I started preparing for the first conversation years ago. Despite this I still felt nervous prior to the first conversation with a patient who had been approved for Assisted Dying. The End of Life Choice Act 2019 came into effect in Aotearoa New Zealand on 07 November 2021. The first time I met an approved patient was only at the start of this year.
I wasn’t sure how it was going to go. We had been in email contact and I knew their illness had led to speech impairment amongst many other losses. They would be coming with their sibling and sibling-in-law, and their sibling’s child. Coming in a for a pre-visit to our venue, some weeks prior to their scheduled assisted death. They lived in another catchment area and were not a patient of our hospice.
What would it be like talking to someone whose death was scheduled with certainty in two weeks’ time. In every other end of life conversation I had was full of uncertainty. When would it happen was a mystery and there were no solid leads or clues with which to solve it. How would it feel like to talk to someone who knew exactly when they would die?
I didn’t have any pre-prepared words for this first time encounter. The patient and their family arrived and I went out to welcome them to our venue. I escorted them into the living room area, showed them the kitchen and courtyard access through the kitchen door. The bathroom and bedroom doors were left open for viewing.
My team and I chatted to the patient and their team of loved ones. Within minutes I had the answer to my question about how it would feel to talk to an assisted dying patient. We talked about who they were and what their illness had taken away from them and their family. It became apparent that FOMO (Fear of Missing Out) was not happening, instead it was AMO (Actually Missing Out) that was happening, due to debility and disability from the disease process.
I came to the realisation that it felt no different than any other conversation with a palliative care patient. This was because the patient was a palliative care patient. Someone with an incurable, life-limiting illness, who was already dying. They had chosen an alternative to standard palliative care treatments but still needed our care and compassion. I relaxed and went back into my comfort zone, and it felt like I was talking to any other hospice patient. Any other palliative care patient who deserved to be treated with respect and kindness. We had a nice conversation in which we all got to know each other better and shared a few laughs.
We bade each other farewell and the patient would come back with other loved ones in a fortnight’s time. We remained in email contact and numbers were confirmed for the scheduled appointment when we would meet again.