Intended for healthcare professionals

Feature Essay

The bench: reflections on an incurable diagnosis and control at the end of life—an essay by Paul Cosford

BMJ 2020; 371 doi: (Published 30 September 2020) Cite this as: BMJ 2020;371:m3716

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Demedicalisation: radically reframing the assisted dying debate—an essay by Lucy Thomas

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"Last rights" makes the case for assisted dying

  1. Paul Cosford, emeritus medical director
  1. Public Health England
  1. paulcosford{at}

Incurable lung cancer has prompted Paul Cosford to consider again his personal views on assisted dying

Perhaps it is the same for us all, whatever our age—if we know that we are approaching the end of our life, it is helpful to have a place of contemplation. I walk from the back door, along an old track and across the field that is the home of two familiar chestnut coloured horses. They raise their heads as I pass, and a poorly constructed wooden bench sits in the field beyond. It is perfectly situated for the view, which appears just as the path starts to descend a sandy ridge. Two rough planks, one to sit on, one for leaning, are fixed to the two decaying tree stumps that form its legs. It wobbles slightly but is strong enough for me to rest and ponder.

I am not an old man, but like the bench I won’t last long. I know that the incurable lung cancer, diagnosed three years ago, will end my life before many more years pass. But I don’t rail against the world as I sit on the bench. I’ve seen enough people die younger and in worse circumstances for that. I do watch the world go through its familiar cycles, knowing that I won’t see many more. The inquisitive lambs of spring, full of life then suddenly disappearing as their short lives end in the abattoir. The crops, subtly changing colour through hues of verdant green, then replaced by the bare soil of the ploughed fields after harvest.

I think about how the view …

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