Assisted dying bill (TW assisted suicide discussion)

Citation needed.

Canadian law has been expanded to a degree that I personally don't agree with, but as I understand it the US and Australian states which introduced assisted dying for people with a terminal illness have not extended that to other people, even where the legislation has been in place for over a decade.

Also a nurse and totally agree. OP I understand where you're coming from. You are talking about the last two weeks of your mum's life when there was no hope and she was suffering. I'm so sorry she, and you, had to go through that. But my worry is that it's such a slippery slope, would people not ready to die feel coerced into it? So many people talk about the elderly "bed blocking" and taking up so much of the NHS resources. And some families (NOT you OP) can be unscrupulous! And there's the question about mental capacity and the ability to consent. I'd just be worried what it could all lead to in time ..a bit too Logan's Run for my liking!! I'm probably being way too over-dramatic but I feel very uneasy at the thought of it.

I support it. I think it is an important choice to offer. We don't allow animals to suffer in the way we allow humans to, because we recognise it would be cruel.

IMO any involvement of the NHS in assisted dying taints it and sullies the medical and nursing professions. Professions that are about health promotion and life preservation should not be mixed up with any kind of positive intervention to promote death. I am not talking about keeping people alive at all costs. It is already possible for patients’ medical problems to not be actively treated if it is deemed to not be in their best interests. The field of palliative care aims to ensure as good a death as possible and I learnt early in my medical training of the doctrine of double effect: Relieve the patient’s pain. If the medication dose that relieves pain has the effect of killing the patient, so be it.

My impression from working as a healthcare assistant and junior doctor is that many people struggle to see their relative greatly diminished and want the process to be sped up. The patients were usually calm with symptoms being treated to the best of the clinician’s ability but dying takes time and I’m afraid I don’t see why relatives need to be spared the discomfort. Dying is part of living. The duty of the medical professional is primarily to the patient. Assisted dying will just contribute to the current tendency in the U.K. for illness and death to be regarded with distaste. ‘Die quickly, die quietly’ just about sums it up.

The bill will eventually pass, if not now then sometime in the future and then scarce resources will need to be diverted from patient care. The only way I can see it working practically is for each NHS trust or group of trusts to have a dedicated team for assisted death referrals so that would mean extra salaries to be paid, premises to be found, for a start. Any other arrangement would create havoc and division among medical and nursing staff.

Tbf Canada has a different system. I believe I'm right in saying that the changes to their laws have come through their Supreme Court. Our system doesn't work that way - our Supreme Court couldn't rule that the terminally ill adults bill must be extended to include other people.

Good point, well made. 👏🏻

The current bill would allow terminally ill people with full mental capacity, who are not expected to live more than six months, to take their own life with medical assistance.

So it would not have helped your mother if she was unconscious at the end and would not have contemplated taking her own life before this point.

Are you advocating for a different bill altogether that would allow family to make the decision and a doctor to directly end a person's life?

This is something that bothers me generally about these discussions - people says things like, 'of course there would be safeguards' and then start talking about, e.g. dementia in the same breath.

I’m not in favour mainly because the right to die will inevitably morph into the duty to die - to spare relatives the distress of watching the dying process.

I think one can clearly see how vulnerable people could easily come under pressure to ‘do the right thing’ or ‘be kind’ to their family and submit to assisted death.

I used to be very much in favour of it but I have watched with growing horror what is happening in Canada with their MAID programme.

I am not convinced that there are adequate safeguards within the bill as it stands. I also have no trust in our country to run it well and therefore I am not in support.

are these nhs doctors? Is it fair to ask them to do this? What if they don’t want to ?

I imagine, like with abortion, they won't have to be involved if they don't want to.

When we have the kind of society that supports people to LIVE with dignity then we will be the kind of society that can handle the responsibility of assisted dying

I couldn't have put it better myself, @AnonyMouse80

How easy, though, to argue that we could better afford to support those with a decent life expectancy were it not for the costs of caring for the terminally ill - and if this was adopted it's an argument I'd expect to be made all too soon, though doubtless wrapped up in different words

All the people comparing it to pets there's the issue that a cat or dog lacks capacity to make its own decisions and you decide for it so this is not really analogous to someone with capacity who has cancer choosing to die and much more akin to ending the life of someone with eg Alzheimer's who lacks capacity to decide for themselves which is not covered by this bill.

