I came to the VAD debate as a friend to, and admirer of, those who practice medicine. Multiple hospitalisations over a lifetime - mine, and those of my family - have only strengthened those feelings.
However, over the last 6 years, as I have talked (and listened) at length to hundreds of doctors and nurses, and the people they treat, talking about end-of-life care, I have become aware of a gap between medicine’s claim that it is delivering person-centred care … and what it, sometimes, actually delivers.
In that gap, I have found many accounts of fear, frustration and suffering from families – and disturbing denials that such suffering is even happening from sections of the medical community.
This seems to speak to something wider and deeper than whether or not assisted dying should be legalised.
It suggests that there is a powerful streak of ‘Doctor Knows Best’ still running through medicine. One, perhaps, best summed up by a senior geriatrician I once heard speak, who, when confronted with figures of public support for VAD, responded:
“That's why we're the profession. I mean we get paid $200,000 dollars a year to make these sorts of decisions. That's why the community gets it wrong.”
As a community we, rightly in my view, place great trust in our doctors and nurses. Rightly, because we ask extraordinary things of you – as you do of yourselves
But what happens when that position of trust is abused? What is the cost to the people you treat? What is the cost to your profession?
How do we get the ‘person’ to the centre of person-centred care?