Death from motor neurone disease can be peaceful

BMJ 1995; 310 doi: https://doi.org/10.1136/bmj.310.6992.1466d (Published 03 June 1995) Cite this as: BMJ 1995;310:1466

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  1. David Oliver
  1. Medical director Wisdom Hospice, Rochester, Kent ME1 2NN

    EDITOR,—Peter Millard's review of “Death on Request”1 raises several questions about the illness of Cees Van Werder de Joode and its “management” by euthanasia. From the film it appears that Cees was offered euthanasia as the alternative to a death from motor neurone disease when he would “probably suffocate” and “suffer terribly.” However, palliative care offers an alternative to these extremes, and symptoms can be controlled so that death can be peaceful. A large survey of patients with motor neurone disease at St Christopher's Hospice showed that choking and suffocation do not occur.2 A patient with motor neurone disease and his family can be helped to find the positive aspects of their life and can be helped to live until death comes naturally.

    The programme may have encouraged further debate on euthanasia, but it showed a one sided approach to the care of terminally ill patients and perpetuated the myths of the distress of dying, in particular of dying from motor neurone disease. The Motor Neurone Disease Association has been encouraging discussion about the fears of dying and providing information about the care of patients as death approaches. Their Breathing Space Programme has provided leaflets for patients and professionals to facilitate discussion of these fears and the positive ways to alleviate these concerns. This discussion may lead to the provision of medication for use in an emergency, and the Breathing Space Kit can be provided to store this medication and to give details of its use for everyone involved in the patient's care.3

    Euthanasia is an issue that needs to be discussed openly, but a film like “Death on Request” may confuse and frighten, epecially when further information is not immediately available at the time of the broadcast. A round table discussion at 11 15, when many of the viewers will have switched off, is insufficient.


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