Robin Mackenzie: Better information would make death so much easier for all of us

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Most of us don't die the way we would want to. On the other hand, none of us want to live in a society where we are encouraged to feel we have a duty to die.

There's a groundswell of people wanting to exercise choices in dying beyond euthanasia and palliative care options. Most of those seeking to legalise euthanasia focus upon allowing health care professionals to help the terminally ill, or those suffering unbearably, to die. Yet others may wish to commit suicide before they reach this stage.

What's stopping this, given that we may now set out to commit suicide without fear of prosecution? Well, the law treats as murder any acts intentionally leading to another's death. Potential law reforms which would make mercy killing a lesser offence than murder have not come to pass. It's the law's job to stop us killing one another, and health care professionals' job to heal us rather than help us die.

This is where we see the demedicalisation of death movement emerging. People want to know how they can manage to have a pain-free, peaceful and certain death without involving doctors or breaking the law.

Information is crucial here. Most ways people commit suicide now, like jumping in front of trains, taking overdoses or cutting their wrists, can and do go wrong. They are not pain-free, peaceful or certain.

So we need more responsible research upon which to make informed choices over end-of-life decisions. We need to find out more about the subjective experience of dying.

Consider recent research into the neuroscience of brain mechanisms, as in the announcement last week that a pill that switched off the brain's pain receptors had been discovered. This could change the qualitative experience of how we die. Developments like this show us the promise of enhancing the dying process. They also highlight the importance of responsible research into the range of possibilities over how we might die.

We don't know what we don't know about the subjective experience of dying. Without information, informed choice is impossible.

From a speech by Dr Robin Mackenzie, director of medical law and ethics at the University of Kent, at an Exit International workshop on Monday