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Crisis Compassion: Talking about how we die

We are currently hunkered down in our homes in order to avoid dying or killing someone else by passing on coronavirus. But is anyone talking about who will die - and how?

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Photo by Bret Kavanaugh on Unsplash.

For many years, GP practices have been required by the NHS to keep a register of people they think are likely to die within the next 12 months, and to try to help them prepare for their death, for example by completing a Do Not Attempt Resuscitation (DNAR) form.

Increasing numbers of people are writing a Living Will to specify their wishes, usually a preference to die at home, not in pain and not surrounded by strangers. This absolves the medical profession of their duty to 'do no harm'. However, many doctors recognise that this is not a conversation which can realistically be managed in a ten-minute consultation and it often doesn't happen.

In Canada, several US states and some European countries, it's possible to plan and carry out your own painless death through medically-assisted dying. Some people in this country have arranged their own death, on their own terms, through the Dignitas service in Switzerland.

The campaign group Dignity in Dying is campaigning for assisted dying in the UK, which has increasing support across the medical profession and society as whole. Its sister organisation, Compassion in Dying, provides advice and support for anyone considering using DNAR forms. Many GPs recommend their guidance.

As a country we are also increasing our use of the Lasting Power of Attorney (LPA), which involves a person delegating key decisions related to health and finances to a trusted family member or partner, because as we age, we often lose the mental faculty to give fully informed consent to what is done - or not done - to us.

Why is the saturated coronavirus coverage not mentioning this critical subject?

Many of the people predicted to die from coronavirus are those likely to pass away within the next 12 months. If that is not us, it may well include someone close to us: a parent, a grandparent, a friend. How many of us have been reached out to, probably indirectly, to help with planning a death? How can we prepare ourselves for being supportive, rather than alarmed or distressed?

My cousin died aged 58 after two years of cancer treatment, remission and palliative care. I remember her asking me if it was okay to stop fighting. She was exhausted. She was desperate to do her best for her adult children, but she had reached the end of her capacity and wanted a peaceful, painless goodbye.

Both my cousin and my mother died in hospices, but because of medical concerns about failing to do everything possible to prolong life, they died too slowly and without dignity. What are we so afraid of and why do we make people suffer?

There is emerging evidence that increasing numbers of people are choosing to die at home rather than go to hospital and risk a solitary death amongst strangers in masks, even though they know that being in hospital may extend their lives.

How can we help those who have, in absolutely sound mind, decided they want to die in comfort and in close company? How can we avoid the decision being taken out of their hands at the moment of crisis, when they can no longer control what is happening to them? How do we have a conversation with someone we love which helps them to decide how to die, without them feeling they are a burden to us, and us feeling that our attachment to them makes it all too hard?

Compassion in Dying can be contacted for help and support on 0800 999 2434 or [email protected].

Making decisions about your treatment: COVID-19

Dignity in Dying

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