Assisted dying

[MikeF]

I’m not sure where I stand on this. Horrible position to be in for anybody. I had a sister who had MND who suffered terribly at the end. Would she have choosen this route? I probably would have if in her shoes. I just can’t comprehend it. I get it, I just struggle with it. And I certainly wouldn’t want to be the one dishing out the medication. Even if it’s not me who administers it per se.

 

[.db.]

Religious folk often regard atheists as delusional, not sure the characterisation is very helpful to understanding either group tbh.

They’d be very wrong to though. A delusion is a belief in something where there’s incontrovertible evidence to the contrary, yet there is no evidence of any kind of any god so not believing in a god literally cannot be a delusion.

 

[Ifwecouldjust.......]

The proven danger of coercion, including self-coercion, is the primary reason why the state should never sanction assisted suicide.

Im hoping that as a result we will see changes to

1. Funding of social care
2. Funding and improvements to Hospice Care (which shouldn't be funded by charitable donations )

Assisted dying should only be as a result of ''no other choice'' rather than an alternative.

 

[.db.]

Much like abortion, it’s not meant to be lauded as a “good” thing, but rather a necessary thing…for those that choose or need it.

Not everything is good or bad, or should be characterized that way.

Very good way of putting it.

I found those celebrating this on the footage on the News just now, very odd: cheering, arms in the air, smiles on their faces and hugging each other like their football team had just won.

This isn’t a ‘good’ thing, but should be an option as a necessary thing for those in a situation where it is better than suffering horribly.

 

[threespires]

That they are happy for the dying and their families to go through torture so MP's needn't make a tough decision.

Does that answer your question?

Yes, albeit I disagree with you. I listened to the debate and I didn't hear anything that suggested this was the motivation of those speaking/voting against the bill.

 

[Millwallawayveteran1988]

We don’t artificially feed someone who is dying no. There’s a point at which this becomes futile, the body is dying and feeding it won’t prevent that death.

Artificial fluids and feed when someone is dying comforts the family and not the patient. The body as it goes through the dying phase struggles to process fluids - they end up in the wrong place within the body pooling on such areas as the lungs/chest - this is a huge part of why you will hear what is often referred to as the death rattle.

Cannulation to deliver those fluids is also painful as the veins tend to become very difficult to use - cannulation is invasive and performing an invasive procedure on a dying patient is cruel and undignified.

If someone can eat/drink they are fed, if they can’t and life can be saved they are given IV/NG feeding/hydration.

If they are dying, death is a natural process and they should not have needless shoves in them and we should look to help with sips of fluid if possible or good mouth care.

We need to be better at recognising deterioration and the dying process.

2 weeks ago my friends dad died, he died with 2 cannulas in, he had ben pulled about, rehydrated, fluids stopped when bloods taken no longer showed dehydration but within 24/48 hours given it all again.

I visited him often, it was clear to me from my palliative care background he was dying, I told the nurses he was dying, he had periods of real alertness and they looked at me like I was mad.

But he couldn’t sustain his body - had reached his natural end, his desire to eat/drink gone. Finished his days with maybe 1-2 spoons of food each meal time.

He was miserable stuck in a hospital bed, and in the end died alone with no one except me calling it he was dying.

His daughter sent home only 2 hours earlier with the Dr saying he wasn’t palliative.

I’d repositioned him in bed a few days earlier and let me tell you he was cachexic
I could feel every bone in his back.

So you see, all those fluids made no difference, maybe kept him going a few more days but what his treatment did was prolong his death. Those fluids shoved into a body that by very nature didn’t need or want them made more urination for which he had to be moved around more to deal with, made a wet chest because his body tissues became leaky and didn’t save his life.

To deliver them he had needles shoved into retracted veins with more than one attempt at cannulation needed to do so, thin frail skinned arms that barely had any fat on.

We need to be better at recognising impending death, better at supporting people to die naturally but without pain.

Flip that over to someone in their 40’s with a life limiting illness and 6-12 months to live and it’s absolutely correct we artificially feed/hydrate not doing so would’ve killing them.

But the fact remains that most people ( not all) that argue about the not giving food/fluids have witnessed their elderly relatives die without bags of fluid.

