The guilt of those asked to help a loved one die can work both ways

Every day she lives, she regrets that she didn’t kill him.

She had the means, the opportunity and the motive. As an intensive care nurse with a superb reputation, she would never have been suspected. She knew the chances of being caught were tiny, back when he asked her to do it. She knew he needed her to do it. But she couldn’t.

He was not a long time dying, mainly because his prostate cancer was so far advanced when he went for the test. He was busy and unworried. When he rang the clinic for the results of tests on his patients, he remembered to ask for his own results, too. As his pen started to move across the little pad in front of him, he stopped.

“Something wrong with those numbers, Cliodhna,” he told the pathologist. “You’ve an extra nought in there somewhere.”

“No, Tony, I don’t,” she told him. “I wish I had the figures wrong. I really do.”

She called them out again. He thanked her with careful courtesy, and sat in his tiny GP’s office on his own, looking at the statistical sentence of death written in his own hand. His wife found him there and knew in the silence what had happened. They had always been close enough to know each other’s thoughts. When, after several years of marriage, Deirdre hadn’t become pregnant, they never talked about it. Each knew the other wouldn’t be up for a rake of tests or for the invasive procedures of IVF. Neither felt a deficit in their life caused by being childless. If they never had children, it wasn’t going to cause them a problem.

The day she found him in the office, he gestured at the test results in front of him. Inert numbers shouted implications and guilt at her. Knowing how good he was at taking care of the health of others and how lousy he was at looking after himself, why hadn’t she pushed him to get the test sooner? Now, she knew, he had precious little time and nothing medically useful to be done with that time. They both knew that, while at the same time knowing – both of them – that he would go and talk to an oncologist friend who was doing marvellous work in the area and who might put Tony in a drug trial.

“And if the worst comes to the worst,” he said to her, that day in the surgery, “You’ll give me the old Brompton Cocktail.”

“If you put the wheelie bin out again without a bloody tag, I’ll give you a Brompton Cocktail long before the worst comes to the worst,” she told him.

Their laughter softened the harsh immediacy of the numbers on the pad, the way an artist’s hand scumbles a charcoal outline. But the numbers re-established in their heads, again and again, that day, and when she woke in the night she knew by his breathing he was awake, too.

“You know I will,” she told him. “It’ll never come to that, but I will.”

When he drifted back to sleep, she lay there, trying to remember the drugs that went into the cocktail that ensured an easeful death, and the precise amounts required of each. But for many weeks, that proposition became unreal, because he was fighting to live, subjecting himself to the most extreme treatments therapies. They left him sick, sore and sorry that he had knowingly wasted his time.

He knew the worst, and yet he was still surprised when the oncologist friend asked him about hospice. It would not arise, he said crisply. Deirdre would handle it, when it came to that.

Even though he had treated hundreds of patients with the disease, he still clung to the notion that he would experience a period of undiminished good health before final deterioration and felt cheated when it didn’t happen, when, instead, he was catapulted into pain, sickness and a sudden fragility that went way beyond weakness. They worked at controlling the pain, she fighting tears when the morphine – in the beginning – made him improbably optimistic, euphoric and funny.

Then it stopped reaching the pain. Or, if it did reach the pain, the downside was that it also rendered him almost comatose, so that he could neither focus nor converse. It was then he asked her to kill him. She tried to distract him, but he was obsessed with the promise of death and the possibility of release from the agony.

She got him to postpone it, all the time nodding, yes of course, yes, she remembered the promise, yes, it would be done. Definitely.

She never understood why she couldn’t do it. It was not religion, because she was at best an a la carte Catholic. It was not fear of the law, although that did come into it in a small way that shamed her. She simply couldn’t do it, despite him being the most important thing in her life.

When an elderly British television personality confessed, a week ago, to having smothered a lover suffering from AIDS more than 30 years ago, the chronic grinding guilt flared into present misery.

That TV presenter had nothing but a pillow at his disposal. The dying man was in a hospital, and the broadcaster had no access to painkillers or any form of pharmaceutical life-killers. So he had taken the pillow and suffocated the patient.

She shuddered at the thought – and at the comparison. She had been in a better situation. At her hands, Tony could have floated into eternity, not been tortured for the minutes without oxygen.

Every radio programme she turned on seemed to be discussing assisted suicide. She wanted to agree with the angry convinced callers who called it un-Christian, but wondered how Christian it had been to force Tony through the extra days of pointless pain.

Then again, some callers talked of pain as a learning process, an ennobling factor in human life. It didn’t seem to her that the pain had added nobility to Tony, and she knew she had learned nothing from watching it, other than an abiding contempt for herself. The arguments whirled around her, none making sense to her. Yes, of course, relatives who stood to inherit might want to dispatch their father or mother early. But that happened anyway.

Yes, of course, some doctors might want to rid themselves of patients whose condition was a daily reproach to them. But Shipman had managed to kill hundreds without the benefit of a law empowering any of his patients to make the choice to die. Yes, of course, someone suffering transient depression might get around the rules and abandon a life filled with promise.

Because she had never feared the existing law that much, though, she was not in immediate sympathy with the appeals for an assisted suicide law in Ireland.

She was, however, sympathetic towards the broadcaster. They were united in disunity. He had suffered decades of confused guilt for killing someone he loved.

She had suffered decades of guilt for not killing someone she loved.