Assisted Dying: The day my father told the doctor he wanted to die
As liberal societies struggle to give life the value it deserves, Islam provides clear guidance in the chaos of serious illness.
I can’t quite remember what I was doing when the doctor called to tell me that my father had expressed a wish to be sent home from hospital to die. She then proceeded to tell me that considering his condition that he would in her words “last a few weeks or a month” and would eventually die. She was very nonchalant and matter of fact about the whole thing.
This came as a bit of a shock. My father was very ill, he had been hospitalised for over a month and despite the usual ‘Do Not Resuscitate’ (DNR) procedures the NHS feel obliged to remind you about every other day there was no speak of him dying anytime soon.
I knew my father wasn’t in the best of moods because earlier in the day as I had made my routine morning visit he had told me there was no point in me being there if I wasn’t going to do anything for him and that I should go and not bother coming back. I knew what he meant but it was out of my control, I will come back to this.
My plan had been to go back later in the day and send my wife in first as cannon fodder to pacify the situation whilst I pretended to find parking, it was a tried and tested method.
My father had been admitted a few weeks earlier having fallen on the way back from Pakistan. He had subsequently developed other complications to the point where his digestive system had stopped working. Due to this he had been nil by mouth (meaning no food or water) on and off for nearly a month, he was only allowed to wet his lips with water but not drink anything.
Throughout this time he never complained once, for someone who would eat anything it was a big ask to be this patient. He had lost 10kg or more of body weight and in recent days he had become more withdrawn, not saying much. I would struggle to bring up conversations which were somehow not going to lead to the inevitable mention of food. It’s amazing how many conversations involve food.
By this point I was also at my wits end from the first day my father had gone into hospital it was an uphill battle with the system. There was the initial obsession with getting him into a care home upon his release, the lack of information, the hours of waiting around to see a doctor, the constant worry about what was happening. Anyone who knows me knows I can argue better than anyone but the NHS is such that even I had reached my limit.
My father had rarely been admitted to hospital before and even at 82 was 100% totally independent. Baring the use of a stairlift he never asked or needed any help. So for him this was a big change and all he wanted to do was go home.
My father’s frustration towards me was borne out of awaiting a colonoscopy to run some tests. It was these tests that would determine his long term prognosis as he wasn’t responding to treatment, he had been waiting for weeks for the procedure, all whilst nil by mouth. The doctors kept telling him he could eat and drink once the tests were done.
He was tired, hungry and very ill, it at this point the junior doctor who had called me had advised my father that the colonoscopy which was scheduled had been cancelled and they didn’t know when they could fit him in for another one. This meant he would stay nil by mouth until the hospital got around to giving him the tests he needed.
My father’s response to this had been:
“why don’t you let me go home and die then “
There was no reassurance from the doctor, no discussion about his state of mind, no let us call your family and discuss this, it was taken as that was his desire that he wanted to be sent home to “die”.
The next day my father had been put onto TPN (artificial nutrition) due to concern over his weight and he looked much better physically and emotionally he was almost back to normal as he no longer felt famished.
As I sat with my father I was asked to have a “chat”, the conversation involved the consultant, the ward manager and the junior doctor. They always seemed to corner me for these conversations when I was alone, never giving the me the opportunity to get other family to the hospital to offer advice and support.
The consultant (a junior I later learnt) told me that my father had expressed his desire to go home and die. I was told the hospital were willing to send him home as palliative. This meant all treatment would stop he would get no drips, no artificial nutrition, nothing. The feeling I got was they were willing to start the paperwork straight away.
He then went on to tell me that how long my father survived would depend on what he ate and how much he ate. I told him that it was inhumane to try to starve a person to death and give him the option of eating himself to death or starving to death.
Being the commiserate professional the junior consultant was so sure of his diagnosis that he said I was wrong and even if my father stayed in hospital on the TPN he wouldn’t last more than a month and would deteriorate and die.
By the time I drove the seven or so miles back home, everyone but my youngest son knew what the doctor had said. Everyone by then had had a good cry.
The hours that followed involved getting all his grandchildren to see him irrelevant of what hospital policy was, everyone tried to remain positive but there was this dread as to what my fathers frustrated comment had triggered.
My father for his part had been positive all the way through, he always said no one should be worried and that at the age of 82 he had seen enough of life for him to be satisfied if his time had come.
Liberal society makes life an individual choice
Last week the ‘Assisted Dying’ bill was passed through parliament, baring it getting past the house of Lords it will eventually be made law. Although with the Health Secretary Wes Streeting saying there is no budget for an assisted dying service , nothing is clear. The Prime Minister Kier Starmer has since pushed back asking him to make it work. In democracy even death is a political football and economic decison.
This obviously is a very emotive issue and much of the debate in parliament involved personal experiences as the one I have described, involving patients with long term crippling conditions some far worse than my fathers.
These kind of debates in liberal societies often end up in polarised views as society struggles to find the opinion they should legislate into law for the everyone else to follow. This has been highlighted by Wes Streeting initially backing the bill but having subsequently been disturbed by what campaigners have highlighted.
Questions such as to when someone is ready to die , who decides when someone is dying or not, what is terminal, how long someone has to live etc. All of these decisions are left to the professionals who themselves are constrained by a system built to budget and not necessarily make the decisions that aim to prolong or preserve life.
