“Right to die”

Editor—My many years' experience of caring for dying people—I was medical officer to a small hospice in the early days of the hospice movement, and for 12 years a consultant geriatrician with a special interest in palliative care—have led me to believe that sometimes it is wrong to encourage or help people to hang on to life until the last moment—there are worse things than death. I agree with Grayling's assertion that people have the right to decide when and how they die.¹

Their lives and their bodies belong to them, not to the medical staff or even to their relatives. Too often medical and nursing staff have tended to take over patients' bodies, as though they owned them and knew what was right for them. We must learn to be less arrogant and less controlling as a profession and allow patients more autonomy. This is happening in general hospitals more, as patients become better informed, but hospices still tend to be rather too proprietorial about their patients. We need the utmost sensitivity and humility when dealing with dying people. It is too easy to be patronising and assume we know what's best. We are not in their shoes.

I agree too that there really is no difference at all between withholding treatment, with death as the result, and giving treatment that causes death. We are kidding ourselves if we think that there is. I believe we must grasp this nettle, for our patients' sakes, and offer a compassionate and peaceful death to those for whom palliation is no longer relieving their distress. We fail in our duty to them otherwise.