Assisted Dying

[Thephoenix]

This morning The House of Lords are debating the 2nd reading of the private member's bill on assisted dying.
It's aims are to enable adults who are terminally ill to be provided at their request, with specified assistance to end their own lives.

The BMA have now ended their opposition, and the last you gov survey I read showed about 80% of the public in favour and 10% against.
Various other countries have adopted or are considering similar legislation.

As I'm now well past the Autumn of my life and fast approaching the depths of Winter, it's a thought that becomes more pertinent particularly as I've experienced, and am still experiencing, many family and friends who are suffering from terminal illnesses, or caring for others.

In a touching interview on TV this morning, a husband was describing how the current lack of assistance had affected himself and his dying wife who had made it clear that she didn't want a long lingering death.

The phrase he used was...."It's not about shortening life, it's about shortening death."

So my question is, taking all the controls and guidelines described in the bill (which is available to download on line),

Would you wish to make the required declaration requesting assisted dying if you were facing terminal illness?,
and what are your general views on the subject?

[Moby Dick]

Yeah a fulfilled life doesn’t have to be long.
As soon as I am aware that my quality of life is being impacted on I would be happy to go before I become a burden on family.

Can you sign up without a terminal illness?
Quality of life is being severely impacted by pussy inflation.

[Watts.E.Dunn]

Course all us barstards heron want to go shagging the best bit of puss we've ever known, but of course as we'll be physcially knackered ain't happening !

What we need is some sor tof virtual reality system whilst transitioning:)

So if anyone wants to finace the devlopment i can give them a number of my swiss bank account!

OK that was in very poor taste;!

[Dipper]

That’s a great point about shortening death.

I didn’t expect this to be in the topics but it is something we should all discuss more.

I doubt anyone would want their “life” artificially extended if it was a no way back situation. Without wanting to get too dark, I think about death a lot, especially funeral and other arrangements since some close family passed on all in the space of a few months.

It’d be great if we’d all make our final instructions clear to our loved ones and anything else that might help them with the whole process and their lives after.

[berksboy]

Yes i would , anyone in any doubt should visit  a "care" home .

[lostandfound]

It's already a lot better here than in some other countries, with our hospices, which can offer a dignified end, with treatment withdrawn, painkillers administered and family gathered around.

Nothing like that exists for example in the US - which spends much more than we do on healthcare, and for those "fortunate" to have great healthcare provision can greatly prolong the time it takes to die.

[Aldebaran]

I have long believed that quality of life was at least as important, if not more so, than quantity of life. Much of the objection to voluntary euthanasia comes from religious organisations. Personally I believe in the absolute right of a person to terminate their own existence, or have someone do it for them, if living has become so unbearable that they can see no other way to end their suffering, whether than is mental or physical.

[daviemac]

Yeah a fulfilled life doesn’t have to be long.
As soon as I am aware that my quality of life is being impacted on I would be happy to go before I become a burden on family.

You say that now but the closer you've been to death the more you value life.

[Watts.E.Dunn]

You say that now but the closer you've been to death the more you value life.

Yes been there and dun that!, some years ago now but thank god for the skils of the air ambulance and hospital:))..

[daviemac]

Yes been there and dun that!, some years ago now but thank god for the skils of the air ambulance and hospital:))..

Me too, CPR and defibrillator put me in a group of only 28% to survive. It changes your whole outlook on life.

[Doc Holliday]

This is an unbelievably complex subject. I am unsure where I stand on it?

My understanding is the BMA have withdrawn their opposition to this particular bill, due to it's fairly restricted and limited criteria and therefore use, but not opposition to assisted dying per se?

[Marmalade]

This is an unbelievably complex subject. I am unsure where I stand on it?

My understanding is the BMA have withdrawn their opposition to this particular bill, due to it's fairly restricted and limited criteria and therefore use, but not opposition to assisted dying per se?

There’s been bills for nigh on a hundred years. None have have passed or got anywhere. In England you can make a legally binding directive to refuse life-prolonging treatment in certain circumstances, that’s about it.

[chrishornx]

Yeah a fulfilled life doesn’t have to be long.
As soon as I am aware that my quality of life is being impacted on I would be happy to go before I become a burden on family.

