If we are serious about improving people's lives, we must also be serious about improving their deaths
The worst day of my life was the day my mum decided to die.
It was nearly 10 years ago. Mum had been told a week or so earlier that the severe headaches she had been suffering for the last several months were a result of secondary breast cancer. It was a terminal diagnosis.
Still, things hadn’t seemed so bleak on hearing that news. There were interventions that could give her an extra few months, maybe even a year. She told us she wanted to spend that extra time with us and to “get her affairs in order” (always a practical woman).
And then that day came. For one reason or another, I was alone in hospital with her for the full day. It was relentless. From the moment she woke up, she was in excruciating pain. She was unable to think straight, unable to properly communicate, unaware, at times, of where she even was. The medication given to her by the nurses barely had any impact at all. I felt totally and utterly useless.
It was at this moment that a consultant came to see us, to talk about her options for life-sustaining treatment. She told him she did not want it. He asked again, gently, making sure she understood. “I want to die,” she told him.
It was only that evening, when a successful procedure had finally given her some relative comfort, that I brought the subject up again. And that’s when she explained, calmly and thoughtfully, that she did not want to go through another day like that one, and that it was time for her to die.
She did so peacefully, and relatively pain-free, 10 days later.
Refusing life-sustaining treatment may not be the same as proactively opting for assisted dying, but there are parallels. It gave my mum a sense of control over the disease that was killing her. It allowed her to avoid further pain. It made her an active participant in her own death, rather than it being something that happened to her.
When I read stories about people with terminal illnesses, people who want to end their own lives on their own terms but are unable to do so, I think of my mum. I think of the fact that, in hindsight, she had a pretty good death – something that many people with terminal diseases are deprived of.
Assisted dying is a sensitive and deeply personal issue. I fully understand why attempts to change the law on this in previous sessions of the Scottish Parliament have failed, and why so many of our MSPs may be hesitant to get behind Liam McArthur’s fresh bill now. But as the debate goes forward, I hope our parliament is mature enough to properly consider the issue.
Prue Leith, a patron of charity Dignity in Dying who visited the parliament last week to give her backing to the bill, is right. Post-Covid, we have become much better at talking about death. “Up to then as a nation we were very good at not thinking about death and, therefore, it was possible for governments to not devote enough money to palliative care, and to not bring a bill forward,” she told reporters.
But with a more open conversation now possible, it is important we consider all options. Improving care for those with terminal illnesses and offering assisted suicide are not mutually exclusive. Both can be done.
Yes, there will need to be a strong system of checks and balances to ensure no patient is ever coerced into choosing death. Yes, particular thought must be given to ensuring the most vulnerable people do not suffer and rules don’t erode over time. And yes, there can and should be improvements to palliative and community care.
But if we are serious about wanting to improve the lives of the people of Scotland, we must also be serious about improving their deaths. For me, that means giving people the option of ending things on their own terms, with dignity, if they so choose.
I know the Scotland I want to live in – and die in – is bold enough to do it.