Dying in dignity

Jun 30, 2011 Editorial

Death is inevitable. Every living thing on this earth will die but that is of no interest to people unless that living thing is a human being. Many of us could die from some terminal condition such as cancer, tuberculosis, leukemia or some of the many ailments that could attack the human body. In these cases death is painful. Most painful could be the period leading to death.
Some people have found the pain so unbearable that they have opted for suicide and there have been many such cases in Guyana.
Analysis shows that most of us will die in a hospital. There we would expect to be cared for right up to the last. And it is the hospital with its medical staff that should make our last days on earth as comfortable as they could be.
But within recent times, there have been complaints from the public that the nurses at the Georgetown Public Hospital are uncaring, that they offer shabby treatment to sick people. The doctors have not been spared the criticisms. More often than not, they do not tell the patient about his condition. And worse, they would say that they have done all they could and the best thing is that the patient goes home to die.
Many of us have seen the suffering. Sometimes the suffering is such that those around us cannot bear it and wish for our death. In the United States not so long ago conditions like this spawned Jack Kevorkian who was described as the Angel of Death. He helped people kill themselves.
The medical institutions had failed these people with the result that they opted to die among their loved ones who would be more caring than those in the medical institution. And they opted to die by their own hands.
But there are some among us who feel that dying should not be degrading; that people need not suffer pain. These are the people who are now seeking to make palliative care an integral part of the local health service.
Amazingly, Guyanese set great store by how their relatives live their final moments. People have been known to hire people to help their relatives yet many of these people who happen to work in the health sector do not transform the same level of caring to others in distress. It has become necessary now for people to effect the necessary training for something that was once natural.
But we should not be too harsh on the nurses who are more often than not the last people see before they leave this world. The system does not set store by emphasis on care for the terminally ill except for a few tubes and saline by way of feeding. The system does not stock large suppliers of pain killers.
About four decades ago Great Britain which prides itself on patient care began to recognize the importance of people dying in dignity. For example, the medical authorities there recognize that the way children see their relatives leave the world often impact on them for the rest of their lives. It was out of this recognition that palliative care became an integral part of the health care system.
It was also out of this reality that children are allowed to feature at bedsides of dying people who have been made comfortable.
Guyana saw its first palliative nurse about two decades ago but they have not been very active given that they are only three. Now there are efforts to make palliative care an integral part of the curriculum of nurses, doctors and even the other health care workers. Efforts are being made to have people visit their ailing relatives at any time to eradicate the shock of turning up and finding the patient dead.
At the same time, the drive is on for the medical institutions to stock up on painkillers. The Georgetown Public Hospital, for example, is hard pressed to find morphine, said to be the king of the pain killers. For one, it is considered a dangerous drug because of its highly addictive nature.
There is the fear that giving terminally ill people morphine and other highly addictive pain killers would turn these people into addicts. However, surveys have shown that such people do not become addictive to the pain killer.
The team, therefore, is pressing to have the government stock up on the kind of pain killers that would make palliative care a success. There is also need for a counseling service for those nurses who become traumatized at the death of a patient.
When palliative care becomes entrenched it will be another boost for the health care system.

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