Is it politic to target terror of death?

Charles 12 Comments

According to the BBC, the UK is falling off the pace in the international race to live forever. There may be a measure of national shame here. In a table of 18 countries we stand at #11 behind Greece.

Spain is top. Spaniards enjoy an average of 70.9 years of healthy life. Finland is bottom. Finns eke out a paltry 67.3 years of healthy life. 

What’s chilling (perhaps) is the number of, by implication, ‘unhealthy’ years that follow. In Spain, it’s 10.5 years. In Finland it’s 12.8. In the UK it’s 11.3 years. But the report does not linger over these dispiriting figures. 

Instead, it highlights can-do-better-must-do-better declarations from the health police. According to them, we smoke too much, drink too much and eat too much. Says Health Secretary Jeremy Hunt, sounding stung, “For too long we have been lagging behind and I want the reformed health system to take up this challenge and turn this shocking underperformance around.”

The prize is sizeable: ‘30,000 lives a year could be saved if England performed as well as its European neighbours’. 

What a fascinating verb that is. Saved. 

When what they mean, of course, is extended a bit. 

Is it a good idea, one wonders, for the public health quangocrats to incentivise us to look after ourselves better (and save them money) by targeting and exacerbating the terror of death? There’s a little bit more to cause of death than self-indulgent lifestyle choices — which is why everyone born in the year 1890 is now dead. 

Apart from anything else, there’s another costly quango tasked with undoing all this terror in the interest, again, of healthy attitudes (and cost saving). It is called Dying Matters, and it is ‘committed to supporting changing knowledge, attitudes and behaviours around death and dying, and aim[s] to encourage a greater willingness to engage on death and bereavement issues.’ 


  1. Charles

    I listened to these reports yesterday and was struck by the new measure you highlight here – the years of ‘healthy life’ that we can expect to enjoy. I think we should hear a lot more about this.

    It’s worth pointing out that the overall figure for life expectancy – because it is an average of all deaths in a country – owes more to the numbers of early deaths than the great ages some people reach. It’s the premature death rate that really counts, and in the UK that’s not improving.

    What stands out for me is the fact that there are only small differences between countries in the period of ‘unhealthy’ life we can look forward to in our last few years. They can stop us dying young but, all over the world we are lingering on for much the same period of time. Perhaps we need a new quartet of horsemen to stalk us – Dementia, Diabetes, Drugs and Despair – before ever Death and his chums appear on the scene.

  2. Charles

    Can anyone answer a question: what proportion of NHS funding is spent on extending an elderly or a very ill person’s life by a few days?

    That isn’t to dismiss the value of a life, but resources, as we keep being told, are limited. Just at the anecdotal level, I know a few people with cancer who have said “no more chemo.” It helped them to a certain point, but as the search for some effective drug got increasingly desperate, they simply pulled out, and focused on the quality of the life they may have left. I salute them. Spending thousands on prolonging a life that by then is scarcely a life? Is that what we are doing?

    No-one underestimates the agony families go through around such decisions, or how difficult it must be for doctors, dedicated as they are to saving lives at all costs, but there surely comes a time when enough is enough.

  3. Charles

    The accepted ballpark figure is that 50% of healthcare costs come in the last year of life. But we have seen ‘go gentle’ initiatives like the Liverpool Care Pathway beasted as a front for cost-cutting and the spectre of death panels is never far away.

    The grown-up conversation has a long way to go.

  4. Charles

    My terminally ill mum was persuaded to have radiotherapy for palliative reasons. An ambulance picked her up from one hospital and took her to another. On the third day of treatment, the ambulance driver wouldn’t wait five minutes for mum to finish her lunch. She’d been looking forward to her chocolate pudding. It’s the little things that hurt when you watch someone you love dying.
    She died a week later. The radiotherapy tipped her over the edge and seemed to do nothing to help the pain.

  5. Charles

    The insinuation of a lot of blogs and comments lately is that euthanasia is better than good palliative care. When celebrities like Will Self state they would rather kills themselves than suffer, that is given the newsworthy status of an expert pronouncing on the subject of suicide/assisted suicide. Having just had a positive response for a post (Robert), I’m now going to make myself unpopular again by stating that I think euthanasia is massively misguided.

    Labour peer Lord Falconer is to launch his fourth bill in the House of Lords this May seeking to legalise assisted suicide, says the website of Dignity in Dying (formerly the Voluntary Euthanasia Society).

    He will push for doctors to be given the power to help mentally competent adults with less than one year to live to kill themselves.