Apparently that’s barbaric and cruel not to shove needles into someone who is naturally dying but it’s ok to shove a needle into someone who still has 6-12 months to live.

To me you can’t have it both ways.

You can have a terminal illness for years but you become actually terminal only a short time before death.

Thanks very much for such a detailed response.

 

[Magicpole]

I am for it. We should have the choice if we are suffering too much. Not just for ourselves, but those we leave behind. Nobody needs to watch someone you love suffer needlessly.

 

[metalblue]

Guardrails are always important, but the vast, vast majority of people would prefer to choose the date and time of their death than live in pain and abject misery.

I can only speak for myself, but the cottage industry that has blown up squeezing every last penny from the infirm, bleeding them dry of their last dime in high priced assisted living facilities with substandard medical care, is far more distasteful to me than someone choosing not to go through it.

My wife and I each have Healthcare POA over the other, and have made sure that we each understand the other’s personal wishes regarding end of life care, stipulating it in our trusts.

You rail against the myth of god but happily pedal this myth of people always die in pain and abject misery?

Herein lay the problem with this debate - it’s littered with the ill informed using their own beliefs or personal experiences extrapolate some universal truism that simply doesn’t exist.

I’ve no problem with people having the right to choose - however if we keep peddling this lie then everyone with a life limiting illness will think they are going to die in pain and abject misery and a lot are going to unnecessarily opt for this and lose precious time on this planet - of which we all only get one go at. Unless the religious folk are right but I’m not getting in to that!!

 

[metalblue]

I think religion reflects our species' reluctance to accept death as a better alternative to life.

This is a fabulous quote. We do have an unhealthy relationship with death and accepting our own mortality, it’s often a taboo subject - hopefully bringing this debate to the fore will allow as to bring the topic out of the shadows.

 

[johnny crossan]

They’d be very wrong to though. A delusion is a belief in something where there’s incontrovertible evidence to the contrary, yet there is no evidence of any kind of any god so not believing in a god literally cannot be a delusion.

It really does depend on what you choose to believe is evidence. Those who think modern science alone provides all the tools to understand the universe and our place in it are basically deluded - although perhaps not very helpful to point this out ;-)

 

[Marriedtoablue]

In a civilized world not to be able to be given a choice of dying a slow painful death or the ability to go out dignified boggles the the mind. Take out the nutters who believe in a made up entity and any sane person would hate to see a loved one suffer. As long as these decisions are made by the person who it pertains to, we have Do Not Rescuitate in place already that have to be done by that person, what is the problem. People deciding to die just to give their loved ones money, well I’d like to think if the relationship is that good the families would have non of it. We don’t let animals we love suffer yet we do to humans, it’s scandalous.

The issue is though, you don’t actually know what the death will be like.

In course of my career I have worked 8-9 years as a Specialist Palliative Care nurse and I have seen people die in a number of different situations.

I have seen Cancer patients who with no pain, are scared they may have it at the end who have wished they could just have an injection who have then had peaceful deaths.

I have seen people up mobilising to the bathroom, drinking etc who have died later that day.

And I have seen numerous frail elderly patients die over a course of a week or so as their body slows down and deteriorates - these are the ones where family struggle with us not artificially feeding them despite the fact they are 80-90+ years old, semi conscious and just coming to their natural end.

They are comfortable but it’s painful for the family who wish they’d hurry up and die - and yes family do say that ( including my own when family have been dying).

Only once have I seen someone battle with extreme pain at the end of life. The number of good deaths I have seen far outweigh the bad.

How does one begin to even presume what death will look like.

You mention in your post the choice of dying a slow painful death or the ability to go out dignified.

How and when do you propose the definite decision that someone will die in pain is made?

People fear pain at EoL. It’s a well known researched fact but you or anyone else can not 100% guarantee that someone with a terminal illness will actually be in pain and nor can it be guaranteed they will die within this 6 month window.

We once had a complaint made that a 6 month prognosis was given and the person was still alive 2.5 years later!

Therefore there is potential for people to take this option out of fear which may not even materialise.

