Opinion: The dying deserve a voice before death

Peter Cardy, chief executive of Macmillan Cancer Relief

"I thought Macmillan only provided nurses for dying people," said the cabbie after I told him about the breadth of our work for those living with cancer.

It's a common misconception - almost 50 per cent of the hundreds of people diagnosed with cancer on the day you read this will still be alive in five years' time. Of course, this also means that more than 50 per cent of people diagnosed with cancer today will be dead, despite progress with treatments.

The common first question after hearing the 'C' word is "how long have I got?" If we talk only about living, where will people turn when the dread of dying from cancer becomes a reality?

The debate about rights at the end of life, including the right to die, will soon break back into the public arena. Lord Joel Joffe's Bill to permit doctors to help people end their lives will return to Parliament after the House of Lords committee report. In expectation, the pros and antis are sharpening their arguments. The terms of debate seem to have changed in the past few years, not least because the debate can take place at all.

Although the doctors' and nurses' bodies have changed their stances somewhat, vested interest will still make the most noise. In previous rounds, the medical and legal professions have filled most of the airspace, with the rest occupied by the tabloid press screaming "mercy" or "murder". I recently heard a representative of the British Medical Association deliver a speech about end-of-life decisions that came entirely from the point of view of the doctor. Pardon me, but whose lives are we are talking about?

Where, in all this babble, is the voice of the person soon to die? Unheard, it seems, and unasked. According to the Voluntary Euthanasia Society, 81 per cent of the public want the right to a merciful death, yet it's obvious that our views when we don't expect to die soon differ from those when we do.

Tens of thousands of people die every year in what we would consider distressing circumstances, with powerful and toxic drugs legally at hand for treatment or pain relief. Yet hardly any use them to take their own lives. A shift in priorities takes place as death approaches - a shift that medicine, the law and the media do not understand.

Macmillan is not agnostic about this - we argue passionately that the small and fading voices of the dying should be heard and understood before any change in the law takes place.

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