Can you sign up without a terminal illness?
Quality of life is being severely impacted by pussy inflation.

nothing has been approved yet to sign up to

[scutty brown]

I watched both my parents, in their nineties, go through hell as they died.
Took my father three weeks from the "any time now" announcement, my mother six. Both were in unbearable pain. If anyone tells you that pain relief works, don't believe them. I hope no-one else has to go through the experience of their mother begging to be suffocated with a pillow to end things.
In both cases the end came due to considerate district nurses who decided "enough is enough" and gave a final strong dose of painkillers which ended the suffering. I just hope that when my time comes there's someone around who's caring and brave enough to do the same for me.
Death is rarely dignified. It's more often a horrorshow of pain, frustration and torture. If this bill can minimise that in any way I'm all for it.

[lamboman]

Yes i would , anyone in any doubt should visit  a "care" home .

Agreed I'd never been in one until 2 years ago.
I was shocked,many occupants staring blankly into space one of the saddest sights I've ever seen and this was in a good care home.
It's hard to find a balance though.

[radioman33]

Louis Theroux did a documentary on bbc iplayer called Altered States choosing death,in America they have the family around the bed and watch the love one pass away in a dignified way.

[Marmalade]

Louis Theroux did a documentary on bbc iplayer called Altered States choosing death,in America they have the family around the bed and watch the love one pass away in a dignified way.

I wouldn’t trust anything Louis Theroux produced further than I could push him off a bus.

American States vary a lot. Some have assisted dying, some don’t. Hardly something to leave thinking about ‘until the time comes’ either. What are going to do about it then??

[lamboman]

I wouldn’t trust anything Louis Theroux produced further than I could push him off a bus.

Why?

[Thephoenix]

It's already a lot better here than in some other countries, with our hospices, which can offer a dignified end, with treatment withdrawn, painkillers administered and family gathered around.

Nothing like that exists for example in the US - which spends much more than we do on healthcare, and for those "fortunate" to have great healthcare provision can greatly prolong the time it takes to die.

That can happen, but I've also experienced close relatives with advanced Alzheimer's unable to swallow, with bowell incontinence, drugged to the eyeballs with no dignity whatsoever, somehow surviving for week after week, with family members alternating at the bedside, whilst the poor person gasps from one laboured breath to another.

In circumstances like that you're hoping the next gasp will be their last.
Sometimes you're lucky and can actually be there at the end.
More often than not it's sods law and they pass away when you've nipped out for a fag etc....almost as if they know you're not there and want to spare you the actual dying breath.

[Thephoenix]

I have long believed that quality of life was at least as important, if not more so, than quantity of life. Much of the objection to voluntary euthanasia comes from religious organisations. Personally I believe in the absolute right of a person to terminate their own existence, or have someone do it for them, if living has become so unbearable that they can see no other way to end their suffering, whether than is mental or physical.

You're right about the religious organisations.
His Lordship The Arch Bish has already taken the opportunity to speak against it.
Interestingly enough in the surveys I've read the majority of 'religious' people don't agree with their leaders, except for members of Islamic faiths.

[Moby Dick]

You say that now but the closer you've been to death the more you value life.

Yes surviving a near death moment changes your outlook on life.
That’s quite different to getting old, yet in both cases you value time and health more than money.

As you get older you realise you physically can’t do what you used to be able to do.

You realise from the death of your parents there will be a point when you won’t be able to eat, drink, get up, get dressed, wipe your own arse without assistance. Or you suffer serious decline in mental ability.
It would be at this point I question why I would wish to prolong death.

That’s quite different to being a survivor of a car crash, or a heart attack.

[king tarzan]

I fully agree with it

[Blackpool Rock]

From my experience around 30 years ago with an elderly relative I would argue that we already have euthanasia in this country however it's just not officially recognised / sanctioned / openly admitted

Without going into detail from what I saw the medical staff appear to assess an old person considering age and condition then make a judgement as to whether they think they will survive or how long and what the cost will be then decide whether to give medical treatment.

