Assisted dying bill (TW assisted suicide discussion)

Good that her palliative care was excellent, sadly it is so hit and miss. I understand when you say that it was still an distressing experience.

So given our privileged yet still diabolically evil experience, how many other people receive poor palliative care every day and have even more traumatic deaths who could be helped by assisted dying during those final weeks?

I still don't understand why the proposed solution is to kill people a few weeks or months before natural death rather than provide proper palliative care.

Pleuritic/neuropathic pain caused by infection is opioid responsive? Interested in your evidence base for that?

Yes, I worry about that too re '6 months' sorry for the straw man - one of the good things is that friends and family in several cases have lived more than a year after being told they were terminal thanks to improvements in cancer treatment.

And personally no, if my family member wanted to live that bit I wouldn't want them to spare me the memories.

Ha 6 months could definitely make a difference to my relatives - people that inherit generally aren't that young themselves these days, esp given length of probate etc.

It’s based on ‘nothing’. Another example of ill thought out and rushed documentation dressed up as a legal process.

@52crumblesofautumn

So the family will inherit six months earlier ? That is hardly likely to make any difference to anyone.

Why would a family NOT want an end to watching the trauma and suffering?

Why would a dying person NOT want their relatives to be spared witnessing that?

Exactly @Onand .

My concern is , as stated by the surgeon on R4 Today this morning, that the demographic in the H of C leans towards the young. Who may not have seen or witnessed this kind of suffering.

I suspect dementia will get me, but of course by definition that is outside the scope as capacity will be lost. That is why we need legally enforced living wills.

In my decades of care home visits I have lost count of the number of formally able , intelligent, professional people I have seen in care homes, dribbling their food, and pissing and shitting in their adult nappies.

Some of them howl in despair. Others are just gnarled husks, hoisted in and out of bed. They know no one. Their fear and horror above all else is palpable. It is beyond cruel.

There is no good death for these people. It is a living tomb.

That's the reality. And no amount of patronising kiddie visits at Christmas from the local school, or choruses of If you're happy and you know it - along with healthy chair based exercises of course - will expunge that.

Those places are a living hell and I will kill myself rather than go to one, if the law has not changed.

It is so sad reading all these harrowing experiences. Why has palliative care become so poor? Why are people dying protracted painful deaths with poor symptom control, some getting treated for inevitable infections despite having weeks or days to live.

Years ago Macmillan nursing teams used to manage end of life care. Now, certainly ime though it may be a postcode lottery, it is GPs and very basically care staff who are providing this complex care.

It is no wonder some believe this bill is the answer when they've had such traumatic experiences of loved ones dying. to all those affected and op, if you haven’t already please access counselling to help you come to terms with what happened.

Assisted dying has bigger incentives to family coercion than abortion though - family stand to get immediate personal gain from the death, reduced caring responsibilities/money/and end to the trauma of watching the suffering.

I have qualms about the state having bad incentives here too because in the end, shortening cancer care is going to cost the state less.

My worry is, imagining myself, that six months from death is unprovable, and also that in practice the mind would be too far destroyed to be able to make the decision.

Out of interest, does anyone know why the demarcation line is 6 months of life remaining? Why not 1 year? 3 months? Is there a reason for that time period or is it random? I do think this is one area where there's a 'slippery slope' waiting to happen.

Signing by proxy is not the same as signing due to lack of mental capacity. Unfortunately.

'I have already outlined why and how antibiotics and steroids can significantly improve QOL for some people.You have failed to demonstrate why that is not the case ( and ‘because I say so) isn’t a convincing argument.'

Yet 'because I said so' seems to be your argument.

I have no issue with steroids being given to control symptoms, if you read my comments I have said it is the unnecessary and intrusive blood sugar monitoring that is unnecessary in someone's final days. It is pointless and causes everyone distress to be faffing on disturbing someone.

Once again, any pain or discomfort caused by an infection can be treated with opiates not antibiotics that can cause distressing GI symptoms. That isn't because i said so it is a fact.

Plenty of evidence on this thread why end of life needs to be vastly improved. Let people die peacefully.

I've made my wishes on this very clear to my next of kin - and in writing. Why should they NOT be my proxy when I'm not able to express my wishes myself? We have registers for organ donation, we could have a register for end of life wishes. I'm concerned my wishes wont be followed and those opposed to easing the pain of the dying will force me to suffer.

But instead of suggesting, for example, a register for end of life wishes as a way to reduce the risk of coercion those who are opposed to assisted dying have nothing constructive to say. In some minds one possible "coerced " person apparently outweighs any amount of suffering from people who could benefit - they just want to see people suffer.

But isn’t this a bit like the idea of coercive abortion?

It absolutely shouldn’t happen, there are safeguards to prevent it (two drs signatures etc). But I’m almost certain it does occur, people eg partner or family putting pressure on a woman to abort against her wishes.

However, that doesn’t mean we ban abortions for everyone, the vast majority who are not being coerced and have weighed up the options and are making the best decision for them in the situation they find themselves in?

It absolutely is a slippery slope.

I have already outlined why and how antibiotics and steroids can significantly improve QOL for some people.

You have failed to demonstrate why that is not the case ( and ‘because I say so) isn’t a convincing argument.

Coupled with your assertion that you will be ‘instructing’ HCP’s it is clear that this very much an issue that needs to be considered by others when reading this bill, particularly with regards to the frightening lip service that is paid to the role of a ‘proxy’

'When we have people talking about instructing HCPs to act at their behest regarding a relative, we’re already teetering even closer to the edge of the slippery slope'

Do try to understand the points that are being made and the importance of context. To instruct a hcp to stop, for example, taking blood samples that have no bearing on treatment, or to not give antibiotics to someone sadly moribund is not close to any 'slippery slope'.

Unfortunately maybe hcps can make a distressing and painful situation worse by constant and unnecessary interventions instead of, as has been said, focusing on a dignified and comfortable end of life.

The truth is that the person will be dead. Coercion is going to be very hard to prove

Indeed, @NotOneOfTheInCrowd, and that could easily explain why some are quite so happy to wave the questions about coercion aside.
All very well insisting "it won't happen" when you know perfectly well it would be very difficult to prove it had, and it's not as if the dead would be around to give a view

Won't "big pharma" be providing (and setting the price of) the suicide drugs?

Edited to add yes they will, @ConfusedBear, but if we're talking a pure numbers game they'll already make more out of palliative drugs than they might out of a few suicides ... until, that is, the concept grew as it has elsewhere

My dad stopped being able to swallow so he inhaled his food and got infection after infection, lastly pneumonia. In the end they withdrew everything (including hydration) except morphine to let him die as he was skin and bone and in a cycle of infections. His quality of life was nil. God knows how he must have suffered. It took him eight days without hydration to die (after three weeks of no nutrition) with phlegm building up in his airways. It was ghastly. I wish he could have been helped to die much sooner but he had dementia so even with this proposal he couldn't have been helped. But for myself I would rather sign something beforehand to ask that my life be ended if I get to that point than endure what he did.

Suicide drugs are cheap and out of patent. Much less expensive and profitable than palliative chemo for a dying cancer patient.

However like you I very much doubt that they're genuinely lobbying for this: the upside is pretty minimal and the negative publicity should they be exposed would be severe.

You think "big pharma" is opposed to this bill for financial reasons? Won't "big pharma" be providing (and setting the price of) the suicide drugs?

I wouldn't have brought cost into this debate, however given that you have. I don't expect the bill to have any negative effect on the profits of pharmaceutical companies. They'll do what companies always do find new income streams (I e. Assisted dying medication) and increase the costs for their existing products. They'll probably make money out of it.