Jayne Dowle: Death’s last taboos come out into the open

As in birth, every death is unique. I would never dream of pontificating one way or another. And by the same argument, the matter should not really become a political football, or used as a weapon in a moral crusade.

So while I am glad that this comprehensive new report by the Commission on Assisted Dying has been carried out, because it was long overdue, it still makes me feel uncomfortable to think that there has to be guidelines.

Once you start making rules, there will always be someone who disagrees, and this is where the trouble starts.

And let us not forget, whatever legislation is eventually brought in, in the middle of the debate there will still be individuals and families who don’t know which way to turn. Just because there are rules in place doesn’t make the decision on ending a life any easier.

Yet, I suppose that we are lucky, in that progress has been made. The stand-out conclusion is that assisted suicide should be legalised, but the person whose life is about to end is the one who should make that irreversible decision.

In effect, what this does is to prevent the possibility of anyone playing God over another person. The individual at the middle of it, literally, takes their life into their own hands.

And we are lucky too, because what this Commission has also done is to bring the last taboo – death – into full-scale public discussion. It is not the jolliest of water-cooler topics, but we’ve all been provoked into wondering and talking about something which most of us would prefer not to engage with. You can’t get away from it on the news. You can’t avoid the questions your children ask you about it. And you can’t help but think “what would I do in that situation?”

It amazes me that we live in a world where so many individuals are quite happy to go on television and give birth, or show off their most revolting health problems, or demonstrate the intimate details of their sexual prowess, yet if you asked many of them to contemplate death, they would shy away in fear and disgust.

How many of us have actually even made a will? Taken an hour so out of our busy lives to put down in writing what we want to happen when we go? I finally have, and it is a strangely liberating experience. It also makes you feel incredibly grown-up.

I am glad that this debate has helped us to tackle that fear which our grandparents and great-grandparents looked in the face. If you grew up with high childhood mortality and poverty and dangerous industries and war, you couldn’t afford to be squeamish.

When I did a book about the former mining village where I live, I was amazed to find one story, about a local lady who worked – voluntarily – as both the midwife and the “layer-out”.

In the days when not everyone could afford all the services of a funeral director, she would go round, dress the body in a shroud, and lay it out, usually in the front room ready for burial. This is in living memory, mind.

How things have changed indeed. However, as the growing debate around assisted dying proves, I sense change in the air again. Last year, when my friend’s husband was terminally ill with several inoperable brain tumours, he blogged about his day-to-day experiences until he became too sick to do so.

And when this happened, his wife took over, updating the world via Facebook as his condition deteriorated. No doubt, this approach shocked a few people, but being so open about what was happening helped to raise awareness of a condition which is still largely misunderstood. And it certainly made us all think.

Even 10 years ago, when we lost my uncle to cancer, no-one openly discussed “end of life care”. But now I have another friend, a nurse, who specialises in this. It fascinates me that she can sit down and devise a programme with someone about how they are going to manage their own death, surrounded by the people they want to be beside them, with the pain relief and special things they want in place.

The people my friend looks after are the lucky ones though. Usually, they are ending their days in their own homes, in as much comfort as possible. As well as laying down recommendations for a clear legislative framework, this report also calls for better end-of-life care in hospitals and hospices, and more open discussion about death.

Amid all the debate, I only hope that this is what happens. There are not many things guaranteed in this life, but one thing is certain – death will happen to us all. The sooner we acknowledge that, the more we become in control of our lives.