Saturday 24 November 2012

Death and dying: End of Life Exit strategies

As a Humanist/Rationalist, I have always had an interest in the humanist position on end of life exit strategies.

Quite simply, this is about a making a conscious, rational decision that if diagnosed with a terminal disease or for any other reason deciding that quality of life is unacceptable, having control over the end of the life process, ensuring that the end of life happens in a quick, painless manner, rather than suffering a lingering death as the victim of a society that is dominated by relgious beliefs that prevent humans receving the same level of terminal care as a family pet.

Disclaimer: I hope to live a long and satisfying life and have no suicidal ambitions at present. Unfortunately it is the stigma of discussing end of life  that forces me to make this disclaimer as otherwise many of my friends would believe falsely that I am contemplating suicide.

I have no fear of death. Death is nothingness as the brain ceases to function. From a personal perspective, death is no different from a general anaesthetic except that you don't wake up. I remember thinking about this the last time I underwent a GA. As I was wheeled into to the prep room and the the anaesthetic was connected to the veins in my wrist, I was thinking that what I was about to experience would be identical to the moment of death in a controlled environment. That was the last thought I had before I woke up....

However, I do have a natural and understandable fear of dying. Dying is about pain and even more about loss of control as you become weaker and lose control of your own destiny. My greatest fear would be coming semi-vegatitive -suffering but unable to articulate my desire for the pain and humiliation to end.

I feel great comfort in knowing that if I am every confronted with a terminal illness that I will be able to be in control of my own destiny to the end. I am a huge support of Exit International - http://www.exitinternational.net/ a voluntary euthanasia organisation started by an Australian Doctor who actually created a patient controlled euthanasia machine more than a decade ago, but was banned from using it by the Australian Courts.

At the moment, I have two preferred strategies for end of life management. The first is self-management through use of a Helium bag (or a Helium tent for terminally ill couples). The great thing about Helium is that it doesn't produce any subjective signs of approaching hypoxia such as shortness of breath. There is no discomfort at all and unconciousness  and then death happens gradually and painlessly, within minutes as the helium replaces oxygen. However, it is important to obtain the right equipment as unfornately there are many examples of this not working when a heliumu/oxygen mix is unintentionally used instead of pure Helium. See: http://suicideproject.org/2011/08/failed-helium-exit-bag-attempt

This is wonderful blog with people trying to help each other achieve a painless death without any questioning of their intentions.

My second recommended strategy is Dignitas, the Swiss assisted suicide organisaton. http://www.dignitas.ch/index.php?option=com_content&view=article&id=20&lang=en

Dignitas provide a dying with dignity service for those with confirmed terminal illnesses. However, for most of my friends, using Dignitas would mean ending your life a long way from your family and friends, unless you could convince them to accompany you to Switzerland. I've read many wonderful stories from people arriving at Dignitas who have used their savings to pay for family and friends to accompany them to Switzlerland and have have had a wonderful final night out at a nice restaurant before ending their lives.

My strong support for a structued and and humanist end of life strategy is driven by three things. The first is my humanist worldview. Without the fantasy of religion, we can make sensible moral and ethical decisions that are in the best interests of ourselves. Secondly, I have a clear memory of the suicide of my sister, who didn't have the knowledge or support to have a painless end of life. She took rat poison and did not die painlessly. The police who recovered her body initially thought that she was murdered due to the amount of bruises on her body. The brusies were in fact caused by the reaction of the rat poison on her body.

Thirdly, I have fond recollections of my Father, who was a very caring, humanist, atheist Doctor. He had similar principles to myself in respect of end of life care for his patients. I remember one Saturday that I was was with him as he did his hospital round. He had to visit "Mr Smith", who who was an extreme diabetic with a terminal illness. All Mr Smith had wanted was was an ice-cream and was not allowed was not allowed this due to his illness. My dad bought Mr Smith an ice cream and Mr Smith passed away peacefully soon after.

I hope to die a natural death, but it is very comforting to know that if I am am ever diagnosed with a terminal illness that I will be in control of my destiny.

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