TALKING ABOUT MISCARRIAGE
Photo credit: Vitaly Gariev, Unsplash
“For many people, trying to comprehend the concept of a ‘good death’ may seem impossible...
You might think that the term is jarring and insensitive; that the words ‘good’ and ‘death’ should not be in the same sentence.
However, we believe the term ‘good death’ can have positive connotations.
For us, a ‘good death’ is an end of life experience that seeks to remove pain, distress and suffering and takes into account the wishes of the patient and their loved ones.”
Photo credit: Vitaly Gariev, Unsplash
In The Cure, to control population numbers, the government has passed a law that stipulates how and when people die through its Serenity Programme. Each citizen’s life term is set at 120 years, after which they are obliged to ‘transcend’: the state’s euphemism of choice for assisted dying.
The Serenity Programme normalises the idea that you have a predetermined number of years to live, after which you choose to die, even though you are healthy.
In return, every individual is promised a healthy old age, with free annual boosters of the anti-ageing ReJuve therapy, and a good sending-off at a transcendence ceremony. The state encourages you to plan your death as you might a birthday or wedding celebration, and provides licensed Serenity Programme practitioners, to help make it the best it can be.
Writing this story led me to consider, what might a good death look like?
Photo credit: Kristina Flour, Unsplash
When we talk about a good death, (and that’s if we talk about death, which to be honest most Brits don’t) the general view considers this to be a pain-free, peaceful death, with dignity.
But it isn’t just about the medical side of things.
For many, what distinguishes a good death from a bad one, is being aware of what is about to happen, and having the time to plan and prepare for it with family and friends.
The irony is that despite this, many of us feel uncomfortable discussing our death with loved ones.
A recent survey by the Co-op revealed that only a third of respondents felt OK talking about it, and had done so. Whether this is down to awkwardness, lack of time, or fear, there still seems to be a real taboo about death and confronting our personal end-date.
In The Cure, the Serenity Programme is presented as a respectful conclusion to your life that involves meticulous planning: a personalised exit to celebrate the years you’ve enjoyed. In many ways, the ceremony is more like a wedding party, than a funeral. You select a theme, and send out invitations to those you care about. People say nice things about you, and you’re there to hear them, and join in their toasts with champagne.
Before your last dance, you get to share memories and say goodbye to your loved ones. Even the instrument of death can be tailored: champagne shots or chocolate bar, you choose.
This might not be your idea of a good death, but I quite enjoyed turning the funeral concept on its head, and giving my character one last hurrah. Then, after I finished writing the book, I discovered such ceremonies actually exist. They are called living funerals, or pre-funerals: a farewell party with family and friends. Far from mourning the person that’s gone, it’s about celebrating the person while they’re still alive, and telling them the things that you want to say.
Living funerals tend to be favoured by those with terminal conditions, because sadly, unlike the rest of us, they know all too well when they are going die. Which brings me back to another aspect of what makes a good death.
Having control over where, when and potentially how you are going to die.
“Even if the Commons debate results in a change in the law, it looks as though it may come too late for me. I will probably not be given the chance to die in my favourite place, my New Forest cottage.
Never mind. Even if that choice is not possible for me in my lifetime, I hope it will be possible for you in yours.
It is our life. It will be our death. It should be our choice.”
Photo credit: Vitaly Gariev, Unsplash
I recently attended two debates on Assisted Dying. Compelling arguments were made on both sides by qualified medical professionals who work in intensive and palliative care. Whilst there were clear differences of opinion, there was consensus on two things: the need for more general discussions about dying, and significantly more state funding for palliative care.
Some form of assisted dying is legal in at least 27 jurisdictions, including all six states in Australia, New Zealand, Canada, Switzerland, Belgium, the Netherlands and ten states in the USA.
A Private Member’s bill on Choice at the End of Life was introduced to the House of Commons last year. It was fiercely debated with huge media coverage and the majority of MP’s voted in favour of the bill, which means it will proceed to the next iteration before coming back to the House for further review.
The bill proposes legislation to support assisted dying for terminally ill, mentally competent adults. This follows an inquiry launched by the UK’s Health and Social Care Select Committee in January 2023, and a citizen’s jury held this summer where the majority (70%) believed the law should be changed to permit assisted dying.
However, as the controversy around this bill shows, assisted dying remains a highly contentious subject.
Whilst support for assisted dying legislation has grown, there are still concerns about its abuse and whether people could be actively pressurised or feel under an obligation to enter into assisted dying contracts. Many disability rights groups and religious groups actively oppose the introduction of new laws, arguing that the government should instead focus on providing better palliative care.
There are also concerns about the welfare of medical professionals asked to enact the legislation.
Learnings from other countries that have introduced assisted dying laws indicate that strong medical and judicial oversight can help overcome these barriers. What’s more, assisted dying legislation and investment in better palliative care are not mutually exclusive.
The Select Committee’s inquiry found that palliative care often improved in those countries where assisted dying legislation was introduced.
In the meantime, a UK citizen who is in terminal decline and wants to put an end to their suffering is left with three options.
Pay thousands of pounds to travel alone to Dignitas in Switzerland, attempt suicide by themselves, or refuse food and medication.
Surely none of the above could be considered a good death.
“Like many others facing terminal illness, I love my life, and I don’t want to die, but I also don’t want to endure unbearable pain with no option to choose a peaceful death.
If the time comes when I can no longer tolerate the suffering, I want to be able to make that decision; to die at home, surrounded by the people I love.
I ask MPs to do the right thing and change a law that is forcing dying people like me to choose between suffering a painful death, travelling abroad to die alone or taking my own life.”