Psychological pain is a different matter but let’s not conflate the two and attempt to rationalise this very important decision on assisted death based on the concept that all people within the terminal phase are in agony. Its simply not true.

There will sadly be people who have witnessed loved ones in pain at EoL - we should not diminish their experiences but we shouldn’t assume that they represent everyone either.

Finally you mention the DNAR having to be done by the person - you are wrong.

DNAR remains the final decision of the medical professional. It should be discussed with the patient and family with the ideal outcome of a careful discussion explaining that treatments would be attempted to treat any reversible issues but that in the event of the heart stopping ( death) it’s not considered in their interests to perform CPR.

It is always hoped with good communication that the reasons for DNAR are understood but the decision is a medical one.

 

[Marriedtoablue]

I am for it. We should have the choice if we are suffering too much. Not just for ourselves, but those we leave behind. Nobody needs to watch someone you love suffer needlessly.

This decision should NEVER be about those we leave behind - this is exactly why it needs tight control if it were ever to come into force.

To make the decision to end your life to prevent others distress would be a form of coerciveness.

This decision needs to be about the person and the person alone.

Sorry to say, (despite the well meaning of your post) your comments about those left behind highlights one of the biggest concerns in the whole debate. It’s not about the families suffering.

 

[threespires]

You rail against the myth of god but happily pedal this myth of people always die in pain and abject misery?

Herein lay the problem with this debate - it’s littered with the ill informed using their own beliefs or personal experiences extrapolate some universal truism that simply doesn’t exist.

I’ve no problem with people having the right to choose - however if we keep peddling this lie then everyone with a life limiting illness will think they are going to die in pain and abject misery and a lot are going to unnecessarily opt for this and lose precious time on this planet - of which we all only get one go at. Unless the religious folk are right but I’m not getting in to that!!

I think you are spot on here about the debate, which I think is simply too important to be handled legislatively the way it has been. Most of us, including myself, are quite poorly informed and it's been informative to listen to a couple of health care professionals on here provide the benefit of their knowledge and experience. I think as dignified as the debate was yesterday, there was no depth to it and it's not clear to me that the depth can be injected in during the commitee stage. This question bleeds into so many other aspects it really needed to be done in the context of a proper public consultation that also sought to educate us better. It shouldn't have been left to a PMB with lobbying groups (on both sides) presenting partial narratives that suit their position. However it was, so I think it's now incumbent on those MPs who voted yes as a means to continue the debate rather than to settle the legislation to now follow through on that in the next stages.

 

[stonerblue]

This decision should NEVER be about those we leave behind - this is exactly why it needs tight control if it were ever to come into force.

To make the decision to end your life to prevent others distress would be a form of coerciveness.

This decision needs to be about the person and the person alone.

Sorry to say, (despite the well meaning of your post) your comments about those left behind highlights one of the biggest concerns in the whole debate. It’s not about the families suffering.

No it wouldn't be 'a form of coerciveness'. It would be an adult making their decision based on how they feel about lots of things.

 

[Blue Maverick]

The proven danger of coercion, including self-coercion, is the primary reason why the state should never sanction assisted suicide.

That’s why you have the 2 doctors thing in place

 

[threespires]

It really does depend on what you choose to believe is evidence. Those who think modern science alone provides all the tools to understand the universe and our place in it are basically deluded - although perhaps not very helpful to point this out ;-)

I'm not sure words like delusion are useful on either side of the debate but it is entirely fair to say that science and faith being pitched in diametric opposition to each other is a recent phenomena and not one that is based on a specific set of scientific breakthroughs that 'settled' matters but mostly on the now discredited Conflict Thesis of a 19th Century British Chemist and an America Academic. Public discourse is still stuck in this rut created by this thesis despite the relevant communities themselves having moved on from it in the second half of the 20th century. The reasons for public perception being stuck there are imo complex but ironically not that much to do with either science or religion!

 

[Blue Maverick]

The issue is though, you don’t actually know what the death will be like.

In course of my career I have worked 8-9 years as a Specialist Palliative Care nurse and I have seen people die in a number of different situations.

