Part three of our blog series on dignity in dying by Jan Ashton on preserving dignity by not artificially extending life.

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There is a missing element in debates around dignity and assisted dying– the fact that people’s lives are often artificially prolonged.

I come at this from a very personal perspective. My dad, Tom, is 96 years old. This time last year he was, with a little help from my brother, looking after himself, making his own meals and doing his own shopping in Morrisons. Now his dementia, which had been mild for a few years, has worsened so much that he is unable to walk, is doubly incontinent, seemingly doesn’t understand anything which is spoken to him, is violent and will punch hard when people come too close, his speech is just burbling, and he shakes so struggles to feed himself. He’s now in a nursing home for people with dementia who also have behavioural problems.

I’m glad Theos’ report argues that dying with dignity must mean far more than choice, independence and control – the three words the Assisted Dying campaigners sometimes say must be in evidence if a death is to be dignified. My Dad couldn’t die with dignity, on this definition, as he can’t let his choices be known; he has no independence; he has very little control – he often knocks his medication out of the nurse’s hand – the staff just find other ways of medicating him.

In lots of other ways, I am so thankful that Dad is being treated with dignity. When changing his pads, they will shut the curtains. Despite his punches, they try to shave him most days. They remember he has tea with sugar and when he thumps them, they are polite and say, ‘Please don’t do that.’

But in one major way, he’s not being treated with dignity. His life is being medically prolonged, a chance to die has twice been denied him.

Dad is a committed Christian and a mild–mannered man. In recent years he had spoken openly about it being time for him to join Dora, his wife, in the grave; he certainly believes heaven is a place to look forward to, a wonderful place to spend eternity.

The Nursing Home have a policy of not allowing anyone to die if their sickness is curable. So when my dad had pneumonia, he was taken to A and E and strong antibiotics given so he recovered. He had heart failure and his kidneys were failing so his GP was called in urgently and medication given and he recovered. My brother and I, having Power of Attorney for Health and Welfare, tried to ask that his pneumonia and kidney/heart failure were not treated and my dad to be made comfortable so that he can die. The staff seemed shocked that we asked for this. It was as if death was unthinkable and they would fail in their duty if he died.

Why is it so important that he is kept alive? Perhaps there is a fear of being sued for negligence. The training to care for people might mean that letting them die feels like a failure. I worry also that it is death itself which is the problem. That we are becoming death–phobic. Is it because there is no corporate belief in an after–life; life is now all there is and therefore, it has to be prolonged at all costs?

My other concern is the change I’ve experienced in my own views this past year. I’ve now filled in an Advanced Decision saying if I am incapacitated in any way, I want to die. And as dementia is now the number one cause of death in England, I worry that this refusal to allow death to happen is driving demand for Assisted Dying. If nursing homes can’t allow the death of very elderly people to happen in due course, I and perhaps many others are thinking we might need more radical action. In these cases I believe ceasing care at the right time is just as an important part of dignity as person centred care for as long as it wanted.

Dad 8 months ago with his great–granddaughter

Dad now