Choice over dying

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We all know that skilled ­palliative care is frequently of immense value in terminally ill patients. This leads some people in the debate on assisted dying to say that all we need do is make good palliative care more widely available.

But, unfortunately, this ­ignores the fact that palliative care does not relieve all suffering in all ­patients. Some patients suffer distressing deaths in spite of the best palliative care. The reality is that palliative care is like other medical treatments, often of great benefit, but also with limitations and failures.

There is also a small minority of patients who do not want to go down the palliative care route at all.

They simply hate the idea of their deterioration, their ­increasing dependency, their loss of ­control over what is happening to them, and their having to complain about symptoms and receive unpleasant treatments.

These patients say they are going to die soon anyway – why are they forced to go through all of this?

We cannot turn a blind eye to these categories of patients whom the present system fails. The way forward is both to make good palliative care more widely available, and to enact Margo MacDonald’s bill to give patients the right to choose for themselves the way in which they die.

(Dr) Jack A Macfie

Albert Terrace

Edinburgh