So for instance someone with a particular condition age 60 may get good treatment whereas the next person age 90 may not, my understanding is once they start giving treatment they struggle to withdraw it but if they never start treatment they can effectively kill someone, perhaps times have changed but it all comes down to cash 

Anyway back to the question and yes I do agree with "Assisted dying" so long as the correct safeguards are in place to stop it becoming a way to bump off Grandma to get the inheritance etc

I've not seen it 1st hand but I know people who watched their parents dying from cancer in an exceptionally painful way, one friend was there at the point his Mum died while coughing up blood, it stays with you forever.

I have thought about this subject quite a lot and I guess everyone's stance is a bit different depending on their circumstances and whether they have a partner / kids / grandkids etc
The best option is obviously to die peacefully in the night following a particularly intense punt the day before and a couple drinks of your favourite tipple just before bedtime but we don't normally get to choose like that, unfortunately 
Personally if I get ill and decline to the point where I don't feel that I have a good Quality of life then I intend to go at the time of my own choosing 
Unfortunately as already said we don't always get to choose but I hate to think that I will end up sat in a chair in a care home for years on end doped up to the eyeballs and sitting in a piss stained chair until the money runs out that is 

[Strawberry]

This is a difficult subject, for me there is always 'what if' and of course the action is very final.

I think it depends on each, individual situation.

[ronthebrummie]

I`ve seen my Mother and my ex Mother in law both in their 90s suffer a long painful end with cancer, wouldn`t wish it on my worst enemy, my Dad was 92 and he just lost the will to live. It was so hard on all of us, so yes i`m all for it, I`ve spoken at length with my daughters about it, I certainly don`t want them to have to look after me, so its a massive yes from me, small injection and away you go.

[standardpostage]

I agree with assisted dying. I don't want to suffer a long and painful illness. I don't want to end up an incontinent cabbage in a care home.

I've worked in care homes, very sad.

[notcalledchris]

For me it is less an argument as to whether assisted dying is a good or bad thing (I am sure if we look hard enough we can find examples of both  good and bad).  It is a question of allowing adults to make their own decisions even if they are decisions we might disagree with. 

[Jonestown]

From my own experience with family members and friends there comes a point in the progress of a terminal illness when a quick death is a blessing for everyone concerned, where that point is maybe hard to recognise at the time.

I think part of the reluctance of the medical profession to accept some form of assisted dying is that the doing of the actual deed will fall to them, not many people enter the medical profession to become an executioner.

[radioman33]

This is a difficult subject, for me there is always 'what if' and of course the action is very final.

I think it depends on each, individual situation.

What is difficult in making a personal decision if you have stomach cancer,in terrible pain,or MND ,motor neurone disease,unless you’re religious it’s a simple decision,your quality of life is zero and you are dying in pain so get a nice death asap.

[lostandfound]

That can happen, but I've also experienced close relatives with advanced Alzheimer's unable to swallow, with bowell incontinence, drugged to the eyeballs with no dignity whatsoever, somehow surviving for week after week, with family members alternating at the bedside, whilst the poor person gasps from one laboured breath to another.

In circumstances like that you're hoping the next gasp will be their last.
Sometimes you're lucky and can actually be there at the end.
More often than not it's sods law and they pass away when you've nipped out for a fag etc....almost as if they know you're not there and want to spare you the actual dying breath.

The deaths I observed were I believe with the Liverpool pathway - maybe not adopted by all hospitals, or not yet.

Frank Field is I think in a hospice so I hope and expect that may be available to him, esp as he was MP for Birkenhead, and I guess still lives in the area.

[Gordon Bennett]

If it were bought in I could see the "legal industry" rubbing their hands together at thought of another gravy-train income stream for themselves. Imagine the injunctions, judicial reviews, appeals etc. Whatever the medics decide there's bound to be a relative fighting the decision.
This sounds like something that's left discreetly in the background without any laws being introduced to simplify things as I believe the opposite would happen, it'd suddenly get mired in legal action/challenge. Judges, QCs and solicitors getting rich off it, NHS losing money defending itself.

