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Assisted dying bill (TW assisted suicide discussion)

310 replies

Onand · 24/11/2024 13:30

I appreciate this is a divisive subject and a sensitive topic for many. Please avoid this thread if you find any discussion of suicide, death, trauma, terminal illness, cancer and faith triggering.

I’m curious to know how others are feeling about this subject, from what I can see there isn’t a lot of discussion, is this a MNHQ decision or an indifference from posters?

My opinion and views on this potential landmark decision are based on my horrifying experience of watching and waiting for my mum to pass from end stage cancer several years ago.

For over four years she fought advanced cancer, she took every treatment and trial offered to her. She endured major abdominal surgery, many blood transfusions, multiple rounds of chemo, lost her hair several times, her bones started to crumble causing excruciating back pain, severe abdominal swelling, double nephrostomy as her kidneys failed, multiple lesions on her brain that caused debilitating headaches and personality changes, her teeth and bones were decaying due to a calcium disorder, various hospital stays for infections, the list goes on.

Truly the most hideous nightmare cancer ‘journey’ anyone could ever imagine, it always felt like one step forward and two backwards and yet she carried on without much fuss or sign of fear to protect the family and herself from the true horrors of suffering.

She never wanted to die and so she never gave up or gave in- that was until the last few weeks of her life when she had no choice. The immense damage and toll cancer had done to her physical body was too much to survive any longer so the last infection she had took her consciousness and so began the final horrifying curveball that cancer has up its evil sleeve, this one is for the loved ones though, because now you have to wait and watch for the end to come. Anyone who has endured this knows exactly what I am talking about, a horror that truly brings home the meaning of hell of earth.

If the assisted dying bill was around whilst my mum was alive I know she would have never entertained an early death whilst she was still in control and able to fight, but I do know that her love for the family would have also meant she would never have wanted us to endure that final two weeks of watching and waiting for her body to shut down if it could have been avoided and she was able to specify what was to happen at the end. There was no possibility of her ever getting better or a miraculous recovery, death was very inevitable and a certainty but we still had to sit and watch, doing oral care and leaving the room as they checked for bed sores and did secretion suction. The only thing I could do to protect and help her was the make sure she was undoubtedly unaware of what was happening as she feared death and leaving us behind- the thought of her being remotely aware meant we were constantly asking the nurses for more and more sedation.

If this bill gives patients the choice to avoid the hideously evil ending of a terminal illness and the following ptsd that impacts the loved ones left behind then it is an opportunity I strongly agree with. Watching a loved one die an agonising death is soul destroying and something I hope no one has to ever endure if said loved one could choose to avoid.

How do others feel?

OP posts:
ThisAquaCrow · 25/11/2024 12:56

Puzzledandpissedoff · 25/11/2024 12:43

This bill does in fact cover euthanising those who lack capacity. There is an entire section that will legalise consent by a proxy. If a person cannot communicate their consent, a proxy can sign the consent on their behalf and the bill states that the signature of the proxy is to be legally the same as if the person to be euthanised had signed it themself

Indeed, @SugarandSpiceandAllThingsNaice - again a useful reminder for the many who haven't read it but insist tthe safeguards are adequate

As for the link from Oregon about expensive cancer drugs being refused but suicide offered instead, words fail me except to express an utter expectation that the cash strapped NHS would fall upon the idea all too fast

You mentioned those who "make something out of death" @Noras, and if talking about targets I'm also concerned about the organ donation issue.
Clearly many of the terminally ill wouldn't be suitable, but what about the case of an otherwise healthy person who'd suffered a massive injury? How easy to blur the margins and talk about how they wouldn't want to live with the results

Edited

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.

NotOneOfTheInCrowd · 25/11/2024 12:56

Like with many things there are opportunities for abuse, I think those who could abuse the system would more than likely already be looking to speed up their inheritance quicker with or without an assisted suicide bill. Also how many people are we assuming would be murderers or consider murder by using assisted suicide for nefarious reasons under coercion? I’d like to think we’re talking of a very tiny minority and not the millions of people this could potentially help. One is one too many. There is 100% going to be coercion on some levels. It’s not possible that there won’t.

One of the reasons why people campaign against capital punishment for instance is because a miscarriage of justice could mean that an innocent person is put to death. Even if it’s just the one, people argue that it is one too many, even if that means thousands of heinous criminals being put to death.

So why is it suddenly different when it comes to assisted dying.

So one miscarriage of justice is one too many but one person being coerced isn’t? The needs of the many and all that and to hell with the few?

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

Alphaalga · 25/11/2024 12:52

Take a look at our own system, that of other countries and at the state of the world in general.. then ask yourself if humans as a collective have proved themselves anything like capable of safeguarding vulnerable people against politico-economic expediency and coercion creep.

Does anyone even know which way's forward anymore?

