Thursday, August 03, 2006

Death and Suffering

[posted by dinah]

A few days ago, Dr. Crippen (NHS Blog) wrote a moving piece called Removing Death from Life. He takes a look at dying, the hospice system, the what we've come to expect from death:

There is a danger that the hospice movement will steal death from life. Death should take place in the home. With the family. If there is no family, the hospices are wonderful. If the family cannot manage, for whatever reason, the hospices are wonderful. But they are not compulsory, nor are they a “better” option. They are a failsafe.

The second, and more serious problem, is that the hospice movement and the media have conspired together to present death and dying as something that is really rather wonderful. A clap-happy learning experience to be shared and enjoyed with all the family. The gullible like to invest in this.

As a society, we've come to believe that people don't need to suffer. If you're in pain, something's wrong, go to the doctor, it can be fixed. In many ways, this is a good thing, fewer people suffer needlessly with mental illnesses because of the awareness that some suffering is the result of a treatable disease: they come for help and they get it (this is good). Others are diagnosed with illnesses that, had they waited, would have been fatal (say early stage cancers, infections that might spread, and the list marches on). This is also good. Life, however, remains chock full of suffering, and not all of it is about treatable illnesses, and Death is no exception. Family members suffer when their loved ones die miserable deaths, only now they are left to believe they should have done something "more" to help the loved one die differently.

As Dr. Crippen so bluntly puts it:

Dying is unpleasant. With optimum symptom control it need not be painful, or not for long, but it is uncomfortable, it is distressing and it can be undignified. Much can be done, and much should be done, but let us not try to spin dying into something it is not. It is, I repeat, an unpleasant business.