Dr. Richard Coker, Author of Timor Mortis
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The Pat Kenny Show. With Timber Living Log Cabins. Saturday and Sunday from 10am. On Newstalk. Conversation that counts. I came across a headline at the Times of London the other day which stopped me in my tracks. Quoting an eminent physician, it ran, Well, on further investigation, I discovered that the doctor had worked in the NHS for some 45 years, witnessing life and death in many forms, and had just published a book entitled Timor Mortis – How We Live With Death. Now, this derives from the phrase, Timor mortis conterbit me, translated from the Latin, fear of death disturbs me. Well, the author himself, Emeritus Professor of Public Health, Richard Coker, joins me now. Richard, good morning and welcome.
Good morning.
What does 'Timor Mortis' mean and why is it the book's title?
Good morning. Pleasure to be back in Ireland, in a sense.
Well, it's great to have you. Reading the interview with you in The Times, which, of course, is based on the substance of your book, You talk about, you know, the first time perhaps that you shortened a life. And, you know, the headline says one thing. The detail says quite another.
The headline is fairly punchy. And I presume that was to to get a lot of people to read it. I mean, all doctors see death. They're very familiar with it and they're introduced to it well before they become doctors as medical students. And then they're introduced to suffering. And this notion of assisting death really is just the balance between alleviating suffering, which all doctors should do, and trying to avoid suffering. Death, trying to prolong life. And so the balance is really between these two issues. We all we all of us die and very few of us want to suffer intolerably. And at times to relieve that suffering facilitates or speeds up death. It's a nuanced issue, but it's getting a lot of traction because the suggestion is that laws perhaps might put people on a slippery slope to euthanasia or whatever.
Now, you talk about the practice of medicine. It is about humanity first and foremost. And that humanity might involve prolonging the life of somebody where they can live that life well or somewhat well. On the other hand, for someone who is in a terrible situation of pain and whose life is going to be definitely limited by their condition, perhaps gently assisting them along that path in a pain-free way might be the better course.
Yes. I mean, I think we need to be careful that it's not the doctor's decision, that it's the patient at the centre of this. And so the relationship between the doctor and the patient and their relatives and good communication is critical. All patients should be the author of their own story. And it's very, very important that doctors don't step over that and think that they have some sort of God-given right to do things that the patients don't want. The real challenge, or one of the challenges that I've seen in practice, is that we seem to... we seem to give a great deal of emphasis to autonomy and the competence and capacity of patients when they're in terminal decline. And yet, when they are actually completely infirm and incapable of making decisions, either because they've got something like a terrible respiratory disease, which I described in the book, or something like locked-in syndrome, which is where you can barely communicate because you're
all your neurological processes have basically closed down. In a sense, we remove from those at the very end of suffering, at the far reaches of those who are most suffering, we sometimes remove the capacity for them to make a decision. And that's something that I've been disturbed by and tried to address in the book, that we should be having conversations about death and dying much more openly, not just doctors, but everybody.
Now, you talk about this high-tech medicalization of the hospital world, I suppose, and the idea that someone can be declared dead on the basis of data rather than on the basis of humanity or the literal experience of those around the sick bed.
Yes. I mean, in fact, some definitions of death rely on technological measurements.
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Chapters
5 chapters
1
What is the main topic discussed in this episode?
0:01–0:49
2
What does 'Timor Mortis' mean and why is it the book's title?
0:49–5:52
3
How did Dr Richard Coker describe his experience shortening terminal patients' lives?
5:52–8:39
4
How does medicine balance alleviating suffering with prolonging life?
8:39–15:15
5
Why does Dr Coker argue patients must remain at the centre of end‑of‑life decisions?
15:15–16:40