Ultimately the ‘Assisted Dying’ bill puts individual choice backed by medical opinion first above and beyond the effects allowing people to end their lives has on wider society and the precedence it sets. Once you let people take their own lives where does it end. The bar will only be lowered and lowered as the the years go on.
As some disability campaigners have highlighted patients could be persuaded it is better for them to then end their lives than live through a horrendous condition. This has included those suffering from Down Syndrome. There is also the concern as to the level of care that will be provided to the seriously ill if there is an option to end their lives.
Concerns over the bill have been raised by Royal College of Psychiatrists, the Royal College of Physicians, the Association for Palliative Medicine and disability campaigners.
A brilliant article which covers some of the issues surrounding individual choice is below. (read after finishing this one).
Islam sanctifies life
Throughout my fathers illness and the discussions the doctors were having with his family, the only one consistent was Islam. That all decisions had to be based on what Islam had ordained for someone in life and death.
Islam sanctifies life, in fact one of the Maqasid (objectives) of the Sharia is the protection of life.
The Quran says:
Say, ˹O Prophet,˺ “Come! Let me recite to you what your Lord has forbidden to you: do not associate others with Him ˹in worship˺. ˹Do not fail to˺ honour your parents. Do not kill your children for fear of poverty. We provide for you and for them. Do not come near indecencies, openly or secretly. Do not take a ˹human˺ life—made sacred by Allah—except with ˹legal˺ right.1 This is what He has commanded you, so perhaps you will understand.
[Translated meaning of the Quran: Al-Anam 151]
Also unlike the bill passed last week Islam prohibits taking of ones life for any reason.
Life doesn’t end by medical opinion
After the initial shock of what had happened we tried to reconcile ourselves with the hadith of the prophet (saw)
Narrated from Abu Hurayrah (may Allah be pleased with him) that the Messenger of Allah (peace and blessings of Allah be upon him) said:
“The martyrs are five: the one who dies of the plague, the one who dies of a stomach disease, the one who drowns, the one who is crushed beneath a falling wall, and the martyr who is killed for the sake of Allah.”
Al-Bukhaari (2829) and Muslim (1914)
To be honest after wrapping my head around the whole issue and reading the above hadith I was ready for the worst. In fact I thought if my father was going to pass then he was lucky it was due to a stomach condition.
Almost two years on from the phone call and despite what I was told on that day, my father is still with us alive and as well as he can be.
The initial diagnosis of my father’s condition was incorrect and as one senior consultant put it “they’d been chasing the wrong thing for weeks". He was discharged from hospital a week or so after the whole ‘he wants to die’ conversation.
He is and won’t be the how he was before he went into hospital, the weeks in hospital and subsequent illness has meant he he is now bed bound. This means my father has lost most of his independence, it means someone has to be around all of the time. I can’t just galavant off for more than a couple of hours without some serious forward planning. I sleep better on the sofa downstairs than I do in my own bed, I have learnt to do things I thought I never would. Everyone in the family has had to help and chip in.
It was given me an opportunity to fulfill my obligation towards my father, trust me I am not doing him any favours, something being an old school Pakistani parent he still reminds me about.
We have commanded people to honour their parents. Their mothers bore them in hardship and delivered them in hardship. Their ˹period of˺ bearing and weaning is thirty months. In time, when the child reaches their prime at the age of forty, they pray, “My Lord! Inspire me to ˹always˺ be thankful for Your favours which You blessed me and my parents with, and to do good deeds that please You. And instil righteousness in my offspring. I truly repent to You, and I truly submit ˹to Your Will˺.”
[Translated meaning of the Quran: Al-Ahqaf 15]
It also means my father has seen his grandson buy his first car, learn how to drive and get his first job.
He has seen his granddaughter start university. He and is still the only one in the house that a game of FIFA is ended immediately for, no waiting five minutes to finish the game.
He sits in the garden and most likely secretly bemoans the destruction two years of neglect have done to his many years of hard work.
Yes there have been nights and moments when I have thought this is too much for someone to go through. He still has numerous conditions, pops too many pills and there are good days and bad days. There could be worse days to come. But these are moments for expiation of his sins.
(the wife of the Prophet) Allah's Messenger (ﷺ) said, "No calamity befalls a Muslim but that Allah expiates some of his sins because of it, even though it were the prick he receives from a thorn."
The Prophet (ﷺ) said, "No fatigue, nor disease, nor sorrow, nor sadness, nor hurt, nor distress befalls a Muslim, even if it were the prick he receives from a thorn, but that Allah expiates some of his sins for that."
Most of all it has given my father time to reconcile his relationship with Allah (swt), to ask for forgiveness and to be with his family.
May Allah (swt) continue to make it easy for him.
The question of death is something extremely uncomfortable especially in liberal societies where it is seen as a taboo subject, not something to be contemplated often. Whereas in Islam death is a part of life and something to be contemplated often about even from a young age.
In the mental and emotional chaos that serious illness creates, humanity needs a clear set of rules not political debate or funding rows. People need guidance to stop vulnerable minds being moulded by an ideology that doesn’t value life be that in Gaza or on hospital wards in the UK.
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