PROBLEMS on which the general public may have a view, but lack the knowledge necessary to make an informed choice, are many. That addressed by Melanie Reid (Leave managing of death to the discretion of doctors, May 17), is important because, as she says, it can affect us all. But we do not leave all complex decisions to the experts. Should the decision on whether we start building new nuclear power stations be left to engineers and scientists, or be a public one?
In health matters this issue may become more common. Iatrogenic disorders, by which I mean those induced by medical, scientific or other intervention intended to improve health, are far commoner than they used to be. I would include in these the age-related conditions such as failing joints, failing eyesight, Alzheimer's, increased incidence of cancer, strokes, etc. A century ago, dying was a lot easier and quicker. Many were carried off by a short acute infectious illness, and those who before antibiotics lived their allotted span, had the old man's friend, pneumonia.
Intervention throughout life, from childhood disease vaccines to f lu jabs for the elderly, have all helped to keep us fit and well to much riper ages than formerly. It is welcome intervention but that extended life does come at a price. Most deaths now seem to be such protracted affairs compared with a century ago, Melanie Reid says that most are fated to end up wretched, and partners can be so overloaded that they end up wretched too. An agerelated, infectious, treatment-resistant, disease that sensed when our immune system was failing, would help, because it would be ethically acceptable, but there should be a ban on research to find a cure. The paradox is that the best time to go is when fit and healthy, just before the onset of severe terminal decline.
We must be careful in our terminology. Melanie Reid says that treatment should be perhaps withheld from those who have had a catastrophic stroke. I lost two siblings to such. My sister from perfect health collapsed into a coma from which she died in two days. It might have been better had my brother gone the same way, but he lingered on for a few months. He was conscious and could communicate with impaired speech, but needed everything done for him. I would have opposed any suggestion that sustenance should be withheld.
Chris Parton, 40 Bellshill Road, Uddingston.
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