This week an incendiary opinion piece by the former editor of the British Medical Journal and BBC medical correspondent has been making the rounds. Dr. Richard Smith, an honorary professor at the University of Warwick and chair of the International Centre for Diarrhoeal Research, has suggested that cancer is a swell way to die and we should really stop trying to take that whole experience away from people. Smith quickly loses his audience with some profoundly ignorant assumptions and uninformed generalities. There's a whole lot wrong with his argument. Let's start from the top:
1.) After comparing four types of deaths, Smith assumes that dying of cancer is the best. He argues that, "You can say goodbye, reflect on your life, leave last messages, perhaps visit special places for a last time, listen to favourite pieces of music, read loved poems." This completely Disney-fied view of cancer death sure would rock, at least relative to other things he mentions like sudden death, organ failure, or dementia. Except that cancer doesn't play by the rules, and this sort of language completely discounts weeks, months, and even years of continuous physical and psychological suffering that survivors are forced to endure before the end.
2.) Smith argues that it's better for your loved ones if you die of cancer. They'll be much happier than if you'd been randomly hit by a bus or suffered a heart attack all by your lonesome. Because, he claims, you get to reconnect and revisit and do lots of other things that start with "re." And wouldn't that be great? Sure, but dead is dead. No one is going to miss you less because you knew you were dying. And not all cancer patients have families or support networks in the first place. Or they don't always have the energy to engage in romantic adventures in their final days. Even if they do, humans generally have a hard time with death as a concept, and the closure Smith espouses will likely be far overshadowed by depression and pure existential terror.
3.) Smith's argument assumes that only older people die of cancer. This is news to the 72,000 new young adult cancer survivors who emerge on the scene annually. Not to mention teenagers, adolescents, and infants. The majority of people who die of cancer aren't equipped to go out riding off into the sunset. This former editor of a major medical journal should have spent some time as a hospice social worker before he offered up an opinion on whose death could beat up your death. I know, because I once wrote a piece arguing the merits of different ways to shuffle off this mortal coil that wasn't incredibly offensive and didn't start an immediate smear campaign against my good name.
4.) He thinks that oncologists are "overambitious," and that we should "stop wasting billions trying to cure cancer, potentially leaving us to die a much more horrible death." I guess you'd have to be on board with the previous arguments to get behind this one even a little. The truth is, anything that kills people is worth aggressively funding a cure for. End of story.
5.) Smith espouses that the pain of cancer can be circumvented through "love, morphine, and whiskey." You might not know just how asinine this is if you've never had to live through chemo or immunotherapy. Even on a purely physiological level, this advice is awful. Treatment dehydrates you, making the effects of the drugs worse than they already are. Drinking is therefore a great way to worsen your suffering, not alleviate it. Love might take the pain away, if the paranoia and fear fade long enough for it to seep in. And morphine is a palliative measure that's usually provided for someone who is actively dying so they don't completely lose their minds in terror. For further reference regarding actual pain management and end of life scenarios, check out this comprehensive guide from American Nurse Today.
In short, Smith's self-espoused "romantic" view of cancer death has nothing to do with reality. It's hard to imagine that someone who's found a successful and very public career in medicine would have such fundamental misunderstandings about one of the most prominent human diseases. With all the backlash surrounding the post, let's hope that in the future Smith thinks long and hard before putting pen to paper on an issue he clearly doesn't understand.