It is heartless not to assist people to die: Debbie Purdy

The multiple sclerosis sufferer Debbie Purdy died in the Marie Curie hospice in Bradford on December 23 2014. Having been denied her right to travel to Dignitas in Switzerland, which would have exposed her husband to the risk of prosecution under the 1961 Suicide Act, she took the only option available to her – refusing food. Death by starvation is not pleasant. The relevant Wikipedia entry describes some of the symptoms:

The body breaks down its own muscles and other tissues in order to keep vital systems such as the nervous system and the heart muscle functioning.
… Early symptoms include impulsivity, irritability, hyperactivity, and other symptoms. Atrophy (wasting away) of the stomach weakens the perception of hunger, since the perception is controlled by the percentage of the stomach that is empty. Victims of starvation are often too weak to sense thirst, and therefore become dehydrated.

All movements become painful due to muscle atrophy and dry, cracked skin that is caused by severe dehydration. With a weakened body, diseases are commonplace. Fungi, for example, often grow under the esophagus, making swallowing painful.

I apologise for introducing such a gloomy subject into the dying embers of 2014, but it is too important to pass by.

The American physician has discussed at length what he calls the “failed medical experiment” of preserving and extending life at all costs in his fascinating and humane book, followed by his Reith Lecture delivered on 9 December “The Problem of Hubris”  (available on podcast). When questioned after this lecture by the President of Dignity in Dying about why doctors have been so slow to push for change in the law on assisted dying, when it is often the settled wish of competent people, Gawande responded thus:

When suffering is so great that we have no means to stop it and prevent it, and it’s unavoidable suffering, I do think we have means that are effective and can be carefully targeted to only those that are falling in that situation to allow them to have a prescription that would hasten their death [as he did with his own father, himself a surgeon]. We have several states in the United States where it is legal now … I think often just knowing that that option is there is relief enough, in case the suffering becomes that terrible.

But surely, as his questioner pointed out, the decision needs to be that of the patient, not the doctor, for obvious reasons – we cannot prevent ourselves falling into the hands of a religious or anyway generally pro-life medic. Gawande’s father was lucky because of his own and his son’s status in the world of medicine.

Nobody in the lecture hall disagreed with Gawande. As Simon Jenkins points out in his Guardian column, we should mark Purdy’s death by legalising assisted dying.

That two terminally ill people a month go to Switzerland to end their lives and 10 times that number kill themselves surreptitiously at home is a poor comment on modern Britain. It puts the country on a par with American creationism and Irish anti-abortionism.

…Indeed, objection is largely confined to religious prejudice and medical authoritarianism, to those who hold that the state and the professions should hold sway over individual freedom and dignity.

Apparently, Purdy’s husband thanked the Marie Curie hospice in Bradford for helping his wife through what Jenkins calls “the awful experience of self-starvation forced on her by parliament.”

How much better if he were now able to thank parliament for relieving others of having to face the same ordeal.

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Related reading:

• Supreme Court rejects right to die appeals
• “No precedent”? Then set one! The Nicklinson right to die case
• Proposal for a “Dignitas” style clinic in Fiji for Australian, New Zealand and Indian citizens
• Locked-in sufferer’s challenge to ban on voluntary euthanasia fails in the High Court
• British Columbia Supreme Court grasps the nettle in right to die case
• A step closer to the legalisation of assisted suicide?
• What is a life worth living? Further analysis of “M” – Daniel Sokol
• States Not Obliged to Assist Persons Wishing to Commit Suicide – Antoine Buyse
• GMC to announce policy of striking off doctors who prolong the lives of terminally ill patients against their wishes [updated]
• New assisted suicide guidance “focused on motivation of the suspect rather than characteristics of the victim” – DPP [updated]