Advance Decision to Refuse Treatment
Many of the people we talked to were unsure what an Advance Decision ( also known as an Advance Decision to Refuse Treatment, ADRT or...
When people find out that they have a terminal illness they often feel depressed (see ‘Roller coaster feelings‘). Some of the people we talked to said that when they discovered they were going to die they had considered suicide to ‘get it over with’. Two people had attempted to kill themselves. One man, for example, had survived an overdose. He had then looked at the Internet and put together a bottle of tablets that would end his life, which he said he would use if things ever became unbearable.
A woman with breast cancer had also tried to kill herself, but regretted the upset this had caused her family. She didn’t think she would try again, but liked the idea of having a pill to end her life if she ‘got to the end of the line’ and was in a lot of pain. She said that if she ever considered suicide again she would tell the family first.
Talking to other people and recognising that there would still be good things in life were sometimes described as reasons to keep going despite suicidal feelings. Some people told their doctors how they felt and started to take anti-depressants, which helped them to feel better.
When we were talking to people for this site there had been several high profile discussions of assisted death, including the case of Diane Pretty (a woman with MND) who had appealed to the European court of human rights. Many people discussed their view of euthanasia. The word euthanasia (from Greek) literally means a ‘good death’ or death without suffering, though some people use the word to mean ‘mercy killing’. UK law does not allow assisted death, but some other countries do permit doctors to help people to die in carefully controlled circumstances. Charlotte was working in Holland, when her uncle, who was aged 76, had an assisted death. Physician assisted suicide is legal in Holland but must be done under strict rules.
Some of the people we talked to had witnessed other people’s experiences and become convinced that people should have a right to choose when to end their lives. Most mentioned the moral complexities and the dangers of abuse but could not see the point of causing further suffering. As one young man put it, ‘I don’t believe in suicide but if someone’s dying and they know they’re dying and they’ve only got x amount of months, let ’em go happy. Why let them suffer?’
A woman with chronic obstructive lung disease wished that euthanasia were legal in the UK. She anticipated a time when her quality of life would be so poor that she might want to die. She said that it would be nice for her to have her family around her when she died, but didn’t want any of the family involved in her death because she didn’t want them to get into trouble with the law.
Others also thought that UK law should be changed to allow euthanasia for those with terminal illness. A woman who had seen her mother die in great pain and with loss of dignity said that it would be a comfort to know that if she were dying she could say goodbye to her children and be given an overdose of morphine.
A man with multiple sclerosis had worked in a nursing home and had seen people die in pain. He felt strongly that pressure should be put on members of parliament to get them to change the law, so that if he could no longer enjoy life he could be ‘put to sleep’.
Many people we talked to had spent time in a hospice, either in the day centre or as an in-patient. They all spoke very highly of the care they received and many enjoyed their experiences (see ‘Hospice day care’ and ‘Hospice in-patient care’). However, one woman had spent a month in a hospice and had seen nine women die. It had not been a pleasant experience. She hoped she would be able to find a way to put herself ‘to sleep’ when the time came, and she said she would be grateful if someone else could help her.
A woman with motor neurone disease also wanted the law changed so that if she became a ‘total cabbage’ someone could help her to die. She believed her husband had suffered unnecessarily and did not want the same for herself. Like several others she said that laws on euthanasia are made by ‘people who are able-bodied’, who ‘don’t have a clue’.
When talking about their personal situation several people said that they found that the wish for euthanasia gave rise to a conflict within them that they found hard to sort out. Some people discussed the moral complexity of the situation. Many pointed out that it would be unfair to prosecute a caring partner who had helped with a suicide, although one man said that relatives might want a sick person to die and so encourage euthanasia. A few people said it was important that each case should be judged on its own merit.
Some people with religious beliefs are strongly opposed to any form of assisted death but some said that it might not always be God’s will to prolong life. One Christian had reluctantly concluded that quality of life could be so poor that assisted death would be appropriate, but worried that some might decide to end their lives because they were thinking more about their carer than themselves.
One argument against euthanasia is that people should not need it if their pain is correctly controlled. A man with prostate cancer had great faith in palliative care and opposed any change in the law, suggesting that euthanasia was ‘the next stop to murder’. A man who was dying of bladder cancer was sure that pain could be controlled but recognised that the palliative care team might find it hard to ease the suffering of someone with a very debilitating neurological illness.
Many of the people we talked to were unsure what an Advance Decision ( also known as an Advance Decision to Refuse Treatment, ADRT or...
Many people discussed practical matters, such as sorting papers, making a will, planning their own funeral and burial, donating organs for research, adapting the house,...