Expanding Compassion To Include Choice

We are very grateful to Dr Kelley Joubert who contacted shortly after her mother’s agonising death to share this powerful story…

“I would like to begin by sincerely thanking you for the work you are doing. I came across your organisation after searching for “assisted death in South Africa” two weeks ago, following the loss of my mother to cancer. I am writing in the hope that sharing her story may further support your advocacy for the introduction of medically assisted dying in our country.

My mother was diagnosed with ovarian cancer four years ago, which later metastasized to her lungs. The chemotherapy agents she received, including doxorubicin and Lynparza (olaparib), carry a known risk of secondary malignancies such as Acute Myeloid Leukaemia (AML). In October last year, blast cells were detected on her blood smear, and a bone marrow biopsy confirmed a diagnosis of AML.

AML and its treatment are associated with profound pancytopenia, leaving patients highly susceptible to infection. My mother developed sepsis and was hospitalised for two weeks. During this time, she was unable to continue her cancer treatment. The leukaemia progressed rapidly and spread to her brain, resulting in leukaemic meningitis. The only potential treatment option required lumbar punctures every three days — an invasive and burdensome intervention with limited hope of meaningful recovery.

After extensive discussions with her oncologist and a palliative care specialist, my mother was advised that no curative options remained, particularly given the genetic mutation driving her AML, for which no targeted treatments exist. She was informed that ongoing care would likely involve repeated hospital admissions, persistent infection risk, and progressive neurological decline. She made the courageous decision to transition to palliative care.

She passed away within two weeks.

However, her final days were marked by profound suffering. Severe thrombocytopenia resulted in uncontrolled bleeding. She experienced significant oral mucosal haemorrhaging, gastrointestinal bleeding, and intracranial bleeding. The neurological impact included seizures, visual loss in one eye, difficulty communicating her needs, and escalating terminal agitation.

While palliative care aimed to keep her comfortable, what unfolded was deeply traumatic — for her and for those of us caring for her. Her final week was one of visible distress and loss of physical dignity.

If medically assisted dying had been legally available in South Africa, my mother could have exercised autonomy over the timing and manner of her death. She could have chosen to pass peacefully, with dignity, surrounded by family, before the most devastating complications unfolded.

The Constitution of the Republic of South Africa enshrines the right to human dignity (Section 10) and the right to bodily and psychological integrity, which includes autonomy and control over one’s body (Section 12(2)). For patients facing inevitable decline and unbearable suffering, denying the option of medically assisted death arguably conflicts with these constitutional protections.

This is not about abandoning care. It is about expanding compassionate care to include choice. It is about recognising that some patients, despite optimal medical treatment, reach a point where suffering cannot be meaningfully relieved — and that in such cases, dignity and autonomy should remain protected.

I respectfully urge policymakers to seriously consider incorporating medically assisted dying into South African law, with appropriate safeguards, so that patients like my mother may have the right to choose a peaceful and dignified death.

Thank you for your courage and continued advocacy in this deeply important matter.”