Dying is not a subject most people want to contemplate. It engenders sad emotions and fearful prospects. Nonetheless, it is a subject which we will all have to face more frequently as our population ages.
What prompted me to write this blog was a short three paragraph piece in The Daily Telegraph on the 19 April – just a page filler – not a big news story. The report covered the fact that a Primary Care Trust in North Essex had suggested to care homes that they should not dial 999 when an elderly person was dying, providing they held a “do not resuscitate” form from a resident, their family or a doctor. The suggestion was that care homes were ignoring such requests and dialing the emergency services anyway.
I am sure this policy is well intended. It is certainly true that most people would prefer to die at home. Whereas currently the majority of people die in hospital, all too often in desperate circumstances. Therefore you can sympathise with GPs / PCTs who are trying to enable more people to die in their own homes.
The problem as ever is in the detail:-
Who decides when someone is dying ?
- An unqualified care assistant on duty alone in the middle of the night ?
- An about-to-be-bereaved relative in a late night phone call ?
- A local doctor covering the night shift who has never met the resident before ?
Who waits in the wings to pass judgement ?
- The care home owners rightly fearful of ending up in a court action over negligent care ?
- The Care Quality Commission every ready to be holier than thou with the benefit of hindsight ?
- The coroner at an inquest weighing the opinions of all the people who weren’t there ?
- The no-win-no-fee lawyers ever eager for the next lucrative case which can be made to drag on for months / years ?
With these witnesses and prosecutors behind you, it is a very bold person who can make a compassionate decision on life or death.
The medical profession is more and more able to prolong life at all costs, while the legal profession is increasingly geared to assigning blame at great expense. An unholy alliance accidentally designed to ensure elderly people do not die with dignity in their own homes.