Dying Death And After

A case for non-intervention

BMJ 1995; 311 doi: https://doi.org/10.1136/bmj.311.7021.1691 (Published 23 December 1995) Cite this as: BMJ 1995;311:1691
  1. David Fowler, emeritus readera
  1. a Mathematics Institute, University of Warwick, Coventry CV4 7AL

    In May 1994 I sent an expanded version of the following letter to friends and colleagues.

    “This will be a rather personal and serious letter, so please don't start reading until you have some time and calm to reflect on it.

    “On 9 January, at a peak of intellectual activity, emotional strength, and, I thought, physical wellbeing, I worke to a strange collection of sensations: I felt sick, my left eye was twitching strongly, and I smelt a strange sweet smell. This passed after a few minutes; then suddenly, some time later, I was sick. ‘Isn't the body a funny thing,' I thought and was going to leave it at that, until the same thing happened three times the next night. I went to the doctor, who sent me to a neurologist; I now take 300 mg of carbamazepine a day. I have had perhaps a dozen episodes and have been sick five times, but never since taking the tablets. These are all the symptoms I have had. The most inconvenient thing is that I am not now allowed to drive.

    “I also had some tests, and computed tomography of my brain showed a tumour inaccessibly deep in my left frontal lobe. This diagnosis is imprecise since it does not reveal the nature of the tumour. I might live out a natural span, I might not. A more precise but still not entirely reliable diagnosis would be possible by doing an intrusive biopsy. But, even with perfect knowledge, the range of treatments is limited, and these treatments will give only remission from symptoms.

    “We have of course discussed the situation with our GP, the consultant neurologist, and my brother—a consultant physician who is strongly concerned for his patients' quality of life. They all agree that, if we feel comfortable with …

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