Page 3, 2nd February 1973

2nd February 1973
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Page 3, 2nd February 1973 — Tender, loving care is needed when it is time to say goodbye
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Organisations: Catholic Church
Locations: Glasgow

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Tender, loving care is needed when it is time to say goodbye

Often it seems, in the view of modern society in this country, death is the only obscenity left. Certainly it is the only unmentionable subject, surrounded by conversationally euphemistic barriers and taboos which would do credit to the most primitive and superstitious of tribes.

Someone "passes away," "passes on," even "passes over," He does not die. Perhaps that would be too strong a reminder of our own inescapable mortality.

In view of this curious and only partly explicable social convention. one might expect a conference entitled "The Hour of Our Death" to be sparsely attended, its proceedings shrouded in a decent gloom.

On the contrary, for Saturday's conference, held at Westminster Cathedral Hall, two applicants had to be disappointed for everyone who successfully obtained a seat. Nor was interest confined to this country; one reporter had flown from Denmark to be present.

The lectures and discussions throughout the day were characterised by nothing less than a joyous acceptance of the fact of death, and a caring and sincere determination to make the experience a happy one for even the most timid and apprehensive souls.

"The Hour of Our Deathwas not a conference held by the Catholic Church, as the chair: man, Cardinal Heenan, made clear from the outset. The object of the corference, suggested by two young non-Catholic doctors, was not only to present the case against euthanasia, but also to discuss the proper care of the dying.

Objection to euthanasia, the Cardinal emphasised, was not simply a Catholic scruple. "It is not even a Christian scruple. It is a question of the rights of man.

"If we are inactive, there will be a Euthanasia Bill, and it will be successful. The Catholic Church in this country deliberately made no pronouncement when the Abortion Bill came before Parliament, although everyone knew the .Catholic condemnation of abortion. We were told by politicians that if the Bishops made a pronouncement against the Bill, this would confirm the Humanist contention that only Catholics objected to abortion.

"Now this country knows what a terrible thing abortion is. And now we are faced with euthanasia. We must not make the same mistake again. We must not allow this thing to go quietly under the counter without any opposition."

To underline that objection to euthanasia came not merely from Catholics, only non-Catholic experts had been invited to give their views at the zonference, .which was attended by people of many different religious denominations and none.

All had just one thing in common: their interest in the care of the aged and the incurably sick.

Just over twenty years ago, a lonely young man died in a hospital ward containing fifty beds. During his last illness his only regular visitor was a hospital almoner.

Together they talked about her idea for a home or hospice. where people would feel that they were members of a family group rather than patients, or soulless "cases."

The young man had £500. He left it to the almoner, Cicely Saunders, "to be one window in your home."

So that she could realise her dream, Cicely Saunders became a qualified doctor. She is now Medical Director of St. Christopher's Hospice, where patients of all ages come to be part of her "family" in a very real way.

At the conference, Dr. Saunders, now acknowledged throughout the world as an expert on the care of terminal illness showed coloured slides which were much more telling than any words she could possibly have used to explain the atmosphere at St. Christopher's.

People come to the hospice, troubled in mind and often racked with bodily pain. The staff are experts in the control of pain; in a very short space of time pain is no longer a problem.

But other problems remain. If a patient has an incurable illness he must come to terms with it, with the approach of his own death, with how to say good-bye, how to prepare and comfort his loved ones. Acute pain can obscure these problems, keep them shadowy and in the background.

Now that so much more is .known about the control not only of pain but also of other distressing features of illness, like nausea and weakness, patients in the course of terminal treatment have to come to grips with mental and emotional stress with clear minds. Hospice staff are experts in helping them with these problems too.

Dr. Saunders talked about the fact that so often the patients who request death are simply saying: "I want relief from pain." Once relief has been given, they appreciate the time to say goodbye peacefully and in the time left to them, Often, however, there was a barrier between the patient and his family, a barrier of unshared knowledge. Perhaps a husband had an operation which he believed had been successful. His wife might know that it had not

succeededsbut might not have the courage to tell him.

Once, in a situation like that, when the husband finally realised and had accepted that he was dying, Dr. Saunders had asked, "Would you like to have been told more, or would you have preferred your wife to have been told less?"

The husband's reply crystallises his distress at the barrier built up by his wife's unspoken knowledge. "Whatever we had, I would have wanted to share it."

This, said Dr. Saunders, was one of the ingredients which could make the time of dying something different. "It is sharing which is important."

'Then she showed a slide of a family group gathered around the bed of a woman who only had a few hours to live. Her baby grandson was playing on her bed. "His presence there makes saying good-bye so much easier for all of them," she explained.

And the small dog curled up on the counterpane beside another patient helped to make her point.

Professor W. Ferguson Anderson, a specialist in geriatric medicine, from Glasgow, mentioned the vast strides made recently in this country in knowledge about the care of the elderly. "We are at least ten years ahead. of any country in the world; our standard of nursing is envied by all nations. Is this work in vain, is it useless?" he asked.

He described conducting a well known TV commentator around a geriatric unit. They came across a 92-year.old man sitting in a wheelchair. Both his legs had been amputated..

-You doctors!" exploded his guest. "Why can't you put that poor old man out of his misery?"

-Why don't you ask him how he feels about it?" suggested the Professor.

The commentator did so. The old man looked at him silently for a few minutes. Then he took his pipe from his mouth. "Sonny." he said, "Life is sweet."

Asked how many of his geriatric patients had requested euthanasia, the professor replied: "Theie is a very short answer to that: none."

One of the young doctors who had suggested the conference to Cardinal Heenan remembered four patients, out of a total of over two thousand with terminal illnesses, who asked for euthanasia.

"But once their pain had been controlled, they changed their minds. Except for one very persistent man. So one day I gave in. I said. 'All right, let's do it now, shall we? "Oh no, doctor!' he protested. 'I didn't mean now I just meant when I get much worse than 1 am!'"

All the speakers at the con

ference stressed that dying should not be a terrifying and lonely experience. Dying ought to be the culmination of living; like all the deepest experiences of our lives it should ideally, be something in which all the family takes part.

Dr. Saunders said: "Research has shown that most families wish to care for a dying relative at home as long as possible, but often welcome admission to hospital at the end."

Once patients have been admitted. unrestricted family visiting should be the rule. Where patients have no families, she said, the staff of the hospice must take the place of the family. The most important thing was for the patient to have someone who would listen to him. "Not standing up at the end of the bed listening sitting down beside him with time to listen."

Patients at her hospice are not removed from the small wards when the end comes. "We have curtains which can be drawn around the beds when a family wishes for privacy. But usually they remain open. The patient and his family want to share the death with friends made in the ward."

This kind of loving care is:the answer to euthanasia. If 'the teachings of Dr. Saunders and of Professor Ferguson Anderson could be more widely disseminated. the modern horror of death would disappear. Thankful ly. medical and nursing students are now being taught about terminal care, and often being given direct experience of it.

Perhaps, as the result of the devoted work being done in the handful of hospices. now existing, we may all come to look up on death. like Peter Pan, as "an awfully big adventure": not a dismal end. but a hopeful beginning.

Maureen Vincent




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