Ask Virginia Ironside

QResponding to the woman who is being kept alive against her will (January issue), and as a retired front-line doctor, I cannot overemphasise the importance of advance decisions (ADS) and the need to make one’s views known to relatives.

The pressures on doctors are to push ahead with aggressive treatments with tube-feeding, CPR etc, and even intensive therapy unit admission; so these are now becoming part of a ‘natural death’.

And the ways we are now pretending that death is never going to happen are quite extraordinary. It’s clear just how undignified and brutal are last-ditch attempts at CPR – are we involved in resuscitation or resurrection? The recent Noel Conway decision (rejecting his request for assisted dying for his terminal illness) was expected but based in large part on the likely effect on those seen as ‘vulnerable’. How long will it be before any rejection of potentially life-prolonging treatment – currently a ‘right’ – will be seen in a similar light?

The good news is that a hospital has been fined £45,000 (money payable to the relatives) for insisting on a feeding tube and prolonging existence against the wishes of the very elderly patient, despite the latter not having taken adequate steps to make her wishes clearly known. We need more of such cases. It is all too easy to override an AD, particularly when some member of the family is pushing for treatment. Simon Kenwright, Kent

AThank you for your first-hand experiences. I might add that it’s also important to keep your AD up to date. One reader, armed with an AD, was told by her hospital that it was no longer valid and she had to wait till her husband recovered before he could sign a new one. By then, of course, it was too late.