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Thursday, December 20, 2007

Can people simply decide to die?

Recently, I wrote about "deathcat" - a cat named Oscar with a very good record for predicting when patients in a nursing home were within a few hours of death.

Of course, Oscar's human friends were elderly patients suffering with dementia, and nothing was being done to prevent them from dying, so he probably picked up vital clues by scent or some similar method. But what about people who just die when they are ready, in the full knowledge that it is time to move on?

That does happen, according to coronary care physician Hugh Montgomery, who gives this year's Royal Institution's Christmas Science lectures in the UK.

As Stuart Jeffries reports in The Guardian (December 11, 2007),
He tells the story of a church organist he treated. "She had a condition which meant she had to be on a drip, but she kept pulling it out. She told me: 'I don't want a drip any more.' I said: 'Your chances of surviving are very low if you don't keep it.' But she told me that Jesus was waiting on the other side and was calling her. She was with her husband and so I said: 'If you're both comfortable with that, do that. I can give you pain relief.' As I got up to go she said: 'Aren't you going to kiss me goodbye?' and so I gave her a kiss and left. Moments later she was dead.

"What I have found again and again is that dying patients hold on for a loved one to arrive - say for a son to get the visa to fly to London and see mother in hospital for one last time. My father, who was unconscious in hospital for the last couple of days of his life, died at the rare moment when we - my mother, sisters and me - were in the room at the same time."

A number of palliative care physicians have told me similar stories. One even went so far as to say that people in their nineties can die pretty much whenever they want to, by ceasing to try hard to remain alive - which makes sense, when you think about it.

Montgomery's thesis is certianly consistent with the basic hypothesis of The Spiritual Brain that the mind is real, and not simply the buzz of neurons in the brain. But the main thing to see here, in my view, is how much we actually mean to each other - that is, how much we promote - or diminish - each other's survival. Good thing to keep in mind during the holiday season, which often stresses relationships.

There is much else of interest in Jeffries' article, including a discussion of relative mortality rates among grades of civil servants. Highly recommended.

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