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So. Assisted Suicide. Good or Bad idea?

hifinutt said:
you can certainly give an independant assessment of capacity but how do you suss out duress . people can be VERY convincing . If i had mnd i am pretty sure i could put up a very convincing show to persuade any medical practitioner . but my motives may well be influenced by the desire to relieve others of the burden of worry and care .
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The point is that it would be you that swallows the pills, pushes the plunger or whatever. If your reason for doing so is to relieve others of worry and care then that is valid.

It might be impossible to know if someone did so under duress but what, and how relentless, would that have to be to convince someone of sound mind to agree? Possible but extremely unlikely I would think.

If the election can be made only within 6 months, what would be the motive to have it done sooner?

On a separate issue (or perhaps related to duress), I assume no insurer would pay death benefits for what is essentially suicide unless they had already paid under critical illness cover.
 
hifinutt said:
Drs are VERY powerful people . there may be whistleblowers but in the NHS they are OFTEN silenced

Not long ago this happened in Gosport


At least 450 patients are thought to have died after the administration of inappropriately high doses of opioids between 1988 and 2000 at Gosport War Memorial Hospital. In June 2018, the report of the Gosport Independent Panel into failures of care was published. The report found no evidence that the pharmacists providing services to the hospital, or the Portsmouth Hospitals NHS trust drug and therapeutics committee which covered the Gosport War Memorial Hospital had challenged prescribing practices.

That such prescribing practice remained unchallenged for a prolonged period of time despite initial concerns being raised by nursing staff raises concerns for current providers of pharmacy services. These providers include the traditional hospital pharmacy services as well as newer service models that include outsourced and alternative service providers.

this is RECENT and can happen again .

More than 15,000 death certificates are being examined by police investigating the deaths of patients at a hospital.

An inquiry found 456 patients died after being given opiates at Gosport War Memorial Hospital between 1987 and 2001, but no charges have been brought.

An independent investigation, led by Kent and Essex Serious Crime Directorate, is reviewing millions of pages of evidence.

About 150 detectives and staff are expected to be involved in the probe.

Police began the inquiry in 2019 into 700 deaths after the Gosport Independent Review Panel found there was a "disregard for human life" at the hospital in Hampshire.

Coroner-led inquests in 2009 found drugs administered at the hospital contributed to five deaths.

https://www.bbc.co.uk/news/uk-england-hampshire-56404256
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This is a Shipman-type situation and nothing to with the draft Bill on assisted dying.
 
Bob McC said:
I object most strongly to others thinking their religious beliefs should have any say in my right to take my life safely, with appropriate drugs as painlessly as possible if I find my continued existence intolerable.
Arguments around duress are fluff.
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Bob, I agree.
 
Yes, I think it's unfair and immoral to have an individual suffer a long and agonising end to their life and to be forced to watch their loved ones suffer as they wait upon the inevitable, it should be a choice we all should be able to make given we're of sound mind.
 
Last year my father died on dementia. I won’t put my wife through that (she’s much younger than me) if I go the same way.

Failing changes in legislation and while still able, I plan a long walk with a good bottle of whisky on a cold night. We should have the right to end our life as we wish.
 
My dad had his first heart attack at home in 1993 aged 50, and it was just me and him at home. I had done a Red Cross first aid at work course a few weeks before and guessed what was going on. I put aspirin under his tongue and called 999.

He was stabilised in the cardiac unit but they did tests and diagnosed him with Binswangers disease, an ongoing vascular problem. Over the next few years he had more MI’s and mini strokes, which eroded his personality and physical abilities every time. Quite soon after the diagnosis he’d said that he didn’t want his suffering to drag on and he didn’t want his family to have to witness it and make his decisions for him. Unfortunately he was not granted the choice in the end, and we had almost a year where his shell was kept breathing for no benefit to anyone. He didn’t want to suffer and we didn’t want to see him suffer but we were not given an option. Had an early exit been available at the time I know he would have opted for that and we would all have supported him. He died of a final massive stroke at 59. This served no benefit to him or anyone else, and I fully support the right, particularly of those with the competence to decide, when the time has come.
 
It is a hard truth to face, but unless societies find the political will to ration end-of-life care, healthcare services will remain either unavailable or unaffordable for way too many people. IMO, part of healthcare should be about helping people die with dignity and minimal pain. It is of course very sad to see anyone die, but the senseless prolonging of painful existence (not the same as life) is much worse. IMO, physician-assisted dying should be a universal right. Everyone deserves the chance to decide when enough is enough.
 
