I would feel deeply uncomfortable if patients ‘chose’ to die because care that would make life worth living was unavailable
- Rachel Clarke is a palliative care doctor
Which is worse? Being driven to end your life prematurely to avoid future suffering, or because the suffering you experience is unbearable now? Which form of preventable anguish is the most unacceptable? The kind we could avoid by giving patients the right to an assisted death, or the kind we could avoid with half-decent palliative care? Who suffers more?
The correct answer to these questions – and I write with the authority of two decades of medical training and practice, eight years of which have been exclusively in palliative medicine – is that I really, truly don’t know. Matters of dying – when, how, and by whose hand – are as ethically complex as they come. This week’s parliamentary debate of a petition demanding a change in the law – signed by more than 200,000 people and spearheaded by Esther Rantzen, who has terminal lung cancer – was, then, reassuringly measured, with thoughtful contributions from all sides. For if ever a topic demanded nuance and gravity, it is surely that of state-sanctioned killing, albeit on merciful grounds. What we absolutely don’t need, if we want to get this right, is for the debate around assisted dying to become yet another example of entrenched, polarised, pick-a-side-politics in which “pro” and “anti” camps shriek dogma in each other’s faces.
Rachel Clarke is a palliative care doctor and the author of Breathtaking: Inside the NHS in a Time of Pandemic