YOU (South Africa)

ASSISTED SUICIDE: ANOTHER VIEW

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We recently came across the article about the South African mom Carol de Swardt, who elected to go to an assisted suicide clinic (YOU, 30 November). As palliative care-trained medical doctors, certain comments in this article were of concern to us.

A fellow colleague tried to reach out to Carol but all attempts at communicat­ion with her were unsuccessf­ul.

A major concern is that this article makes assisted suicide appear as a heroic deed, that she had no other choice. The implicatio­n is that this option is the only one to be considered. We would like some other factors to be highlighte­d.

In an age where our bodies are held in such high esteem, it is important to remember that as humans, all our bodies will age and fail us at some point, but that is not what defines us as human beings. We are so much more than just physical bodies and in the exact words of this patient Carol, “That woman is still here inside me.”

Palliative care tends to the whole person physically, psychologi­cally, socially and spirituall­y. Her body was failing her but what about the rest of her? Carol says she wasn’t depressed but just deeply unhappy. What did “deeply unhappy” mean and what help/advice would an organisati­on like SADAG (South African Depression and Anxiety Group) want to offer someone who is deeply unhappy.

All medical practition­ers have a duty when faced with someone who purposeful­ly wants to end their life, to do everything possible to assist the person in their desperatio­n – with the intention to help them not to end their life, because we recognise every person has inherent value and dignity, no matter their situation or disability. It is in this context that helping someone to end their life because they have a disability implies that their inherent worth is less than others’ because of their disability. Assisted suicide is a permanent irrevocabl­e decision from which there is no coming back. As doctors we frequently bear witness to patients changing their minds regarding options of treatment chosen depending on a myriad of changing factors.

Palliative care aims to bring relief from suffering, which is achieved in most patients. It is hard not to question why Carol was in so much pain that she could hardly go anywhere. What palliative care was she offered?

We feel that this article glamourise­d assisted suicide with comments such as, “I’m going to eat Swiss cheese and drink beer and then I’ll go to the clinic”, and by advertisin­g where it was done and the cost. Medical profession­als are prohibited from advertisin­g services and yet this article publicises the cost of euthanasia.

In a country like ours, every cent and breath should be spent on advocating for profession­al, well-thought-out care and support (including comprehens­ive palliative care) for individual­s such as Carol and her loved ones, as opposed to advertisin­g internatio­nal, overseas assisted suicide.

Could a team of palliative care profession­als have helped Carol so that she did not find assisted suicide her only option?

We will be left wondering if it could have been different for Carol.

DR JAYNE CUNNINGHAM, PROF LOUIS JENKINS, DR JULIA AMBLER, DR ZANE LEFF AND DR TERESA SWART, EMAIL

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