I have had several chronically ill patients talk to me about the distress hearing these horror stories has caused them. There is a need for good quality supportive and palliative care for all patients, and having conversations on the natural dying process rather than scaremongering
@doctoroxford.bsky.social's article was very helpful for me, too. I appreciate that the body horror aspects are vividly real and relevant, but that measured view was very much appreciated.
This is a fantastic piece. You have described very accurately what went on in my mother’s last moments, and set out very carefully and compassionately the key issues. Thank you!
I confess that I had to steel myself just to start reading your article, being very frightened myself of what to expect at the end, whenever that may be.
Thank you for setting out your explanations and experienced perspective, I have found it very helpful & reassuring.
I held my sister’s hand when she died 21 years ago, and it was a beautiful, peaceful moment. My 91 yo mother is currently in her last days and I’m hoping her passing will be the same.
Thank you for such a beautiful piece.
Thank you Rachel. Yes, when my father died in a private room in Southmead Hospital in Bristol it was just as you describe. I was there with my mother and we were quietly talking about nothing, thinking, hoping he could hear us and be comforted. And a blackbird was singing in the tree outside.
Maybe most of the deaths you see are nice ones *because* you're a palliative care doctor?
Or maybe you are so used to deaths that you don't see what the relatives of the dying person see, in cases where people are unfortunate enough to not slip away in their sleep?
It's nice to read this, but it's not my very limited experience. My dad died of lung cancer, in my house. There was nobody medical with us. We were just left to it, with no guidance about it.
He did drown in his own fluids, & it was long and horrific, and the midazolam he was given didn't help. It didn't sedate or console him. The drugs did not make his death any less terrifying for him. He simply fought it with his whole body until he didn't have enough energy to take one more breath.
I've seen you describe deaths like his death on X, as if they are ok & normal.
But it wasn't ok, & it shouldn't be normal. I know you agree.
But I don't think telling people their relatives will slip away nicely in their sleep helps. Lots of people DON'T die like that. Let's talk about that.
This reflects my experience with my grandad. I feel so privileged to have been with him at the end and as a family we don't shy away from talking about death. It's a shame that isn't a cultural norm in this country because talking definitely helps to remove uncertainty and can bring people closer.
This is a wonderful article, we all need to discuss and talk about the inevitable far more often than we do.. I also recommend ‘33 meditations on death’ by David Jarret.. one of the most life affirming books I’ve ever read..
But the point is that there is still people who suffer and why should they? The bill is about giving a choice. Both palliative and assisted dying can coexist.
my piece isn't addressing the arguments for or against AD, it's about looking at, not flinching from, the one thing that will occur to us all, in some shape or form, because I have seen how much avoidable fear & distress the taboos around dying can provoke in patients.
Good quality palliative care isn't always available. My greatest concern is that assisted dying will become the alternative to hospices and dedicated palliative care wards.
I worked as a ward volunteer in a hospice for over 20 years and saw what a good death looks like. We're still a rich country and good deaths should be the norm whenever possible. I know there will always be exceptions.
There are many layers to dying that we didn’t know and wish we knew before experiencing it with MIL and FIL. FIL was easier as it was in hospital but MIL was awful and we were let down partly by palliative care at home and district nurses.
An excellent article.
I've sat beside a few people as they lay dying. My worst experience was when my sister in law screamed at me that I hadn't alerted her when an aunt (unconscious when I arrived) died in my presence. As if it were my fault. Insensitivity at such times leaves the greater wound.
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Thank you for setting out your explanations and experienced perspective, I have found it very helpful & reassuring.
Thank you for such a beautiful piece.
Or maybe you are so used to deaths that you don't see what the relatives of the dying person see, in cases where people are unfortunate enough to not slip away in their sleep?
But it wasn't ok, & it shouldn't be normal. I know you agree.
But I don't think telling people their relatives will slip away nicely in their sleep helps. Lots of people DON'T die like that. Let's talk about that.
Unfortunately, the care during her multiple hospital admissions was awful.
I've sat beside a few people as they lay dying. My worst experience was when my sister in law screamed at me that I hadn't alerted her when an aunt (unconscious when I arrived) died in my presence. As if it were my fault. Insensitivity at such times leaves the greater wound.