Die Another Way
Reprinted with permission from the “Listener” May 8, 2004 Author Denis Welch
Thought about your own heath lately? You should, according to Rod McLeod. And he’s not talking about the “right to die” at an arbitrary time. Euthanasia is abhorrent to McLeod, who in many years working for hospices has seen thousands of people die without having to make an executive decision about it. No, he wants us to think about dying naturally, but in the best way possible; and that means thinking about it a long time before it happens.
“We do an interesting exercise sometimes for the people we teach,” says McLeod, New Zealand’s first professor of palliative care. “We ask them, how would you want your death to be? And they look at you—what? What do you mean?
“And that’s a very interesting thing to think about. How would you want your death to be? Who would you want to be there? Where would it be? What would you like around you? Would you like music or quiet? Light or dark? Candles or spotlights? Inside, outside? If you’re going to die well, you have to have thought about that.”
Right. So, how far ahead should this thinking take place? There’s a chuckle down the line from Dunedin, where McLeod teaches at the School of Medicine. “I think there would be value,” he says, “in talking about death and dying more in schools.”
Not surprisingly, McLeod is right behind Hospice New Zealand, the body representing the country’s 30 hospices, in its newly launched campaign to raise awareness of what resources are available to the dying.
The more we talk about death, the less scary it becomes—not something so desperately unmanageable that euthanasia is the only option.
“The debate ought to focus on an individual’s ‘right’ to the best medical care possible.” says the Hospice New Zealand’s chief communications officer, Jamie Seymour. “That a minority of people would rather focus on allowing people the right to die rather than the right not to suffer is troubling.”
McLeod puts it this way: “I meet a lot of people who want to be dead—or rather, they don’t want to live like they’re living. And that request almost invariably falls away once their suffering is addressed, their anguish is addressed, their constipation is addressed, some of their family issues are addressed: and some people even go so far as to say that it’s the best time of their lives, because they’re freed up from so many of those other constraints.
By all means have the euthanasia debate, he says, but first put an effective palliative care system in place. Give people a chance to die well.
Dying well. A good death Enjoying, even, what Henry James on his deathbed called “the distinguished thing”. These notions may sound strange in a society where, on the Pakeha side anyway, death often comes as an unwelcome stranger, an offence against reason, the major scandal - as it has been called - of modernity. Hence the tendency to medicalise it, treat it as a health problem. "Our whole culture," says the philosopher Jean Baudrillard, "is just one huge effort to dissociate life and death."
It shows in the resources allocated to palliative care. The current government has done far more in this area than any of its predecessors, but hospices still get barely half their funding from the state the rest has to be rounded up from grants, donations, bequests, street appeals - and many terminally ill patients-still receive inadequate palliative care in hospitals. Most doctors, says Seymour, remain uninformed about it; and hospitals tend to have a vested interest in prolonging life at all costs, rather than helping you come to terms with the inevitable.
As McLeod says, "Death has been pushed aside at the expense of continuing treatment, which is often a solution to a majority of medical problems. Dying is not diagnosed very often. Some clinicians don't think that dying is something that should be considered as an option."
Lorraine Scragg, a Whakatane GP with special training in palliative care, expects the awareness campaign to make an enormous difference. Currently, she says, if a GP has no particular interest in palliative care, and isn't aware of the information around, then "often they just don't know what to do". Consequently, dying people and their families may not ever find out what resources they can access to help them through the last days.
Unless, like Peter Calder, they're lucky enough to be told.
Calder is an Auckland journalist whose mother Joan (he wrote about her movingly in the Listener) was a cancer patient at North Shore Hospital last year. They did 'all the tests’, says Calder, "and they said there was no
