The most important End of Life choice

Recently I went to a show in the Edinburgh Festival. It was the first thing I had enjoyed for a long while, whether live or on TV. Most offerings are destroyed by my declining abilities, especially the ability to discriminate. Sounds, tones, words, colours, faces. I have to put too much effort into distinguishing the faces/actors, catching the words, working out what is going on. 

On dog walks I have met an increasing number of people who are caring for 90-year-old relatives, some of whom have dementia. It seriously destroys their lives. I've not seen a neighbour across the road for several years now although there are people, presumably carers, visiting her flat. She is presumably locked up in her flat waiting to die.

A friend, with a keen interest in end-of-life choices, was partially blind and could only eat soup. He felt he was approaching a time when he would no longer able to enjoy his music. Clearly not a satisfactory lifestyle ... but nowhere near eligibility as a candidate for medically assisted dying. He assembled what he needed to bring about his own death. How many people have the energy to do that?

So my question is: 'How many people are there out there who would exit this world if they had the means to do so?'

I have made several attempts to get a Scottish Cross-party Parliamentary Group to engage with this – seemingly the most important 'end of life choice'. But there is a distinct unwillingness to do so. I checked Age Concern and found that it is precisely not concerned with this issue of age, of our age. 

I wrote to my friend, who has carried out international research in this area, to share how I was feeling and to ask if he knew of any kind of survey which would give an indication of the numbers. He replied that he did not know of any. He's reluctant to share his own dissertation at this stage. However, in 2020, he did publish a 'think piece' in which he underlines the serious tension between the general principle of protecting life and the need to facilitate the death of individuals in certain circumstances, and explores how this plays out within the legal and bureaucratic systems of different countries. 

I tried another friend who is conducting a longitudinal study of ageing using standard psychological tests. Same result, but, in his reply he underlined the importance of having some study in this 'extremely important but sensitive area' and noted that the likes of Dignity in Dying tend to be preoccupied with medically assisted dying for the terminally ill.

Making such a choice is fraught with difficulties. It is not illegal to assist someone to die in Scotland, provided one does not actually push them over the edge. The hazard is that the police are inclined take it upon themselves to investigate whether one might have some ulterior motive for proffering such assistance – and this can lead to considerable stress for those concerned and their families. The same fate is liable to befall those who assist someone to get to Dignitas in Switzerland, even though this organisation is primarily concerned with the terminally ill.

But in any case, my interest goes beyond the terminally ill. I simply want Psychologists to engage with the question: What research is there, if any, on the numbers of older people who are finding life a struggle and not enjoying anything? What are the difficulties encountered, and the choices available?

John Raven
[email protected]

If you are affected by any of the topics covered in this article, please contact the Samaritans anytime for free on 116 123, or you can email them at [email protected]