Can't get my head around the the amount of capital/time invested in the prolonging of life. One day someone is going to have to say no more kids! Unless a global balance of population is reached.
 
I do notice that with cancers that have gone beyond treatable, that the doctors don't seem to try too hard to control infection and prolong life.
The issue with this topic is that the extended suffering for several years is more with dementia and the effects of extreme old age. In both of these the patient is not likely to be able to choose properly.
 
dementia has been mentioned a few times . Its a very sad and progressive illness taking many years in some cases to die . as far as i can see you have the decision to take your life with this bill if you have FULL capacity . so this would be pretty useless in the case of dementia . this is the form the person has to sign :

I have [condition], a terminal condition from which I am expected to die within six months of the date of this declaration. The Attending Doctor and Independent Doctor identified below have each fully informed me about that diagnosis and prognosis and the treatments available to me, including pain control and palliative care. Having considered all this information, I have a clear and settled intention to end my own life and, in order to assist me to do so, I have asked my attending doctor to prescribe medicines for me for that purpose. 15 I make this declaration voluntarily and in the full knowledge of its significance. I understand that I may revoke this declaration at any time
 
the bill states
recognising and taking account of the effects of depression or other psychological disorders that may impair a person’s decision-making;

in holland Aurelia a 29 year old was the subject of great debate on this matter


"These criteria may be more straightforward to apply in the case of someone with a terminal diagnosis from untreatable cancer, who is in great pain. And the vast majority of the 6,585 deaths from euthanasia in the Netherlands in 2017 were cases of people with a physical disease. But 83 people were euthanised on the grounds of psychiatric suffering. So these were people - like Aurelia - whose conditions were not necessarily terminal."

https://www.bbc.co.uk/news/stories-45117163
 
Hook said:
It is a hard truth to face, but unless societies find the political will to ration end-of-life care, healthcare services will remain either unavailable or unaffordable for way too many people. IMO, part of healthcare should be about helping people die with dignity and minimal pain. It is of course very sad to see anyone die, but the senseless prolonging of painful existence (not the same as life) is much worse. IMO, physician-assisted dying should be a universal right. Everyone deserves the chance to decide when enough is enough.
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you are quite right about dying with dignity . at the moment many hospices and community nurses provide this service . as folks worsen with whatever illness they have be it MND or cancer or dementia end stage , they can have access to hospice care . right at the end they often have a syringe driver containing appropriate drugs such as diamorphine for pain, certain drugs for excess secretions , drugs for agitation. etc etc. these can be adjusted so folks can die with dignity

discussing this matter today with a specialist palliative care Dr who belongs to the Association for palliative care . this body represents many Dr`s and healthcare professionals in the UK

this is what they feel


Assisted Dying Bill House of Lords – 22 October 2021
The APM is the world’s largest representative body for doctors practicing or interested in Palliative Medicine. We aim to ensure that no one need die in distress or discomfort for lack of access to adequate specialist palliative care. Baroness Meacher’s Bill seriously undermines this. We have offered the APM’s perspective because our members core practice is care for those at the end of life.

We do not comment on AD itself, but the substantial risks and consequences of legislating for doctors to be involved. The APM’s membership’s position on this, based on recent, independent polls, is clear.

“Assisting Dying” (AD) is a loose term that covers assisting suicide and administering euthanasia. Baroness Meacher’s Bill is vague, ambiguous, and silent on many key issues. This is remarkable for legislation that changes fundamentally a doctor’s duty of care:

  • it contains no safeguards to exclude errors, bias, or criminality
  • it leaves the door wide open to relaxing safeguards and eligibilities in the future, including bringing in euthanasia
  • there is nothing in the Bill to protect people at vulnerable times in their lives, and particularly elderly or disabled people
  • There is no attempt to fill the existing shortfall in specialist palliative care that experiences of bad deaths show to be so badly needed
The UK has led the world in the research and development of hospice and palliative care, pain and symptom control.