Puzzledandpissedoff · 25/11/2024 12:43

This bill does in fact cover euthanising those who lack capacity. There is an entire section that will legalise consent by a proxy. If a person cannot communicate their consent, a proxy can sign the consent on their behalf and the bill states that the signature of the proxy is to be legally the same as if the person to be euthanised had signed it themself

Indeed, @SugarandSpiceandAllThingsNaice - again a useful reminder for the many who haven't read it but insist tthe safeguards are adequate

As for the link from Oregon about expensive cancer drugs being refused but suicide offered instead, words fail me except to express an utter expectation that the cash strapped NHS would fall upon the idea all too fast

You mentioned those who "make something out of death" @Noras, and if talking about targets I'm also concerned about the organ donation issue.
Clearly many of the terminally ill wouldn't be suitable, but what about the case of an otherwise healthy person who'd suffered a massive injury? How easy to blur the margins and talk about how they wouldn't want to live with the results

52crumblesofautumn · 25/11/2024 12:41

‘It’s social murder’ — is Canada’s assisted dying a model or a warning?

www.thetimes.com/article/d9416604-19c4-4d35-b823-0b3272e9dec6?shareToken=f15ea22c7b46f0ccdb839523c9895066

There are plenty of non religious non pharma reasons for thinking that the issue needs more thought. Personally I want to be sure that the courts can cope, the nhs can cope, and that this isn't the hobson's choice option that people take as a default because the nhs is on its knees and they're terrified of a painful death.

Onand · 25/11/2024 12:32

Words · 25/11/2024 12:18

I am totally in favour of it.

Why would you not want to spare yourself and your family experiencing / witnessing a potentially agonising and traumatic death? Such an experience is a terrible burden, so I think wishing to spare family and yourself that is totally rational.

It's also rational to wish that the cost of a final six months' of suffering be instead added to a family inheritance, or gifted to the dogs' home.

I honestly don't see how coercion would work in practice either. I think that is a red herring and totally overstated.

I worry that the debate is dominated by those with religious beliefs. This is an ethical issue, not a religious one.

We treat our animals with greater respect and dignity.

The religious aspect worries me too because too many choose to conflate religious and ethical arguments. I don’t want my personal medical wishes to be impacted because of what someone’s religion says- that’s medieval thinking in a progressive society. I do fear the loud voices against this will be an insidious mix of big pharama and religious purists. I hope the advocates for it are able to overcome them.

OP posts:
52crumblesofautumn · 25/11/2024 12:31

@Onand that's so sad. It's bleak isn't it, the memories that don't leave us.

I really wish this was part of a commission looking across the whole piece, very little that is ever done these days is more than piecemeal or stop gap.

As it is, bill looks likely to pass and nhs and courts aren't sure how they'd cope...

Onand · 25/11/2024 12:26

TammyJones · 25/11/2024 12:19

I agree
(My mum died of cancer ) staff / nurses were great and she passed very peacefully.
I have a dear friend who is quite elderly ( and very comfortable financially)
There is one particular relative who is just waiting ..... it is to open to abuse.

I’m pleased your DM passed so peacefully, both you and her were spared a truly hideous experience and I’m sorry for your loss.

Do you reasonably think that relative of your friend would commit murder for their inheritance? There’s no legal framework for them to abuse now so perhaps you should inform social services if you have a gut feeling that they’re just waiting?

OP posts:
TammyJones · 25/11/2024 12:19

Girliefriendlikespuppies · 24/11/2024 13:48

I'm completely against it.

I'm a nurse abs the repercussions if this passes terrify me tbh.

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

Given how difficult it is to ascertain if a patient has full mental capacity now I have no idea how they can fully safeguard this for society's most vulnerable people.

Coercion, guilt and pressure undoubtedly will be used to make people feel they have to die.

I agree
(My mum died of cancer ) staff / nurses were great and she passed very peacefully.
I have a dear friend who is quite elderly ( and very comfortable financially)
There is one particular relative who is just waiting ..... it is to open to abuse.

Words · 25/11/2024 12:18

I am totally in favour of it.

Why would you not want to spare yourself and your family experiencing / witnessing a potentially agonising and traumatic death? Such an experience is a terrible burden, so I think wishing to spare family and yourself that is totally rational.

It's also rational to wish that the cost of a final six months' of suffering be instead added to a family inheritance, or gifted to the dogs' home.

I honestly don't see how coercion would work in practice either. I think that is a red herring and totally overstated.

I worry that the debate is dominated by those with religious beliefs. This is an ethical issue, not a religious one.

We treat our animals with greater respect and dignity.

Gloriia · 25/11/2024 12:16

Onand · 25/11/2024 12:09

It’s not uncommon for hydration to be withdrawn at end of life- my mum had hers withdrawn 9 days before she died - a decision taken by her palliative care team who assured us it was normal to do so.

We had to do oral care for a few days and then they advised us to stop as it was too distressing for her.

The hardened lymphoedema swelling in her limbs all but disappeared by the time she died, her nefrostomy bags were full of dark brown fluid initially and then they stopped filling a few days before she finally passed.

Yes it is normal to withdraw it as patients can aspirate if taken orally which is unpleasant.

My point about maintaining hydration was to highlight that while I think medication to actively treat should be stopped other supportive measures like hydration should continue where possible and able.

So sorry about your dm Flowers.

