To think that we need to have an honest conversation about euthanasia and care costs

I remember a patient I had when I was a student ODP on placement in recovery.
A chap in his 80s with advanced dementia. He was with us as he had to have a GA to take a biopsy of a potential cancer. As soon as he was awake, he was combative (more so towards women). He had no family or anything... and he absolutely lacked capacity.
As awful as it sounds, I did wonder what the point of a biopsy was. Would he have been put through cancer treatment too?

So your latest logic is that we shouldn’t prolong life if we can administer medication to end it? Therefore killing someone? You may find the wording and terminology uncomfortable but if that’s the practice you’re advocating, then at least have the courage to call it what it is.

I’ll give you the benefit of the doubt by assuming that you’re definitely not in a specialist palliative care role. But your attitude to end of life care and drug administration is troubling and may be something you need to explore further with a clinical supervisor.

I'm sure most people would prefer to have a retirement at 65 and a a few years of good health to enjoy rather than a few extra years loitering around in a care home at 90 getting you arse wiped for you and living on pills

Seriously? You think people would rather die at 70?

Mumsnet really hates old people!

Yep, it costs £thousands... and if you have ever been sectioned under the mental health act, then it is even more difficult to be accepted by them.

He was a person.

I remember a patient I had when I was a student ODP on placement in recovery.
A chap in his 80s with advanced dementia. He was with us as he had to have a GA to take a biopsy of a potential cancer. As soon as he was awake, he was combative (more so towards women). He had no family or anything... and he absolutely lacked capacity.
As awful as it sounds, I did wonder what the point of a biopsy was. Would he have been put through cancer treatment too?

It's very difficult and expensive to go to Dignitas. If you are serious then start saving.

I'd agree that's part of the issue. We are keeping people alive artificially, which makes the whole end process worse.
Maybe there should be agreements not to treat infections etc when people no longer have capacity.

Looking at an even bigger picture, people are having to work until nearly 70 because the average death age has gone up.
But are people in their 60s much healthier and fitter than people in their 60s were 50 years ago? Probably not.

If anything with obesity rates they are probably less fit. And office jobs have become even more sedentary with the advent of paperless offices, no getting up to get files or put them away.

I'm sure most people would prefer to have a retirement at 65 and a a few years of good health to enjoy rather than a few extra years loitering around in a care home at 90 getting you arse wiped for you and living on pills.

Look at your life now and make the changes you need to be happy and fulfilled now, not try and control a process that it is impossible to control.

I’d be off to Switzerland, when I got a terminal diagnosis or dementia. In no account, do I want to go, the way I’ve seen older relatives go! My cats were much luckier. DS did work experience at two vet’s practices and he said, they regarded owners, who let their animals suffer for too long, as cruel.

You’re using deliberately inflammatory language here which isn’t helpful to the discussion. No one is administering pain relief to ‘kill someone’ - the diseases or old age has already taken care of that. HCP’s are administering pain relief to relieve pain, as they should. The secondary impact of which is, in many cases, a faster death. I’m not sure what your problem is - if you’ve been anywhere near clinical practice at the end of life you know full well what I’m talking about but appear to exist in a parallel universe where we prolong the life and therefore the suffering of dying people to what end? More suffering? That’s not, in any way, what happens and you know it.

Of course I’ve witnessed rattling and in every case let someone know the inevitable is happening, do you even know how care at the end of life works? I cannot believe you’ve been anywhere near clinical practice because you seem so completely detached from the reality of the management of death in the majority of cases for elderly and dying people.

i work in care and i agree wholeheartedly. The suffering for so many is just unacceptable. Its almost we have eradicated people dying from old age . So many times they are rushed of to hospital literally on the cusp of death and they pump them with whatever and then return them to us another notch worse .
Why are we so afraid of letting people die 🤷🏻‍♀️

If you’re worried about yourself at the end of your life because of your parents, then have a look at advanced decisions to refuse treatment. If I was ever diagnosed with anything, I’d make one and let my family know.

If you’re an HCP who witnessed a patient experiencing a symptomatic ‘death rattle’ and didn’t act to reassess or refer for reassessment by somebody qualified to do so, and failed to reassess the efficacy of the prescribed anti cholinergic regime and the need for dose increases and amendments, then YOU are part of the reason why we need more investment and training for those involved in the provision of palliative and end of life care.

And at the risk of being repetitive, the doctrine of double effect is an ETHICAL justification for the use of drugs with potential lethal consequences. It has no basis in the law or in clinical guidance or decision making. You can justify your actions in your own head all you like

If I suspected for one second that any of my staff were administering analgesia and sedation on a whim to kill somebody I would expect, and ensure that they felt the full force of the law

And you wonder how traumatic this is for family members just given the morphine and told to give it as we see fit. This is why we probably give too little.

Trying to control death leads to all sorts of anxieties. Best to be more accepting.

Oh ok, so your problem with my position on this is semantic? Or lexical?

I absolutely suggest that nurses and doctors administer pain relief at the end of life that they know will suppress breathing and very likely hasten death, yes. This isn’t up for debate, it’s standard practice. The primary reason for administering the dose is to relieve pain, but the secondary impact is that in someone about to die, it will usually speed things up. I’m sorry if you find this distressing, have you ever seen someone die before?

When I was a practicing HCP I worked in elderly care and latterly in palliative care, so I have witnessed death many, many times. Death, particularly for the elderly, is a process that takes weeks or months in most cases. Patients will take gradual ‘steps’ downwards in their health and their QOL sometimes over many months. Death, more often than not, is a process of deterioration, not a singular event. The final stage of that process is colloquially referred to as rattling. You may have heard of a death rattle? Same thing. Essentially, the lungs fill with fluid and it is incredibly painful as the patient essentially drowns over many hours/ days. I once saw a man rattle for over a week. It’s not often a patient is conscious at this stage and almost never lucid. Occasionally, they scream or cry out because of the pain of it. Once a patient is rattling there is no chance that patient is going to recover miraculously. They will die within hours or days and gradually decline as they do, suffering more and more as they go. It is in these cases where the administration of pain relief suppresses breathing and speeds up the process. For absolute clarity (I assumed wasn’t needed) I am not suggesting doctors and nurses are running around bumping off old people with UTI’s and common colds Shipman style. I am clarifying that assisted dying (not assisted suicide) already exists in a completely sanctioned way in society.

@Noras
Life is what it is. At times beautiful, at times horrific.
When you experience something that is horrific for you, you would do anything to protect your loved ones from it, but you can't protect them from life. And you can't tell what they will be able to handle either. If you let it take up your thoughts now, you are letting the future rob you of your present.

Feeling able to control life after our time is something you may try to latch onto, a way of feeling more in control, a way to ensure you have done what you can, but in reality life will go in the direction it wants, and you really won't be able to alter it.

You are understandably thinking of your son's future. But at the end of the day you will really have to trust that things will be as they will be. Leaving money for your son, and I would hope equally to your daughter too, will in no means guarantee a happier more fulfilled life. There are far too many possibilities, to many unforeseen consequences of every choice.

Some people will lose their parents in prolonged agony, others in their sleep and others in every way in between.

Those around you at the time of your death will manage the best they can, just as you did. Just as I would love to raise my children again, starting from now, so I may be the perfect mother, but it's not possible, I did the best I could for them at the time.
And so did you while assisting your parents.

Yes, we can and should debate issues, but I believe that every choice has a set of both positive and negative consequences.

Don't spend your time worrying about a future which has not yet come to pass.