The thought occurred to me this week - when did we become an either/or society? We seem to be becoming increasingly polar in our opinions, either Microsoft or Apple, iphone or Blackberry, books or a Kindle. Those are surely unsustainable positions. Why can't we acknowledge that there are elements of both which would work for us at different times. After all, when you buy a Kindle it's not like Amazon send a big skip round to your house and take away your existing book collection is it?
What sparked this off in me was attending a meeting of Healthcare Professionals for Assisted Dying (HPAD) at the Dignity in Dying offices in London. It was a good meeting, focusing upon how HPAD could inform the healthcare profession's debate around assisted dying and also support doctors and nurses in practical ways...and it changed my mind for me. Not in terms of being a whole hearted supporter of choice at the end of life but in terms of what we should be expecting from the Royal Colleges in terms of their guidance to practitioners. I admit that when the Royal College of Nursing adopted it's neutral stance towards assisted dying in July 2009, I was a little disappointed that they hadn't gone the whole way and come out in clear support. However Professor Ray Tallis made the point that neutrality is the obvious and most desirable outcome. Why? Because it's the only outcome that complete acknowledges the autonomy of the individual. This is not an issue to be controlled by healthcare professionals who set themselves up as gatekeepers, it's an issue that that cements the partnership between the patients and their health carers/providers. We need neutrality in order to encourage our professional organisations to provide support for healthcare professionals who both do and do not support this contentious question and we need neutrality to enable us to direct patients to the best sources of advice, whatever those sources may be. This is not about either good palliative care OR assisted dying, it is, what it has always been, about informed choice.
Finally, I was a little depressed to note that only 66 of HPADs 380 members are nurses. This despite the fact that nurses would argue that they spend more time with patients than doctors, they act as patient advocates and that some polls suggest that nurses are more open to a change in the law around assisted dying. Nurses care about this question so I would hope that more of them will join HPAD and make sure their voices are heard.