This is why I really don't think it will be very long until people start to push for it to apply to those lacking capacity or for some advance directive mechanism otherwise I don't see how it can assist anyone dying of dementia who will lack capacity way before they have 6 months left.

Most people with terminal cancer are in fact very keen to live for as long as possible. I can't see that many people asking to be euthanised in that circumstance. My mum died young of metastatic cancer. She was desperate to survive and be with her family as long as she could and her death was as OK as I think death can be. She was in a hospice where she did not suffer unduly although obviously seeing my
Mum dying was still horrible. Death is always horrible you cannot take that away entirely.

Also Drs notoriously cannot tell how long someone has left. My mum was given 6 months to 2 years at least 6 years before she died and 5 of those were really good years that she would not have wanted to miss out on.

I am a Dr and I will conscientiously object if I am asked to have any involvement in this. I did not go into medicine to kill people. I am all for letting nature take its course and not 'striving officiously' to keep people alive, which happens all too often, but I do not want to be responsible for ending anyone's life.

Not a nurse, but I agree wholeheartedly with @Girliefriendlikespuppies I say that as someone who’s lost both parents and has a life limiting condition.

Anything in life can be abused, we need to look to what has and hasn't worked internationally so we can have the best protections in place.

While this is true, assisted dying is especially serious as abuse results in death. There is nothing more final than that. We abolished capital punishment because errors meant that on a rare occasion, an innocent person was executed for a crime they did not commit. So even if abuse of assisted dying can be categorised as a rare occurrence, why would we treat it differently from capital punishment? Why is it too dangerous to execute convicts because a handful might be innocent but alright to risk even a handful of deaths of some of the most vulnerable people in our society?

The process outlined to determine true consent and capacity is a mere charcol sketch compared to the rigor of past capital criminal trials. The two physicians signing off on it are not even required to confirm with a specialist that the person is terminally ill or has the capacity to consent. And it is quite clear the court judge is simply there to rubber stamp it as a state indemnification against any wrongful death civil suits that relatives might file against the physicians.

Unassisted is awful for the people that find the person, and the family that may not have had a clue about why.
This won't stop with an assisted bill, because not every person's circumstances will be considered.
Even then there will be family/friends who disagree for whatever reason (religion maybe?)
Who will responsible for checking the person is of sound mind/in enough pain or meets whatever criteria? Are the government proposing to fund this?
If it's self funded then the less well off won't have access to it.
Too many variables atm for me to agree it's a good idea, that's before the possibility of coerced signing.

I know the emotive argument is about the right to die with dignity and in theory I don’t disagree with it.

But while we live in a society with so much needless homelessness, where end of life care is so appalling, where so many people with disabilities or mental health problems do not have the support they need I think this bill puts those people at risk.

When we have the kind of society that supports people to LIVE with dignity then we will be the kind of society that can handle the responsibility of assisted dying.

I think in principle most people are ok with it but there are so many issues I don’t know how you’d solve them all:

1. my own experience with a terminally ill relative is they spent their last 6 months apologising for being a burden. They were actually very low in terms of support needed until nearly the very end and we had some wonderful times in those last six months. I would have hated if they’d left us early then due to misplaced guilt.
2. the current proposition is that two doctors and a judge sign off on each patient. How long would this take to do properly? The switch from “terminal but ok quality of life” to “really suffering and will die within weeks” is often quite rapid. So you then throw the family into begging doctors for assessment and filling in court forms at a really stressful time to maybe cut someone’s life short by a few days by the time it gets through? Would the passing be more peaceful necessarily?
3. are these nhs doctors? Is it fair to ask them to do this? What if they don’t want to ?
4. protection against coercion etc
5. people choosing to take death because admin errors mean they don’t get the support they should be getting
6. people wanting to expand it to mental illness
7. the “easy death” probably won’t be as serene and relaxed as people think and it might traumatise the families and make them feel that maybe it was to early/wrong choice etc. I saw a documentary about dignitas where they filmed the death and he clutched the air and tried very hard to breath. It was upsetting to watch.

there’s probably more. Some of these are solvable but not all. I suspect it will eventually pass even if it doesn’t this time around.

Anything in life can be abused, we need to look to what has and hasn't worked internationally so we can have the best protections in place

In principle that could work if we had the fully functioning infrastructure, proper accountability and sufficient money to make sure it did, @ChocolateTurtle, but sadly we haven't

Protection and oversight cost money too, and how much easier to shrug off alleged mistakes because "they were going to die anyway and the benefits outweigh the cost"

It is possible to have a good death without the need for suicide/assisted dying.

