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‘Patient choice is not just about evening surgeries’

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There are some things one should steer clear of if writing a column at the back of NT. While I think Kerry Katona, public spending, the corrupting influence of the swiss roll, the myth of mental illness and the nonsense that is the internal market seem to me entirely appropriate things to chat about, some things are best left alone. These include football, which one is Ant and which one is Dec, and assisted dying.

There are reasons for this. This is not, and never has been, a football magazine – even when they let David Beckham guest edit the wound care supplement. I happen to believe Ant and Dec are computer-generated and, most importantly, some subjects are too complex and sensitive to put at the back after the jobs. Probably.

But last week, with the news that 23-year-old former rugby player Daniel James, who following a training accident had been paralysed and in constant pain, had travelled to a Swiss clinic to end his life, the debate about assisted dying resurfaced. His mother has defended his decision and urged people not to judge him. And who are we to judge anyway? The wretched throbbing grief his family must be experiencing can only be slightly eased by the knowledge that their son is no longer in pain but they have nonetheless lost their son.

Shortly before the news about Mr James broke, I was teaching a session to nursing students on patient-centred care and we wondered what a word like ‘choice’, which has been rolled out by policymakers, means when we construct care around so many protocols and pathways.

Because we know, don’t we, that one of the reasons ‘choice’ remains a hollow illusion in the health service is because we retain the role of expert, which isn’t completely unreasonable. We choose the protocols and the drugs and the treatment and the rehabilitation and the way the clinics are set up, and we choose the moral backdrop to what is and is not acceptable.

But if choice was ever to become the very heart of the modern health service then the right to choose to die – if living is unbearable and the mind that constructs the decision is ‘well’ – will have to be addressed.

We can’t celebrate our progressive health service for offering the choice for evening appointments or a selection of brightly coloured duvets but ignore the choice by the patient to end their interminable suffering. And I am not here suggesting we should legislate for assisted dying, frankly, I don’t think we should. But if we are going to take choice seriously then we have to at least acknowledge what it means and start having some serious discussions about what doing the ‘right’ thing might look like.

Want to read more of Mark Radcliffe’s opinions? Just click on the more by this author link at the top of the page.

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