  • Over 300 people a day in this country suffer unnecessarily due to lack of access to specialist palliative care services
  • During the pandemic palliative care was widely called upon to help
  • Despite this, it remains a statutory service that is neither funded nor commissioned across the NHS in any consistent form
  • Most service funding is through voluntary donation
  • AD Legislation also signals that the UK is abandoning efforts to improve care of the dying.
We have urged Parliamentarians to reject this Bill. Some of our concerns are outlined in the attached document here.

https://apmonline.org/
 
Colin L said:
Last year my father died on dementia. I won’t put my wife through that (she’s much younger than me) if I go the same way.

Failing changes in legislation and while still able, I plan a long walk with a good bottle of whisky on a cold night. We should have the right to end our life as we wish.
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I agree. Adequate safeguards should ensure that justice is done.
 
have a look at the apm link i posted
“Assisting Dying” (AD) is a loose term that covers assisting suicide and administering euthanasia. Baroness Meacher’s Bill is vague, ambiguous, and silent on many key issues. This is remarkable for legislation that changes fundamentally a doctor’s duty of care: it contains no safeguards to exclude errors, bias, or criminality; it leaves the door wide open to relaxing safeguards and eligibilities in the future, including bringing in euthanasia; there is nothing in the Bill to protect people at vulnerable times in their lives, and particularly elderly or disabled people. There is no attempt to fill the existing shortfall in specialist palliative care that experiences of bad deaths show to be so badly needed.

Over 300 people a day suffer unnecessarily due to lack of access to these services. During the pandemic palliative care was widely called upon to help. yet it remains a statutory service that is neither funded nor commissioned across the NHS. Most service funding is through voluntary donation. Legislation also signals that the UK is abandoning efforts to improve care of the dying. We urge Parliamentarians to reject this Bill.

Evidence from jurisdictions that rely on doctors as gatekeepers on AD also undermine this Bills feasibility and safety. This is not a minor or containable change for healthcare but a paradigm shift in a doctor’s duty of care to those with life-limiting disease Every conversation about dying would change after AD as NHS clinicians will have to to discuss the ‘full range of options’ with patients.
 
hifinutt said:
have a look at the apm link i posted
“Assisting Dying” (AD) is a loose term that covers assisting suicide and administering euthanasia. Baroness Meacher’s Bill is vague, ambiguous, and silent on many key issues. This is remarkable for legislation that changes fundamentally a doctor’s duty of care: it contains no safeguards to exclude errors, bias, or criminality; it leaves the door wide open to relaxing safeguards and eligibilities in the future, including bringing in euthanasia; there is nothing in the Bill to protect people at vulnerable times in their lives, and particularly elderly or disabled people. There is no attempt to fill the existing shortfall in specialist palliative care that experiences of bad deaths show to be so badly needed.

Over 300 people a day suffer unnecessarily due to lack of access to these services. During the pandemic palliative care was widely called upon to help. yet it remains a statutory service that is neither funded nor commissioned across the NHS. Most service funding is through voluntary donation. Legislation also signals that the UK is abandoning efforts to improve care of the dying. We urge Parliamentarians to reject this Bill.

Evidence from jurisdictions that rely on doctors as gatekeepers on AD also undermine this Bills feasibility and safety. This is not a minor or containable change for healthcare but a paradigm shift in a doctor’s duty of care to those with life-limiting disease Every conversation about dying would change after AD as NHS clinicians will have to to discuss the ‘full range of options’ with patients.
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I think that is a self-serving misrepresentation of the Bill as drafted.
 
No it's the concern of thousands of palliative consultants who belong to this organisation . I spoke to one recently

They want more money and resources to give folks dignity at the end .

The problem is mum and dad will possibly consent to euthanasia out of a desire to save being a burden . That is a major concern and some valid concerns in the apm paper
 
There is a chink of light in this process. If one suffers from a Pulmonary Fibrossis the District Nurse in conjunction with the patients Doctor can be issued with a drug that will ease the patient into permanent sleep and death. The doctor district nurse will inject the drug when the patient's discomfort becomes unacceptable. However the patent has to be in a pretty poor state to get the injection - drowning in the phlegm in their lungs.
So far I have not been prescribed the drugs. My brother did not have the drugs and he had a very disturbing death however it was not too long but no doubt very disturbing.

So there is some progress.
 
I theory I'm in favour of assisted suicide being their as an option (although I have serious concerns about whether it should be applied in situations like the one in the Netherlands linked earlier in the thread - the young girl with mental health issues), but I think there are risks and practical difficulties in putting a good solution in place (including the handling "not wanting to be a burden/financial drain" situations).
 
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