Don’t fear death, rather plan for it

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IOL NM ambler4 . Julia Ambler is the founder of NGO Umduduzi, and specialises in the palliative care of terminally ill children and their families.

Nearly two months since Madiba was laid to rest, Julia Ambler still finds herself wondering whether he was allowed to “die well”.

Durban - Nearly two months since Madiba was laid to rest, I still find myself wondering whether Nelson Mandela was allowed to “die well”. Dying well – a phrase coined by Dr Ira Byock – means different things to different people. For most it refers to dying a dignified and comfortable death. The speciality devoted to this concept is palliative medicine.

Palliative medicine is about ensuring quality of life for the terminally ill patient and their families. It provides relief from pain and other distressing symptoms and intends neither to hasten nor to postpone death. Dying with this kind of support should be a fundamental human right. With so much attention given to every aspect of bringing a child into the world, shouldn’t leaving the world be respected in the same way?

So much has been written in the last two years and particularly the last six months about Nelson Mandela and his deteriorating health.

For the most part the public has not known what to believe.

I am not inclined to get bogged down in technicalities and speculation, but now that the dust has settled I can’t help feeling that there is a great deal to reflect upon. It seems even his passing may become a source of learning.

General consensus is that Madiba had indeed been unwell over the last year of his life with numerous hospital admissions.

Last June Archbishop Desmond Tutu described it aptly, declaring: “As the beloved father of our nation uTata Nelson Mandela once again endures the ravages of time in hospital, our prayers are for his comfort and dignity.”

Prodded

However, it was three long months before he was discharged from hospital and even then we know that he was sent home to yet another intensive care set-up.

Intensive care is neither comfortable nor dignified, involving being prodded and poked. This is hardly the gift of peace that should have been offered to an elderly ailing hero such as Mandela.

But perhaps that is just it; his hero status prevented him from being offered good palliative care. So much else was at stake, between an adoring public, feuding relatives, court cases, official visits and possibly the world’s most significant funeral to plan, when would the right time have been to just let him go?

In addition to all this, he had been exalted and glorified to near god-like status while also being used as a political tool.

Who will ever forget the release of those sickening images of an exceptionally frail old man next to a grinning Jacob Zuma? Pale and propped up; a prisoner stripped of his freedom once more.

With all the secrecy and respectful privacy afforded Mandela’s last six months, as the public we do not know exactly what transpired. But with all the evidence we do have it seems very unlikely that he was allowed to “die well”.

Was he offered choice about what he wanted for his last months and days? Did he have the opportunity to sit with his physicians and family and discuss the extent to which his life would be prolonged or where he would like to die? Did his family know of his wishes? Did he fight so hard to stay alive because no one could or would give him the permission to let go? Was he again imprisoned by other people’s desires, wishes and beliefs?

The prolonged illness and death of this world icon should prompt us to reflect on our own mortality. Death is not something to be feared or ignored, rather something inevitable and to be planned for.

My suggestion is to start the conversation with your loved ones now; you never know when it will be too late. Rest in Peace Madiba.

* Julia Ambler is the founder of NGO Umduduzi, and specialises in the palliative care of terminally ill children and their families. For more information visit www.umduduzi.co.za

The Mercury


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