The Standard Group Plc is a multi-media organization with investments in media platforms spanning newspaper print
operations, television, radio broadcasting, digital and online services. The Standard Group is recognized as a
leading multi-media house in Kenya with a key influence in matters of national and international interest.
One of my colleagues recently faced the death of a dear family member following a rapidly progressive terminal illness. It wasn’t easy for anyone in the family, but they dealt with the terminal disease in a very pragmatic way. They understood that a terminal illness cannot be cured or adequately controlled, and death was inevitable within a short period. In medical timelines, one is considered terminally ill if they are expected to die within six months, even though this is an arbitrary estimate and is rarely accurate.
Once a terminal illness is diagnosed, the realisation of impending demise introduces a whole range of reactions in individuals and family members. You will go through various stages of acceptance, ranging from disbelief to extreme anxiety, shock, despair and anger. Individuals diagnosed may slip into depression, and this may last throughout the illness. The end goal is to find some acceptance of the diagnosis and the eventual inevitability of death.
Decisions on the medical management of terminal illness must be carefully considered. As cure or adequate control of symptoms are unachievable, the focus then must be directed at easing suffering, such as pain, ambulation, feeding etc. Aggressive treatment in the hope of an unexpected cure is usually futile. Similarly, this includes the blind pursuit of unproven therapies, which may range from herbal to complementary treatments. Resorting to palliative care to relieve symptoms and improve quality of life in the last days is a more practical approach.
More controversial end of life options are increasingly in the limelight. You may have heard of mercy killing, known as euthanasia in medical terms. This is the practice of medically assisted suicide in terminally ill patients to prevent prolonged suffering. Euthanasia has gained more acceptance and is legally permissible in some countries. Various forms of euthanasia are available, ranging from self-administered lethal medications to physician-assisted suicide in euthanasia clinics.
The decision to end anyone’s life whilst faced with a terminal illness is not easy by any means. It must be well thought out in advance. Loved ones may find it hard to accept such a choice, but they may also get some relief once the suffering of the affected individual comes to an end. My colleague’s family accepted the inevitably of their loved one’s end point. They guarded against futile treatments, only allowing less interventional palliative efforts. Families and medics must resist the temptation to subject terminally ill patients to all sorts of ill-advised treatments. This only prolongs agony to those affected and gives false hopes to family members, eventually leaving them with unwarranted medical bills.
Dr Murage is a Consultant Gynaecologist and Fertility Specialist
join