At Exit, we are sometimes approached by people who tell us that their palliative care is the best. But, like Angelique, they still wish to be in control of their death. They say that while they might not be in pain right now, the quality of their life is seriously affected by their illness. They know that there is often nothing that modern palliative medicine can do about it.
Some of these people are so weak that they cannot move unassisted. Others have shortness of breath which makes independent living impossible. For a significant number of people, it is non-medical issues that have most impact upon the quality of their life.
One memorable case concerned a middle aged man called Bob. Bob was suffering from lung cancer. He was incredibly sad that his favourite past time - a round of golf with his mates - was no longer possible. This person was clear. It was his frustration at being house-bound and dependent on visits from friends and family, rather than the physical symptoms of the cancer, that made him choose an elective death.
While palliative care has a valuable contribution to make, this branch of medicine is not a universal panacea. It remains unhelpful to use symptom management as the benchmark against which a person’s quality of life is measured.
Rather, people rate their quality of life in different ways with no two individuals’ assessment the same. While a life without pain is clearly better than a life with pain, this is not always the most important issue. Instead it is a person’s own individual, complex assessment of their life’s worth that is the key. The physical symptoms of an illness are often only one of many considerations.