It was a great help to have the CMF and Care Not Killing literature (1) available when recently asked to comment about assisted suicide on our local radio. Particularly impressive are the statistics comparing the number of deaths in the UK per annum with the miniscule number of Britons who travel to the Swiss clinic to end their days.

The questions remain as to why any go at all, and why others want to legalise assisted suicide here? I am convinced that what is perceived as rational behaviour is unavoidably influenced by emotional reactions in both doctors and patients. (2)

Any loss of expectation, whether minor (a lost pen) or major (a life threatening illness) can elicit the 'Oh, no!' of denial. In the case of potentially fatal illness this can be acted out by reactions of fight or flight. Traditionally doctors 'fight to save lives' and for a time the sick person will often fight too. Yet for doctors to continue battling relentlessly when it is clearly futile will exhaust and dispirit patients and their loved ones, who might then be tempted to fly away by Swissair. Even the very prospect of meddlesome medicine can conspire with the fear of a painful death to strengthen a desire to end it all.

Hospices, of course, provide the middle way by helping people to live until they die, by the use of symptom control and listening ears. Hope can replace fear, helping denial to give way to a more serene coming-to-terms. Hospice workers do not have shrill voices nor do they lead campaigns, but there is a great need for their principles to be incorporated into public awareness and general practice – and even more so into hospital practice, where most dying patients are found. That is something well worth fighting for.