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David Burrowes: The focus of debate about dying must be palliative care

David Burrowes is the Member of Parliament for Enfield Southgate

Screen shot 2012-01-16 at 08.56.54When did you last talk about dying? Dying is an issue which affects us all but we rarely talk about it. In the media a discussion about terminal illness more often than not turns into one about legalising assisted suicide. On Tuesday morning Parliament has an opportunity to do better when I will be leading a debate entitled “Care for the Dying”. MPs will be able to show their support for care that achieves the best quality of life for patients even when their illness cannot be cured.

“You matter because you are you. You matter to the last moment of your life and we will do all we can to help you die peacefully, but also to live until you die.”

What a contrast between these words 50 years ago of Dame Cicely Saunders, founder of the modern hospice movement and those recently of Baroness Warnock, an advocate of legalising assisted suicide, who said: “If you’re demented, you’re wasting people’s lives – your family’s lives – and you’re wasting the resources of the National Health Service.” Suggesting that we have a “duty to die” she said “I think that’s the way the future will go, putting it rather brutally, you’d be licensing people to put others down.” 

Most of the media give the impression that there are numerous people travelling to Switzerland to be “put down” or ending their lives at home with the help of relatives. The fact that less than 20 ‘assisted suicide’ cases cross the DPP’s desk each year gives a different picture. It is certainly different from the state of Oregon, where physician-assisted suicide was legalised in 1997, which has seen the number of such deaths quadruple. In this country most of the 550,000 who die each year have their dignity respected. In 2010, the Economist Intelligence Unit ranked Britain as top of the league of countries for the provision of end of life care. We should give more attention to the excellent work of palliative care and the hospice movement.

Aside from the small number of high profile terminally ill patients who assert their right to die, we should remember that there are still too many vulnerable people approaching the end of their lives who do not feel valued. They may well feel that their lives are “wasted”. They need the protection of the law and the provision of good quality palliative care.

In healthcare we can often equate dying with failure rather than a normal process. This attitude ignores those who will not respond to treatment but can still be significantly cared for. While death may be a tragic inevitability, palliative and hospice care can ensure that the remainder of life is a life still worth living. Palliative care improves the quality of life for patients suffering incurable, progressive illness in accordance with their values and preferences. Dying of course is not just a health issue, which is why hospices are so good at meeting social, emotional, spiritual and psychological needs. They regard the relief of suffering for the dying as being at least as important as restoring people to good health. The challenge is whether the State and Society shares this attitude.

One good sign is the expansion of local charitable hospices which provide more than £700 million of care, the majority of which is generously donated by the communities that they serve. Additionally, more than 100,000 people donate their time to local hospices each year. We need to highlight this sector, champion its causes, support its growth and take pride as a nation in how we care for the vulnerable at the end of their lives.

The growth of palliative care, not the legalisation of assisted suicide, should be the central debate about caring for the dying. As a country we must do all we can to allow the terminally ill to live life until death, make the intolerable tolerable, replace hopelessness with hope and desperation with serenity.

For me it is summed up by the words of the French biologist Jean Rostand: “For my part I believe that there is no life so degraded, debased, deteriorated, or impoverished that it does not deserve respect and is not worth defending with zeal and conviction".

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