    His last three attempts failed due to concerns about public safety after alarming reports about ‘incremental extensions’ of the law in Belgium, the Netherlands, Switzerland and the US state of Oregon.

    There are additional worries today about the effect the recession is having on vulnerable people and healthcare provision – increasing concerns that any change in the law would put added pressure on elderly, sick and disabled people to end their lives.

    Professional medical bodies and disability groups remain firmly opposed to a change in the law.

    The bill will likely get short shrift.

    1. Charles

      Joining you off piste- I don’t think we need to kill people RR, just learn how to let them die in peace. We’re not very good at that in our wonderful NHS. There does seem to be a throw everything at them policy no matter how sick, old or terminally ill they may be. As you say good proper palliative care is the answer… More of it, more hospices, more time, more listening, more care, more peace.
      Kitty’s mother would have been better served had she been able to enjoy her chocolate pudding in peace rather than be bussed about for a final bash at radiotherapy…
      I have a friend who has been told he has months to live, and was immediately admitted to an isolation ward for intensive chemo. The implication is that they need to be speedily ‘aggressive’ back at the aggressive cancer. I feel there wasn’t much counselling in the decision making process…He is feeling afraid, lonely and abandoned apart from staff visits to administer his chemo regime. The food is crap and he longs for his own bed, armchair and family round him. Is he to spend his last weeks waiting to die while the doctors pretend that they can extend his life for more torture? He’s too scared and fragile to walk away …. because they are telling him to fight- over the top it is then. He wouldn’t choose euthanasia but I feel he isn’t allowed to choose to live his precious life remaining on his own terms either. So so so much more to be done.

  6. Charles

    More likely to make yourself unpopular by going off topic, Richard! The principal theme here is that govt health warnings target and exacerbate terror of death, an emotionally unhealthy mindest — which then all has to be undone by a separate expensive quango.

    I think what comes out of all this is an awareness that our lives are being protracted in ways which are intolerable. Euthansia/mercy killing is an extreme means of dealing with this. Less buggering about from doctors would help, together with an awareness that death is not an avoidable fate brought on by losers who’ve made wrong lifestyle choices.

    As Richard points out, the big issue is the number of unhealthy years we must look forward to. I’d be tempted to adopt even more lifestyle blunders to avoid them. Actually, the record shows, I have!

    Longevity is not all it is cracked up to be and should not be pursued to the detriment of quality of life. In my ‘umble.

  7. Charles

    Sorry, Charles, I see now I was off-message. Written in haste after dinner involving a glass or two. Not about living too long but about the likes of Jeremy Hunt telling us how to live longer by being health junkies. I totally agree longevity is not a trade for quality of life.

  8. Charles

    “For too long we have been lagging behind …” “underperformance…”

    Is his language suggesting that it’s every citizen’s duty to outlive the competition? That the world is in danger of being overrun by foreigners? That Britain will look stupid? Or that he’ll lose votes? Or that the National Illness Service will lose cred?

    What the hell has politics to do with human life expectancy? Butt out, Hunt, you’re only a health secretary, not a healer.

  9. Charles

    You are so right, Charles, to say that this particular grown up conversation has a long way to go. We haven’t even got the sub-dvisions and the language comfortably under our belts yet….

    Eating, drinking and smoking too much will kill you? Too much for whom? And who’d have thought it. We’re going to die.

    So living healthily doesn’t kill you then? I’ve walked behind a lot of fitness fanatics, healthy people and people who, by following Government thinking should have lived for ever. Came as a bit of a shock when they didn’t.

    For me, I don’t want my allocated 10/11 years of declining health and poor life-quality unless it’s bearable. Neither am I going to take the pills at the first signs of decline. If that were the case I’d have taken them when I was forty and my big toe became arthritic. But I WILL know when I’ve had enough and I would like to live in a world which accepts that it is MY choice, not that of doctors or governments how long I should live.

    I don’t want to face my last week like Kitty’s mum. I want good palliative care and a route out when it’s too much.

    Richard, is it possible you went slightly off piste as a result of wetting the new Pope’s head? Always worth a read however off piste you are.

  10. Charles

    On the back page of this month’s EXIT there is a quote by Albert Einstein.

    I want to go when I want. It is tasteless to prolong life artificially. I have done my share, it is time to go. I will do it elegantly.

    Which he apparently said after refusing surgery. He was 76.

    Charles, Ken West has written an article for me on this subject for the next edition of More To Death magazine. I would like to add your take on the subject, from the GFG’s perspective, considering the contents of this conversation. Please?

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