[Proton]

 As for many of US on here, we have seen daily dreadful pain & suffering of our loved one, we were told that they are on the best painkillers possible. My 6'2" father was a "quiet gentle caring man" with chest cancer in hospital, suddenly developed a 24/7 uncontrollable rage and shouting. Hospitals solution was strapped to my dad into his bed for weeks, with doctors trying various medications to very little effect. With my mum loosing three stone with worry and I still got the scares from dad's finger nails digging into the back of my hands. Seen to many good people I knew well, becoming drugged up to a permanent ZOMBIE state in so called care homes...
                           IT'S CERTAINLY NOT LIFE, AS LIFE IS "DIGNITY & EQUALITY" I KNOW IT   

[Doc Holliday]

The deaths I observed were I believe with the Liverpool pathway - maybe not adopted by all hospitals, or not yet.

The Liverpool Pathway no longer exists and has been replaced/updated following criticism.

Some of the answers here indicate the reason this is complex and controversial. When I hear of people saying I don't want to be left miserable in a care home then you need to be aware this bill will mean you will still be left miserable. However that sentiment gives credence to the objectors who fear 'creep'.

Quality of life is a huge subject and is very subjective and individual when trying to quantify. This bill is not about ending life where your quality is deemed poor, but about ending pain and suffering in what is intended to be a very small number of terminal cases (max 6 months) which are beyond the scope of modern palliative care in controlling such pain and distress.

There is also the distinction between not prolonging life by withdrawing treatment and support and actively ending it early. The former is now legally acceptable (in principle at least) but can and does cause issues between the healthcare professions and families.

The relationship 'triangle' between doctor/patient/family can be a problematic minefield. This will just add to it.

Remember also that consent by the patient is of paramount importance and will require that individual to be of sound mind etc at the time of giving consent. This will exclude large numbers of people with dementia, a huge cause of death.
So those saying that is what they want for themselves, get in early with your signature  but bear in mind when it actually comes down to death approaching, it is common for many people to change their minds and cling to life.

The principle of ending suffering, seems straightforward, but it is not.

[Doc Holliday]

There’s been bills for nigh on a hundred years. None have have passed or got anywhere. In England you can make a legally binding directive to refuse life-prolonging treatment in certain circumstances, that’s about it.

Indeed I cannot see this being passed either. I believe the government opposes it?

I suspect the BMA feels the same which means they can confidently withdraw objection and allow the MPs to be the 'bad boys'.

[Marmalade]

Indeed I cannot see this being passed either. I believe the government opposes it?

I suspect the BMA feels the same which means they can confidently withdraw objection and allow the MPs to be the 'bad boys'.

From what I remember, their voting sessions had a strong contingent of younger members that supported legislative change, and probably those members educated in formal (philosophical) ethics. MPs are traditionally reluctant, preferring to do nowt or dismiss the matter as a conscience vote — even when the House of Lords instructed them to do something about it in their judgment of the Tony Bland (Hillsborough disaster) PVS case.

“Keeping people alive” tends to have more placard power than “helping people die”. The best the law can do is decide not to prosecute when someone helps arrange a relative’s trip to Switzerland.

[Thephoenix]

There’s been bills for nigh on a hundred years. None have have passed or got anywhere. In England you can make a legally binding directive to refuse life-prolonging treatment in certain circumstances, that’s about it.

That may be so, but I think as time goes on with more pressure being put on politicians from public opinion, legislation will eventually be passed.

I assume politicians in those countries where assisted dying in some form is allowed, must have eventually bowed to public pressure......

ie... Switzerland, Netherlands, Spain, Belgium, Luxembourg, Canada, Columbia, Australia, parts of USA, France and New Zealand.

I believe if there's a will there's a way.

External Link/Members Only

[Marmalade]

That may be so, but I think as time goes on with more pressure being put on politicians from public opinion, legislation will eventually be passed.

I assume politicians in those countries where assisted dying in some form is allowed, must have eventually bowed to public pressure......

ie... Switzerland, Netherlands, Spain, Belgium, Luxembourg, Canada, Columbia, Australia, parts of USA, France and New Zealand.

I believe if there's a will there's a way.

