THE TAOISEACH’S endorsement of Think Ahead, a project to encourage people to record their preferences about end of life, sets the tone for the continuing advancement of the National Council of the Forum on End of Life. At Forum 2011 in Dublin, Enda Kenny said that engagement in the initiative would help prevent shock, would reduce confusion and encourage everyone to talk, think and tell about their end-of-life wishes. Citizens can now download the Think Ahead form from its website www.thinkahead.ie. Besides recording their desires about the care they would or would not like, they can pinpoint the location of key financial and legal documents, and approve organ donation and a hospital postmortem when they die. Importantly, they can document their wishes on matters such as resuscitation.
If nothing else, Think Ahead will encourage discussion about dying issues. This is taboo for many people, so everything that engenders realistic conversation about death and bereavement should be championed. Mrs Justice Catherine McGuinness, chairwoman of the national council of the forum, puts it well when she notes people think ahead about family weddings, creating children, their holidays, and choosing a car, but not enough people have a private pension or have made a will. Still fewer have taken time to decide who should be contacted in an emergency.
The public mood is changing, however, as demonstrated also in the work of the Hospice Friendly Hospitals Programme, which is also an Irish Hospice Foundation initiative. People are beginning to assert their right to a good death, one surrounded by loved ones and free from pain. They know that they should not have to die in a crowded noisy ward. Their relatives should not be obliged to receive their personal belongings in a black plastic bag. If they wish, too, they should be freely offered non-religious rituals, a demand that is being increasingly asserted.
Think Ahead, which aims to speak for people when they cannot speak for themselves, has had positive responses following consultations with many stakeholders and some Dublin GPs have already piloted it successfully. This support, and the enthusiastic reaction of Forum 2011’s huge attendance, will surely encourage the development of Think Ahead on-line. It would be a recognition that, in the words of Stephen Levine quoted at Forum 2011, “all that exists does not for long.”