Caring for a chronically ill family member is physically and emotionally taxing. I have seen in such situations people struggling with questions on the larger meaning/purpose of life, death, well-being, happiness and such. The very capacity to love and empathize (either oneself or our loved ones) get tested in such situations. I have heard single mothers working daily wages asking if their severely disabled and mentally ill children can be assisted to die… I have also heard parents in extreme poverty lament caring for a severely mentally ill child. These provoke questions at various levels ranging from what is the role of the onlooker/health worker in such situations to the larger question of who’s to blame and whom to hold accountable for such a pathetic situation that some households find themselves in. Is it not largely due to failure of systems and services. Is it just by pure chance that these situations are more taxing in poorer and disadvantaged households?

The context for the above reflection is an evocative blog by Richard Smith on preparing to be demented. See also a letter that he and his mother co-wrote in the BMJ about doctors’ inability to “simultaneously be patient centred and reject assisted suicide”. I have seen several people struggling with Dementia, or struggling with caring for a loved one with Dementia. Richard Smith’s reflections in his blog also reflect the privilege of a doctor in a high income country and a society in which such questions can be posed and philosophically reflected upon. Meanwhile, there are scores of others back home whose life circumstances never allow for such reflections. Worse still, similar choices back home are perhaps in a setting where very basic support for chronically ill children and elderly do not exist…so, one wonders if there is a demand for assisted suicide in settings where systems/services have never given people a decent chance at life, how could one respond?