{"id":22,"date":"2008-10-09T15:58:14","date_gmt":"2008-10-09T14:58:14","guid":{"rendered":"https:\/\/blogs.bmj.com\/medical-ethics\/?p=22"},"modified":"2008-10-09T16:03:04","modified_gmt":"2008-10-09T15:03:04","slug":"death-and-palliation-thoughts-on-purdy","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/medical-ethics\/2008\/10\/09\/death-and-palliation-thoughts-on-purdy\/","title":{"rendered":"Death and palliation &#8211; thoughts on Purdy."},"content":{"rendered":"<p class=\"MsoNormal\"><span style=\"font-size: 10pt;font-family: Verdana\">A <a href=\"http:\/\/www.timesonline.co.uk\/tol\/comment\/letters\/article4908963.ece\">letter in <em>The Times<\/em><\/a> today considers the duty of doctors to ease the dying process, in the light of the <a href=\"http:\/\/news.bbc.co.uk\/1\/hi\/health\/7644094.stm\">Debbie Purdy case<\/a>.<\/span><\/p>\n<p class=\"MsoNormal\"><span style=\"font-size: 10pt;font-family: Verdana\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\"><span style=\"font-size: 10pt;font-family: Verdana\">Dr MS Ali wonders why \u201c<\/span><span style=\"font-size: 10pt;color: #000000;font-family: Verdana\">people like Debbie Purdy and others have to fear that they will not get the necessary assistance from the medical profession to relieve their suffering when they need it\u201d.<span>\u00a0 <\/span>If it\u2019s true that people fear this, that\u2019s a bad thing.<span>\u00a0 <\/span>And if their fear is warranted, then that\u2019s worse.<\/span><\/p>\n<p class=\"MsoNormal\"><span style=\"font-size: 10pt;color: #000000;font-family: Verdana\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\"><span style=\"font-size: 10pt;color: #000000;font-family: Verdana\">Ali then asks whether<\/span><\/p>\n<blockquote>\n<p class=\"MsoNormal\" align=\"left\"><span style=\"font-size: 10pt;color: #000000;font-family: Verdana\">the medical profession [is] failing to reassure people like Ms Purdy that she will get all the necessary physical, emotional and spiritual care to have a natural and dignified death in her own home with her husband by her side, when her condition of MS becomes unbearable to her[.] Does not the medical profession have a duty of care to make sure that patients suffering from incurable diseases live well and also die well?<\/span><\/p>\n<\/blockquote>\n<p class=\"MsoNormal\" align=\"left\"><span style=\"font-size: 10pt;color: #000000;font-family: Verdana\">\u00a0<\/span><span style=\"font-size: 10pt;color: #000000;font-family: Verdana\">Well \u2013 again \u2013 plausibly it does.<span>\u00a0 <\/span>However, I wonder whether the point is much more than trivial.<\/span><\/p>\n<p class=\"MsoNormal\" align=\"left\"><span style=\"font-size: 10pt;color: #000000;font-family: Verdana\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" align=\"left\"><span style=\"font-size: 10pt;color: #000000;font-family: Verdana\">What it lends itself to \u2013 which is non-trivial \u2013 is the \u201cpalliative care\u201d objection to euthanasia and assisted dying.<span>\u00a0 <\/span>It\u2019s a line that\u2019s fairly often adopted.<span>\u00a0 <\/span>The gist is that people only seek death because the alternative \u2013 the kind of life that they\u2019d otherwise lead \u2013 is intolerable.\u00a0 The thought seems to be here that, if Purdy could be reassured about her future, she would not seek death.<span>\u00a0 <\/span>Give people a better life for the rest of their lives, and they would no longer seek to die; therefore we ought to provide palliation rather than help someone to die.<\/span><\/p>\n<p class=\"MsoNormal\" align=\"left\"><span style=\"font-size: 10pt;color: #000000;font-family: Verdana\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" align=\"left\"><span style=\"font-size: 10pt;color: #000000;font-family: Verdana\">But this is hokey thinking, it seems to me.<span>\u00a0 <\/span>Importantly, it seems to be simply false that the only reason why a person might seek death actively is because they fear a lack of care.<span>\u00a0 <\/span>It might be the case that a person simply decides that they\u2019ve had enough, and they want no more of anything.<span>\u00a0 <\/span>Along these lines, it might simply be that Purdy sees a time in which no amount of care will compensate for the fact that her life will be intolerable to her.\u00a0 Maybe being cared for at all is exactly what is at the root of the problem.<span>\u00a0 <\/span>And it\u2019d be hard to tell her that she\u2019s made a mistake in that evaluation &#8211; and, even if she has, there&#8217;s no sign that she&#8217;s incompetent.\u00a0 Liberal though makes space for possibly foolish decisions.<\/span><\/p>\n<p class=\"MsoNormal\" align=\"left\">\u00a0<\/p>\n<p class=\"MsoNormal\" align=\"left\"><span style=\"font-size: 10pt;color: #000000;font-family: Verdana\">That being the case, then the availability of care might mean that some people choose not to seek death \u2013 but it won\u2019t establish that noone ought to, and it won\u2019t establish that we oughtn\u2019t to make the option available.\u00a0 S<\/span><span style=\"font-size: 10pt;color: #000000;font-family: Verdana\">ometimes, it may be true that a person would rather survive given a full range of palliative care and end-of-life treatment.<span>\u00a0 <\/span>But not all the time, and not as a matter of necessity.<\/span><\/p>\n<p class=\"MsoNormal\"><span style=\"font-size: 10pt;font-family: Verdana\">\u00a0<\/span><\/p>\n<p><!--TrendMD v2.4.8--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>A letter in The Times today considers the duty of doctors to ease the dying process, in the light of the Debbie Purdy case. \u00a0 Dr MS Ali wonders why \u201cpeople like Debbie Purdy and others have to fear that they will not get the necessary assistance from the medical profession to relieve their suffering [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/medical-ethics\/2008\/10\/09\/death-and-palliation-thoughts-on-purdy\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[511,472],"tags":[],"class_list":["post-22","post","type-post","status-publish","format-standard","hentry","category-in-the-news","category-thinking-aloud"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Death and palliation - thoughts on Purdy. - Journal of Medical Ethics blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/medical-ethics\/2008\/10\/09\/death-and-palliation-thoughts-on-purdy\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Death and palliation - thoughts on Purdy. - Journal of Medical Ethics blog\" \/>\n<meta property=\"og:description\" content=\"A letter in The Times today considers the duty of doctors to ease the dying process, in the light of the Debbie Purdy case. \u00a0 Dr MS Ali wonders why \u201cpeople like Debbie Purdy and others have to fear that they will not get the necessary assistance from the medical profession to relieve their suffering [...]Read More...\" \/>\n<meta property=\"og:url\" content=\"https:\/\/blogs.bmj.com\/medical-ethics\/2008\/10\/09\/death-and-palliation-thoughts-on-purdy\/\" \/>\n<meta property=\"og:site_name\" content=\"Journal of Medical Ethics blog\" \/>\n<meta property=\"article:published_time\" content=\"2008-10-09T14:58:14+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2008-10-09T15:03:04+00:00\" \/>\n<meta name=\"author\" content=\"BMJ\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"BMJ\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"2 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2008\\\/10\\\/09\\\/death-and-palliation-thoughts-on-purdy\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2008\\\/10\\\/09\\\/death-and-palliation-thoughts-on-purdy\\\/\"},\"author\":{\"name\":\"BMJ\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/#\\\/schema\\\/person\\\/ba3da426ed20e8f1d933ca367d8216fe\"},\"headline\":\"Death and palliation &#8211; 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