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Like Peggy Mitchell, I want to choose when I end my life Melanie Reid

Comment: Melanie Reid, who was paralysed in a riding accident, identifies with EastEnders character.

Final days: It's time to start a conversation about end of life choices.
Final days: It's time to start a conversation about end of life choices.

A few days ago, something extraordinary happened.

Nearly half of all British TV viewers tuned in to BBC One to watch Peggy Mitchell take her own life. The EastEnders character, played by Dame Barbara Windsor, took an overdose of pills after learning her cancer was terminal.

"I'm being eaten alive and it hurts. I don't want to be that little old lady in the bed being looked after. No, no, no. I will go as I have lived. Straight back, head high, like a queen," she declared. And eight million people watched, wept and totally agreed with her.

You can bet that, when the episode ended, millions of families held a conversation along the lines of "Poor Peggy. If it ever happens to me, I'd feel the same," and "I'd totally understand. Me too."

Last week, also on TV, there was a scene filmed in Accident and Emergency, when a distressed elderly lady asked her chronically ill husband, awaiting an emergency lung procedure, whether he wanted the doctors to resuscitate him if his heart stopped. In what was another heart-wrenching moment, the old man shook his head, sadly and wisely. "No," he said.

The clip, when shown on Gogglebox, had exactly the same effect of getting the families talking -- discussing what they'd do, probably for the first time ever. Without exception, they agreed that they too would not seek to be resuscitated.

I wish I could have had the foresight to hang a notice round mum's neck: DNR. Do Not Resuscitate.
Melanie Reid

It is hard to emphasise how vital these conversations are amongst loved ones and family -- and how bad we are at having them until it's too late. Yet from this it's obvious we're happy to have them -- we just need a bit of prompting to do so.

My own mum, who had vascular dementia, had to be put in a home. She desperately wanted to die; I knew because in her more lucid moments she told me so. She spent her whole time trying to escape from the home and eventually, one night, the brave old soul evaded all the security measures, got out of a back door and lay down and died in the freezing garden.

I don't blame the staff at all for her death. But I am terribly sad that when the ambulance arrived, they went through the traumatic, lengthy process of trying to resuscitate her, although she was already dead. I wish I could have had the foresight to hang a notice round her neck: DNR. Do Not Resuscitate.

It's incredibly important to talk to your family and tell them what you want to happen to you when you're terribly ill, and after you die. I think this especially since, out of the blue, I had a life-changing accident and was left paralysed. What if I had been left brain damaged? My family would have had no choice but to have me kept alive, possibly for many years, as a hopeless lump of meat, gobbling up NHS resources which would be better spent helping babies and children. There is something wrong about our society in that we have choice and control in all walks of life, but absolutely none over one of the most important bits -- the way we die.

My mantra is this: I believe in terminal sedation at a point when everyone, including me, knows my time is well and truly up, be if from dementia, disease, pain or old age. So just give me the drugs for God's sake and let me slip away peacefully in my sleep so that I don't have to suffer any more and the people who love me can get on with the wonderful job of living. Carpe that effing Diem, as they say in New York.

Most people would agree with me. According to a Populus poll in March last year, 83% of Scots want to see a change in the law to allow assisted dying for terminally ill, mentally competent adults.

I want terminal sedation at the end, when my time is well and truly up. Who can honestly disagree with the compassion and humanity of that?
Melanie Reid

How many of us know that Scotland has her own Professor of Death? David Clark, head of end of life studies at Glasgow University, is an academic researching what the world is going to do when the demographic tsunami of death hits. He warns that as things stand, we won't be able to cope and there is a crying need for global interventions.

For example -- during the entire twentieth century, 5.5 billion people died globally -- a figure lower than the current world population. That is, more people are alive, right now, than died over a period of 100 years. This year about 56 million people will die, a figure that's estimated to rise to 91m by 2050. The number of people over 80 will have risen from 102 million (in 2009) to 395 million by 2050.

On any given day in a Scottish hospital, one third of patients are in the last year of their life and 10% will die there. Nobody is discussing how to identify those people and offer what's best for them, because ordinary people have outsourced death to experts -- medical staff, politicians, academics, religious leaders -- and such people are naturally conservative and risk-averse.

http://www.bbc.co.uk/news/entertainment-arts-36311929 | default

Professor Clark thinks we should talk. His End of Life Studies blog is active across social media. And the good news is that debate is starting. Successful "death cafés" have been held in Edinburgh, giving the public a chance to chat openly about everything from "good deaths" in the developing world, to housing solutions for the elderly, to the integration of voluntary suicide, assisted dying and palliative care.

This week the Humanist Society Scotland is hosting informal discussions with Dignity in Dying to explore various issues. And although the Assisted Suicide (Scotland) Bill failed on its last attempt, in May 2015, support had doubled from the previous attempt in 2010. It is bound to be tried again. A recent case in the Court of Session clarified that there is no law against assisted dying in Scotland. Without a safeguarded law, however, many people will be unable to get help to die.

From June 9, Californian law changes. It will allow terminally ill adults the fundamental right to choice and control at the end of their lives. California joins Oregon, Washington, Montana and Vermont, meaning that over 50 million Americans will have access to the choice of assisted dying in their own country, compared to zero Britons.

I had a life-changing accident and was left paralysed. What if I had been left brain damaged? My family would have had no choice but to have me kept alive.
Melanie Reid

Euthanasia and/or physician assisted dying are currently legal in three other countries: the Netherlands (since 2001), Belgium (2002) and Luxembourg (2009). By long standing arrangement, Switzerland does not prosecute those assisting suicide, provided they do not benefit.

David Clark points to Belgium (population 11 million people) as a fascinating model of what integrated care can achieve. It is ranked fifth in the international "quality of death" index, with widespread, highly developed palliative care services -- yet one in 20 dies from euthanasia. Two previously opposing concepts, euthanasia and palliative care, have been united; there is no contradiction between delivering the best pain management and enabling a person's life to be ended at their request, by a physician.

Like I said earlier: I want terminal sedation at the end, when my time is well and truly up. Who can honestly disagree with the compassion and humanity of that? Certainly not Peggy Mitchell.

Comment by Melanie Reid. Melanie's Spinal Column appears in The Times Saturday magazine. She recently contributed to The Health of the Nation: Averting the demise of universal healthcare (ed Edmund Stubbs; published by Civitas).

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