Who wants to live forever? In our fantasies, eternal life comes with eternal comforts. But to think about it rationally, as decline without release, a deathless existence is a dreadful way to live. Do not go gentle into that good night, the poet urges. Yet there comes a point when everyone will want to call it a day.
How to determine that point, and to deal with it, is the dilemma facing Dr Kevin Fong in Horizon: We Need to Talk About Death (BBC Two, Wednesday, 9pm). Fong is a clinician working at a time when death might be indefinitely deferred. But if a prolonged life is not necessarily a good life, is it moral to keep intervening?
“I was very envious of people who were dying and leaving it all behind,” says John, a hospice patient with terminal lung disease, now pursuing a peaceful repose. “Dying a happy death, that’s what I’ll be praying for,” he says, before acknowledging the documentary team and adding a morbid joke. “I’m gutted now that I won’t be able to see this.”
Fong's enquiry takes him to St Christopher's Hospice in London, presided over by the sympathetic Prof Rob George, whose job is to come to terms with death: "I believe it's morally wrong to waste a dying person's time."
Although numerous patients feature in the programme, facing the inevitable with a combination of stoicism, humour and fear, Fong’s focus is primarily on the medical practitioners and philosophies that compete or evolve.
It’s telling that Fong’s colleagues, brought to a pub to consider their own mortality, would ask for minimal intervention in the case of critical condition. When you’ve seen the invasiveness of interminable procedures, enough really is enough.
The remaining documentary is taken up with a consideration of palliative care, the end-stage treatment, which, to those who flee death in all circumstances, represents surrender. To its practitioners and patients it requires some glass-half-full rebranding.
One expert affirms the benefits of palliative care to increase the quality of life remaining, but also, in some circumstances, the quantity. Another points to evidence that it can improve prognosis in cancer patients, but only when sought at an early stage. The question goes unasked,though: When would you be ready?
That’s why the programme may ultimately have a more palliative effect for doctors than mortals, counselling us both that there is no shame in letting go. But even Fong seems to wince inwardly, when solemnly enthusing that hospice care is “much more about the business of living than about dying”, as though the most profound situations court responses that are unavoidably glib.
But to accept death as an option really is to face the conclusion of a life and how to spend it as well as possible.
Thinking back to John, sharing his fondness for egg and chips with a documentary he knew he would never see, you appreciate just how generous someone can be with their time.
