hospital but either way their choices were limited.
Now that doctors are able to prolong life in the case of many terminal or chronic conditions this can offer a reasonable quality of life for several years. However, it may then lead to a situation where the side effects of the treatment and/or the progression of the illness become intolerable. Relatives may put pressure on the patient to continue treatment which can add to their distress, whereas if this has been previously discussed and recorded they can all support each other at this difficult time.
In the case of a sudden unexpected collapse, it becomes even more important for the next of kin to know what their relative would want.
A friend of mine was in intensive care after suffering a severe heart attack and the medical team asked his wife seven times if he would want to be resuscitated. She was unable to give a clear answer as he had always avoided any discussion about illness or dying and her children disagreed about what he would want, making a painful time even more difficult. Some people appoint a Health Attorney to make decisions, if they should be unable to speak for themselves but this can be a difficult role, especially if family members disagree.
During the peak of the Covid 19 pandemic, 35 doctors wrote a letter to the Sunday Times and I quote:-
‘Medical decisions will be much easier for us, the patient and their families if we have a clear sense of their preferences for treatment, well before they find themselves in a busy intensive care unit’ The letter included contact details for Compassion in Dying – the organisation which offers comprehensive advice and information on Advance Decisions.
Although this was more important during the height of the pandemic, the same principle applies in any case of serious illness.
Once an Advance Decision is recorded it can be amended at any time. There is scope on the form for a wide range of requests, with helpful guidance notes and an advisor on the number below if required.
Compassion in Dying – for information pack free of charge:-
Telephone 0800 999 2434 or email info@compassionindying.org.uk
Website – compassionindying.org.uk photo?
Assisted Dying
Several polls over the years have shown that approximately 80% of those polled supported a change in the law to allow assisted dying, under certain circumstances, with adequate safeguards. MPs GPs and other professional bodies are gradually dropping their previous opposition to this change.
See dignityindying.org.uk if you would like further information. Dignity in Dying have just published a book which you may be interested in: LAST RIGHTS – The Case For Assisted Dying – by Sarah Wootton and Lloyd Riley
by Christine Pond
Christine Pond is a former nurse, counsellor and member of Dignity in Dying