A good deathBMJ 2000; 320 doi: http://dx.doi.org/10.1136/bmj.320.7243.1205 (Published 29 April 2000) Cite this as: BMJ 2000;320:1205
Sharing control in death: the role of an “amicus mortis”
- James Grogono, consultant surgeon. ([email protected])
- South Buckinghamshire NHS Trust, High Wycombe, Buckinghamshire HP13 6PS
- CHIME/Department of Primary Care and Population Sciences, University College London, London NW1 2DA
- Department of Medicine for the Elderly, Poole Hospital NHS Trust, Poole BH15 2JB
- University of South Australia, Magill, South Australia 5072
- Ysbyty Gwynedd, Bangor LL57 2PW
- University of Wales College of Medicine, Cardiff CF14 7XL
EDITOR—May I offer one further ingredient to a good death as discussed by Smith in his editorial1 —having an “amicus mortis,” a friend at death. Most items on his list of principles use the word control or imply it, yet the very process of death entails losing control. Control of strong drugs is especially difficult for the one who is dying. An amicus mortis makes it easy. I wrote the following within days of my wife's death from cancer four years ago, and it was read at her funeral.
“Towards the end I was given the privilege of care. I don't want to belittle the role of the care team. None the less, I was the lucky one in charge, especially at night, and my task was an easy one, aided by small doses of morphine towards the end.
“She had no pain, no distress, no loss of dignity, no catheters, none of the things my patients in hospital have to put up with. In the last week our nightly family parties had to be in her room. Her last hours were tranquil.”
The role of amicus mortis is life enhancing, and there should thus be no shortage of supply. I had a further small dose of being an amicus mortis at the end of last year when my father died. My older brother, enviably in full retirement, played the main part. He closed down his home in the Carolinas for a couple of months for the purpose. He endorses this view.
The chosen person must have time and love and prescribing power. Perhaps it is an unfair advantage to have a doctor-husband or doctor-sons available, but prescribing power can easily be delegated, and the other attributes are just as important.
I fully agree with Smith that there is …
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