If that's the case then why are there still so many people dying in agony, both physical from the illness/disease or mental from things like locked in syndrome? So many people coming forwards begging to be allowed to die, mostly clearly of sound mind. If I could guarantee I would be able to be without pain and still use my brain I might change my mind, but for some people the very thought of being stuck almost paralysed in a bed depending on others to clean up your excrement and feed you, and unable to engage your brain is horrifying.

As a pp posted above, we would be prosecuted for treating an animal the way we treat terminally ill people

if assisting dying is not legislated for then that could increase the likelihood of people ending their own lives without medical assistance.

Studies have shown that assisted suicide does not decrease the nonassisted suicide rate, in fact it stays roughly the same. In fact the total suicide rates go up (assisted plus nonassisted). So it isn’t true that some of today’s unassisted suicides would be prevented by legalising assisted suicide. Here is one

”Objectives: Several US states have legalized or decriminalized physician-assisted suicide (PAS) while others are considering permitting PAS. Although it has been suggested that legalization could lead to a reduction in total suicides and to a delay in those suicides that do occur, to date no research has tested whether these effects can be identified in practice. The aim of this study was to fill this gap by examining the association between the legalization of PAS and state-level suicide rates in the United States between 1990 and 2013.
Methods: We used regression analysis to test the change in rates of nonassisted suicides and total suicides (including assisted suicides) before and after the legalization of PAS.
Results: Controlling for various socioeconomic factors, unobservable state and year effects, and state-specific linear trends, we found that legalizing PAS was associated with a 6.3% (95% confidence interval 2.70%-9.9%) increase in total suicides (including assisted suicides). This effect was larger in the individuals older than 65 years (14.5%, CI 6.4%-22.7%). Introduction of PAS was neither associated with a reduction in nonassisted suicide rates nor with an increase in the mean age of nonassisted suicide.
Conclusions: Legalizing PAS has been associated with an increased rate of total suicides relative to other states and no decrease in nonassisted suicides. This suggests either that PAS does not inhibit (nor acts as an alternative to) nonassisted suicide, or that it acts in this way in some individuals but is associated with an increased inclination to suicide in other individuals.”
https://pubmed.ncbi.nlm.nih.gov/26437189/

My sister had a "good death"... for two years.

It was awful. I'm sure a good death is something that does exist, I'm not sure if you have terminal cancer or altheimers it is actually possible

There's no way in the world I would want to go through what she went through and would much rather be able to go at a time and place of my choosing in a manner that actually is swift and painless. Also that leaves my family with the positive memories not the negative.

We do need to recognise assisted dying. I'm not sure that this bill is the one, but hopefully it will at least jump-start the conversation

I am a retired medic and although I completely understand why people wish to have some degree of control over ending their life in particular circumstances, I wouldn’t personally liked to have been involved in knowingly ending someone’s life. I did capacity assessments as part of my work. I would worry about having to do such assessments on people wishing to end their life. And families can be emotive and strongly disagree with both medics and other family members about capacity / medical decisions.
I don’t know if there have been discussions about whether this would become part of NHS services if the bill goes through - or private companies like dignitas. At least with a private arrangement the people working there would gain expertise and presumably be comfortable in doing what they were doing.
If it’s an NHS thing - can they compel existing staff to be involved. Is there enough capacity given that the service is struggling to manage even the bread and butter stuff at the moment .

I have cared for both my parents at EOL and am in favour. I'm fairly sure they would have taken an assisted death had it been available. I have also kept animals for many years and every one of our pets has had painless euthanasia at the right time. I would never let an animal suffer at EOL, but sadly as a society we seem comfortable with letting our loved ones die what can be uncomfortable prolonged deaths.

I have stage 3 ovarian cancer, it is in remission at the moment but has an 80 percent chance of coming back. I am also a care worker who has cared for people dying of cancer in their own homes. I believe people should have the choice. I want to have the choice of assisted dying whether, in the end, I choose it or not. Anything in life can be abused, we need to look to what has and hasn't worked internationally so we can have the best protections in place. I don't want to suffer at the end of my life and if assisting dying is not legislated for then that could increase the likelihood of people ending their own lives without medical assistance. I would rather have assisted dying with my family present than suicide (which may or may not be successful) alone because I don't want my family implicated in my death.