External Link/Members Only

It’ll happen when the BMA strongly support it, I reckon, which is kinda what happened in Netherlands. We’ve never had ‘public pressure’ that has the force of law (as they had in Oregon with their ‘Initiative’ if that’s what it’s called — a referendum - type thing that automatically becomes the law if enough people vote for it.) I had a look at the stats — it seems it’s been 70 or 80 per cent in favour for donkeys’ years. Our own government is pretty ‘top down’: once you’ve ‘voted’ for your MP, that’s you’ve had your say and no-one in government is particularly forced to listen, much less get a majority vote through both Houses!

[davxx]

I fully agree with assisted dying.
Had a discussion earlier, we sadly had to have our Cat put to sleep all very dignified and nicely handled by our vet.
It is a shame that similar action cannot be taken for us when our quality of life becomes so bad.

[myothernameis]

There some other aspects of assisted dying, which I think could be a cause for concern.

In an ever aging population, and were living longer, but in our retirement, we make sure we enjoy our self's, to the most, and spend our savings.  You now find your self in poor health, and need to be looked after, and none of you family can help.  There no choice but for you to be put into nhs care, and can only assume over the next few years. 

The cost for care, is going to be a burden on the nhs, so here does the nhs trusts start to look at assisted dying, if thats your wish

Another issue, especially if you have life cover, what do the insurance companies think of this, and would they decree that no payment will be made, if someone is assisted with there death

[binbag]

At face value , of course it should be allowed but once the variable circumstances are considered it starts to get complicated. Unscrupulous people take advantage of any situation, be they lawyers, relatives, neighbours, partners, ex partner. The list goes on and on.
Putting protections into law to cover all possible situations is impossible so do we say it cant be done or do we make a very narrow law that at least helps some people? That'd get my vote but the outcry on behalf of those to whom the law could not be applied would probably be overwhelming, enough to discourage most sitting politicians so I think it's unlikely to pass.

[Blackpool Rock]

From my own experience with family members and friends there comes a point in the progress of a terminal illness when a quick death is a blessing for everyone concerned, where that point is maybe hard to recognise at the time.

I think part of the reluctance of the medical profession to accept some form of assisted dying is that the doing of the actual deed will fall to them, not many people enter the medical profession to become an executioner.

They can't even get Harry Shipman out of retirement either since he topped himself 

[Blackpool Rock]

There some other aspects of assisted dying, which I think could be a cause for concern.

In an ever aging population, and were living longer, but in our retirement, we make sure we enjoy our self's, to the most, and spend our savings.  You now find your self in poor health, and need to be looked after, and none of you family can help.  There no choice but for you to be put into nhs care, and can only assume over the next few years. 

The cost for care, is going to be a burden on the nhs, so here does the nhs trusts start to look at assisted dying, if thats your wish

Another issue, especially if you have life cover, what do the insurance companies think of this, and would they decree that no payment will be made, if someone is assisted with there death

I'm pretty sure that Govts on the one hand like the fact average life expectancy goes up as it indicates that the quality of life is good however on the other hand they are also aware of the increased cost it has in terms of the NHS and also state pensions etc.

As for insurance companies we all know the lengths they go to to avoid paying out, I believe suicide voids any payment and the liklihood is that assisted death would too

[Doc Holliday]

As for insurance companies we all know the lengths they go to to avoid paying out, I believe suicide voids any payment and the liklihood is that assisted death would too

That's a common held view, but Insurance companies recognise suicide as a cause of death and in most instances pay out if at least 12 months premiums have been paid and there is no evidence suicide was intended when the policy was taken out. Currently they do not distinguish between suicide and assisted suicide although the investigation process with the latter is likely to delay payment.

In any case most insurance policies these days will pay out in advance of death (up to 12 months) with a diagnosis of terminal illness, so the suicide element becomes irrelevant.

[Doc Holliday]

It’ll happen when the BMA strongly support it,

It would certainly make it more likely, but whilst the BMA has shifted it's position from opposition to a neutral one, it would take a seismic shift for it to move to support.

The recent policy move to neutral followed a survey of members the results of which show there is very split opinion with many undecided.

Interestingly when you get down to the question would you as a doctor actually be personally involved in administering the lethal medication, only 26% said yes although this was higher 36% when it was prescribing only and the patient actually administered it themselves.

