Life – Terror. Ecstasy. Fight. Denial. Flight. Failure. PAIN. Forgiveness. Reconciliation. Hope. Love. Peace – Death.
My cousin Claire is dying.
Her loved ones have been told she has very little time left, days, hours. I intend to visit her tomorrow, probably for the very last time. She will be asleep (semi/fully unconscious), like my previous two visits and I will not be able to communicate with her. I will try, I will hold her hand, stroke her face and tell her ‘we’ love her very much, hopefully she will understand, I will never know.
Claire has been refusing food and drink for 3-4 weeks. All, life sustaining, intravenous fluids/medication have been withdrawn ‘End of Life’. She is literally waiting to die, her loved ones are watching, waiting for her to die.
Is she in pain?
I don’t know. The medics say no.
She is not screaming out load or moaning in her sleep, but she does not look like she is comfortable, she does not look happy.
Peggy, my mother-in-law (92) has dementia. Fiercely independent she has remained in her own home with only limited professional support ‘care’ supplemented by family. She is difficult, has vehemently, resisted fought off any help, she is extremely demanding, difficult and unhappy.
She does not eat, and lies about her food consumption, she is undiagnosed anorexic (has been for many years), she has never seen any value with food, for her or anybody else, her husband/children.
Peggy is, slowly, starving herself to death.
All of her ‘family’ her husband, parents, siblings are long gone, she is the last (somebody has to be)? She is frail, doddery with rapidly diminishing capacity and mobility. She does not want to live but she is scared to die, too scared to kill herself although she threatens suicide all of the time. She is not religious, does (did) not believe in an after life …. the closer you get to death perhaps the more open you are to the idea?
I live with continuous pain, I cannot remember ‘a time’ without pain. It is not always extreme. I depend on others for assistance with daily living. I regularly consider my own quality of life and the effects ‘my life’ my illnesses are having on others. I am afraid of what my, inevitable slow, painful and undignified death will have on my family, I have considered suicide and I am considering the options of assisted death.
Depending on the circumstances, currently within the UK euthanasia is regarded as either manslaughter or murder. For which, the maximum penalty is life imprisonment.
Assisted suicide is illegal under the terms of the Suicide Act (1961) and is punishable by up to 14 years’ imprisonment. However, trying to kill yourself is not a criminal act.
Both euthanasia and assisted suicide are illegal under English law.
Euthanasia can be classified as:
- voluntary euthanasia – where a person makes a conscious decision to die and asks for help to do so
- non-voluntary euthanasia – where a person is unable to give their consent (for example, because they’re in a coma) and another person takes the decision on their behalf, perhaps because the ill person previously expressed a wish for their life to be ended in such circumstances
Assisted dying allows a dying person the choice to control their death if they decide their suffering is unbearable. It is illegal in the UK.
There are several orginisation actively campaigning for changes in the current UK laws, most are insisting on a law that allows dying people, with six months or less to live the option to control their death.
There argument is this – That dying people are not suicidal – they don’t want to die but they do not have the choice to live.
When death is inevitable, suffering should not be. Along with good care, dying people deserve the choice to control the timing and manner of their death.
Dying people not doctors in control
Assisted dying should be controlled by the dying person. Dying people should have support to take the final act that brings about their peaceful death.
Arguments against highlight that to allow anyone to end another’s life is risky and could be subject to abuse, misuse and neglect. There need to be protection to ensure that an assisted death is completely voluntary.
A safe and comfortable death
Dying people are already ending their lives to avoid painful and undignified deaths. Many pay thousands of pounds and travel abroad to guarantee a safe and peaceful death. They do so to access a proven and safe way to control their death with medical supervision, legally (governed by the laws for that territory).
Many cannot travel so risk a painful and gruesome death by ending their lives at home. Many more are suffering and dying without dignity because they have no choice. Should dying people have the means to control their death safely and comfortably at home.
A more compassionate country and NHS
As a country we have a long and proud history of providing free and compassionate healthcare. Is forcing people to travel abroad and pay thousands of pounds for a dignified death is cruel and wrong? Do dying people deserve high quality end-of-life care and the choice of assisted dying?
The cost of an assisted death in Switzerland is, for many, prohibitively expensive. It costs anywhere between £6,500 to over £15,000 to have an assisted death in Zurich, (Dignitas). The average cost is £10,000.
Some costs might be surprising. For example, a return ticket for the dying person, to ensure they knew they had the option to change their minds if they wanted to and to reduce the chance of suspicion by authorities.