I have seen Cancer patients who with no pain, are scared they may have it at the end who have wished they could just have an injection who have then had peaceful deaths.

I have seen people up mobilising to the bathroom, drinking etc who have died later that day.

And I have seen numerous frail elderly patients die over a course of a week or so as their body slows down and deteriorates - these are the ones where family struggle with us not artificially feeding them despite the fact they are 80-90+ years old, semi conscious and just coming to their natural end.

They are comfortable but it’s painful for the family who wish they’d hurry up and die - and yes family do say that ( including my own when family have been dying).

Only once have I seen someone battle with extreme pain at the end of life. The number of good deaths I have seen far outweigh the bad.

How does one begin to even presume what death will look like.

You mention in your post the choice of dying a slow painful death or the ability to go out dignified.

How and when do you propose the definite decision that someone will die in pain is made?

People fear pain at EoL. It’s a well known researched fact but you or anyone else can not 100% guarantee that someone with a terminal illness will actually be in pain and nor can it be guaranteed they will die within this 6 month window.

We once had a complaint made that a 6 month prognosis was given and the person was still alive 2.5 years later!

Therefore there is potential for people to take this option out of fear which may not even materialise.

Psychological pain is a different matter but let’s not conflate the two and attempt to rationalise this very important decision on assisted death based on the concept that all people within the terminal phase are in agony. Its simply not true.

There will sadly be people who have witnessed loved ones in pain at EoL - we should not diminish their experiences but we shouldn’t assume that they represent everyone either.

Finally you mention the DNAR having to be done by the person - you are wrong.

DNAR remains the final decision of the medical professional. It should be discussed with the patient and family with the ideal outcome of a careful discussion explaining that treatments would be attempted to treat any reversible issues but that in the event of the heart stopping ( death) it’s not considered in their interests to perform CPR.

It is always hoped with good communication that the reasons for DNAR are understood but the decision is a medical one.

In regards the DNAR I would hope that the 2 doctors etc would be the thing for the assisted dying for medical and a persons wishes, I destroyed many a persons body doing frankly needless CPR, all because loved ones where in the room when it was quite clear that person was dead and if they had by sone miracle cone back the mess me made of their sternums etc would have put them in extreme pain.
I suppose I have a more pragmatic view of death these days having witnessed a lot (obviously not as much as you) I do wonder who are we keeping people alive for if they want to go? The family, the god botherers, when at the end of the day it’s the person who wants to go and who is any other human to say no, I wonder how many in the USA with access to guns take that way out because of the pain.

 

[mosssideblue]

This decision should NEVER be about those we leave behind - this is exactly why it needs tight control if it were ever to come into force.

To make the decision to end your life to prevent others distress would be a form of coerciveness.

This decision needs to be about the person and the person alone.

Sorry to say, (despite the well meaning of your post) your comments about those left behind highlights one of the biggest concerns in the whole debate. It’s not about the families suffering.

It’s about both for me

 

[johnny crossan]

That’s why you have the 2 doctors thing in place

In other countries with similar safeguards the practice of 'doctor shopping' is a factor as pointed out in the HoC debate.

Tanni Grey-Thompson: Assisted dying bill will allow families to go ‘doctor shopping’

Exclusive: Sporting hero and disability rights campaigner Baroness Tanni Grey-Thompson has warned that loopholes in the assisted dying legislation mean that safeguards against abuse are non-existent

www.independent.co.uk

 

[johnny crossan]

In regards the DNAR I would hope that the 2 doctors etc would be the thing for the assisted dying for medical and a persons wishes, I destroyed many a persons body doing frankly needless CPR, all because loved ones where in the room when it was quite clear that person was dead and if they had by sone miracle cone back the mess me made of their sternums etc would have put them in extreme pain.
I suppose I have a more pragmatic view of death these days having witnessed a lot (obviously not as much as you) I do wonder who are we keeping people alive for if they want to go? The family, the god botherers, when at the end of the day it’s the person who wants to go and who is any other human to say no, I wonder how many in the USA with access to guns take that way out because of the pain.

I worry when I see medical/emergency service professionals use disrespectful terms about people with religious faith they deal with in the course of their work - even if it's on a football forum.