I cannot foresee a situation where such a survey of Doctor's opinions would be more clear cut allowing the neutral position to shift to support?

The other survey result I found interesting is that...

Overall, medical students were generally more supportive, and GPs generally more opposed, than most other branches of practice.
These specialties tended to be generally more supportive: anaesthetics, emergency medicine, intensive care and obstetrics & gynaecology.
These specialties tended to be generally more opposed: clinical oncology, general practice, geriatric medicine and palliative care.

Ultimately the politicians will decide not the Doctors, but it seems there may be sufficient doctors willing to be 'executioners' subject to the required criteria and legal protection.

External Link/Members Only

[Marmalade]

Med students get compulsory formal ethics training so learn how to balance the arguments. In Oregon, the citizens bill went through many re-drafts before it was acceptable enough to pass. Equivalent here would be the Law Commission taking it on and devising something both rugged enough to be effective while preventing abuse.

[Genesis42777]

The Liverpool Pathway no longer exists and has been replaced/updated following criticism.

Some of the answers here indicate the reason this is complex and controversial. When I hear of people saying I don't want to be left miserable in a care home then you need to be aware this bill will mean you will still be left miserable. However that sentiment gives credence to the objectors who fear 'creep'.

Quality of life is a huge subject and is very subjective and individual when trying to quantify. This bill is not about ending life where your quality is deemed poor, but about ending pain and suffering in what is intended to be a very small number of terminal cases (max 6 months) which are beyond the scope of modern palliative care in controlling such pain and distress.

There is also the distinction between not prolonging life by withdrawing treatment and support and actively ending it early. The former is now legally acceptable (in principle at least) but can and does cause issues between the healthcare professions and families.

The relationship 'triangle' between doctor/patient/family can be a problematic minefield. This will just add to it.

Remember also that consent by the patient is of paramount importance and will require that individual to be of sound mind etc at the time of giving consent. This will exclude large numbers of people with dementia, a huge cause of death.
So those saying that is what they want for themselves, get in early with your signature  but bear in mind when it actually comes down to death approaching, it is common for many people to change their minds and cling to life.

The principle of ending suffering, seems straightforward, but it is not.

Doc Holiday mature and empathic view
I applaud you  Regards G

[Watts.E.Dunn]

Young female relative worked at a private care home, almost ended up depressed as most every day she'd take a "resident" there a cuppa in the day room, try to wake them .. another teabag wasted:(

Did mobile care home work, a bit better she said she had old 80 plus men almost in tears as she had to give them a bath, tears it seemed of grattuide as she was so carefull with them and took good care of them. She said most all would like chatting to her for some company as days would go by with no one around, relatives would rarely turn up to see them..

And not once did any make any impropper suggestions, all were perfect gentlemen she said..


The private ones around now cost around £1500 a Week! funded by the person selling their home, and hoping the money will last long enough!!!

[sir wanksalot]

Young female relative worked at a private care home, almost ended up depressed as most every day she'd take a "resident" there a cuppa in the day room, try to wake them .. another teabag wasted:(

Did mobile care home work, a bit better she said she had old 80 plus men almost in tears as she had to give them a bath, tears it seemed of grattuide as she was so carefull with them and took good care of them. She said most all would like chatting to her for some company as days would go by with no one around, relatives would rarely turn up to see them..

And not once did any make any impropper suggestions, all were perfect gentlemen she said..


The private ones around now cost around £1500 a Week! funded by the person selling their home, and hoping the money will last long enough!!!

I find that deeply upsetting. I have a very close relative who is in her 90's. All her friends are in the cemetery, even the ones a few years younger than her. It is very sad.

[simping]

Can you sign up without a terminal illness?
Quality of life is being severely impacted by pussy inflation.

Hidden Image/Members Only

[myothernameis]

The private ones around now cost around £1500 a Week! funded by the person selling their home, and hoping the money will last long enough!!!

My mum spent around 3 weeks in a care home, before passing away, and the bill came to just under £5000.   If my mum was still alive and in care, we would have had to put our mum's place up for sale, as we could be looking at £60,000 bill for the year