The cost of obtaining an assisted death in Switzerland denies the option to the majority of people in the UK.
A 2017 report by The Money Charity showed that 68% of households in the UK have less than £10,000 in savings. According to NMG Consulting and the Bank of England approximately 80% of private renters and 87% of social renters have less than £10,000 in savings. It is not an opportunity that every dying person has available to them.
A Logistical Challenge
The logistical hurdles that need to be overcome to arrange an assisted death means only some people are capable of doing it. Obtaining paperwork and navigating bureaucratic systems requires knowledge and skills that favour the “sharp-elbowed” middle-class.
The lack of clarity in the law for healthcare professionals means obtaining medical records and reports can prove challenging. But there are other documents that are also required. The process of obtaining paperwork, anxiety caused by not knowing if it would be possible to get the necessary documentation before a loved one died.
A common concern is that this complex process means the loss of valuable time at the end of life. Anger and frustration during the final months and weeks, that could be spent enjoying life, instead spent engaged in bureaucracy.
Arranging an assisted death can have a negative impact on the mental and physical health of those involved. Is this still a preferable choice. Is having the control and peace of mind of an assisted death worth the pains of making it happen?
A Cruel Trade-off
To arrange an assisted death overseas dying people have to negotiate a complex trade-off – Being able to make the journey to Switzerland requires a certain level of health.
This can create pressure to make the journey before becoming too ill to do so, which in turn often means sacrificing quality time that people could enjoy if they were able to remain in the UK.
The Journey Home
Following an assisted death, Swiss authorities must confirm that there has been no breach of Swiss law. This means that police, a public attorney and an independent doctor inspect the body of the person who has died, review the evidence provided by the organisation and, if necessary, interview the professionals and the loved ones who witnessed the death.
Dignitas and Eternal Spirit (two Swiss right-to-die organisations) allow for these procedures, however, it is clear that the curtailing of time spent with the body of a loved one, the presence of officials and the implication that a loved one’s deathbed had become a suspected crime scene is distressing.
The experience of watching a loved one die, in any circumstance, requires time, space and support to process. Organisations in Switzerland that facilitate assisted death also provide emotional support after the death. But this is the limit of support that was available.
While there is comfort in knowing someone has ended their suffering, grief is made more complicated by the death happening in a foreign country?
If a person dies overseas, bringing the body home for burial or cremation in the UK leads to the involvement of a coroner. In the unique circumstance of a person being assisted to die in Switzerland, it is likely that this would lead to a criminal investigation into the actions of those who helped.
As a result, it is most likely that a cremation take place in Switzerland, with a loved one’s ashes collected at a later date or couriered back to the UK.
The reality of having little choice but to have a cremation in Switzerland means that people are denied a traditional funeral service in the UK. This limits the funeral choices available and prevents people donating their bodies to medical science.
It can also have severe consequences for people with religious beliefs that forbid cremation, another example of inequity created by the current law.
The average cost for those interviewed was approximately £10,000.
Nowadays there are more creative and personal choices at the end of life.
That said funeral costs are at an all time high, however, if you are prepared to shop around it is possible for an alternative funeral for as little as £750, rather than spending money on things that don’t matter, it can go towards creating a more memorable service.
1. There is no legal obligation to use a funeral director, you can take charge of some, or all, of the funeral arrange
2. You don’t have to use a traditional black hearse, It can be any vehicle, even a family estate car.
3. You don’t have to have a traditional wooden coffin, the options are endless: willow, bamboo, cardboard, a shroud or you can even make or decorate the coffin yourself!
4. The body can stay at home, If this feels right for you, this is STILL absolutely possible.
5. The body does not have to be embalmed or sutured, these highly invasive procedures are not necessary. The body can be left in its natural state.
6. Many independent-looking funeral directors are not independent, this is important work. Make sure you know who you’re employing.
7. The body is rarely kept at the funeral director’s high street shop, many funeral directors operate large ‘hub’ mortuaries, often located many miles from the high street branches they serve. Ask where the body will be cared for.
8. Funerals don’t have to be expensive, shop around or ask a friend to do so on your behalf. Make sure you’re not sold products or services you don’t want or need.
9. If you’re not sure what the funeral director is trying to tell you, ask them to clarify what they’re saying.
10. Funeral directors don’t know best, families do – A good funeral director will support a family to have the funeral that’s right for them.
My Funeral Wishes – let others know what you want for your funeral
Thanks for reading.