ThisAquaCrow · 25/11/2024 12:14

NineDaysQueen · 25/11/2024 12:07

Read my post again.
I said for me, this would be an issue.
I made no judgement on using these as a criteria for assisted dying

So in a discussion about assisted dying, it’s a reasonable assumption that by listing those criteria, you believe that those are reasons why YOU would potentially choose this route.
In order for you to do this, these criteria would have to be included in the legislation.

And could therefore be used by, or applied to anyone….

NineDaysQueen · 25/11/2024 12:11

SugarandSpiceandAllThingsNaice · 24/11/2024 13:52

I don’t agree with the bill. Sorry.

Assisted dying won’t make death painless and quick- by the time terminally ill people use it they have gone through the worst of the pain and suffering already. There is no such thing as a beautiful, dignified death.

Where it has been legalised it has been expanded either legally or in practice to include people who are not terminally ill, and who would rather live but due to economic duress, emotional blackmail, mental illness or societal pressure end up feeling they have no choice but to die.

Please provide some peer-reviwed articles that support this assertion

Gloriia · 25/11/2024 12:11

ThisAquaCrow · 25/11/2024 12:02

You said you would ‘instruct’ an HCP to act on YOUR wishes. How far does that go ?

And can you answer the question regarding hydration at end of life? What are the complications associated with that ?

Oh I would also discuss resuscitation and pain relief. I would suggest/instruct that a catheter be inserted in a bedbound, dying patient who is incontinent of urine rather than bizarrely worry about the associated risk of UTIs. Things like that.

I would definitely instruct them not to give antibiotics to someone with days or weeks to live. Antibiotics can also cause unpleasant side effects such as nausea and diarrhoea why on earth would anyone want to risk any GI upset just to tick the antibiotic box?

HCPs should work in partnership with NOK so instructing hopefully isn't always necessary.

Onand · 25/11/2024 12:09

ThisAquaCrow · 25/11/2024 12:02

You said you would ‘instruct’ an HCP to act on YOUR wishes. How far does that go ?

And can you answer the question regarding hydration at end of life? What are the complications associated with that ?

It’s not uncommon for hydration to be withdrawn at end of life- my mum had hers withdrawn 9 days before she died - a decision taken by her palliative care team who assured us it was normal to do so.

We had to do oral care for a few days and then they advised us to stop as it was too distressing for her.

The hardened lymphoedema swelling in her limbs all but disappeared by the time she died, her nefrostomy bags were full of dark brown fluid initially and then they stopped filling a few days before she finally passed.

OP posts:
NineDaysQueen · 25/11/2024 12:07

ThisAquaCrow · 25/11/2024 12:00

So the life of a child or adult who is incontinent and unable to communicate is seen as what? Not worthy? Inhumane? Who makes that judgement? We’ve already heard from people who believe they have the authority over healthcare decisions for others….

Read my post again.
I said for me, this would be an issue.
I made no judgement on using these as a criteria for assisted dying

ThisAquaCrow · 25/11/2024 12:02

Gloriia · 25/11/2024 11:59

Not legal authority no. However at the bedside of a dying loved one if a GP suggested prolonging suffering by prescribing antibiotics I believe they would listen to a NOK saying no, let's just keep them comfortable and up the opiates please. Well, a competent and empathetic GP would listen.

You said you would ‘instruct’ an HCP to act on YOUR wishes. How far does that go ?

And can you answer the question regarding hydration at end of life? What are the complications associated with that ?

Onand · 25/11/2024 12:01

FlameGrilledSquirrel · 25/11/2024 11:46

Probably not hoards as you say but we do have to look at the outliers on this one because it will happen.

It’s no different to putting a dosage warning sign on oramorph, surely that drug is more open to abuse than a professional medical team or agreed legal body assessing and approving an assisted death due to irreversible incurable disease progression?

OP posts:
ThisAquaCrow · 25/11/2024 12:00

NineDaysQueen · 25/11/2024 11:52

It's almost impossible to control some pain, so you are being disingenuous.
Also, for me, the thought of being incontinent and unable to express my needs is worse than pain

Edited

So the life of a child or adult who is incontinent and unable to communicate is seen as what? Not worthy? Inhumane? Who makes that judgement? We’ve already heard from people who believe they have the authority over healthcare decisions for others….

Gloriia · 25/11/2024 11:59

ThisAquaCrow · 25/11/2024 11:33

What potential complications arise from continuing hydration at end of life?

And what legal authority does a NOK have in the UK? You believe that you have the authority over clinical decisions when an HCP disagrees with you?

Not legal authority no. However at the bedside of a dying loved one if a GP suggested prolonging suffering by prescribing antibiotics I believe they would listen to a NOK saying no, let's just keep them comfortable and up the opiates please. Well, a competent and empathetic GP would listen.

OliphantJones · 25/11/2024 11:57

I am a Paramedic. I am completely FOR this bill, BUT I also believe palliative / end of life care and mental health care needs significant improvement as part of it. People need options, choice and control over their own life.

Onand · 25/11/2024 11:55

52crumblesofautumn · 25/11/2024 11:41

I don't know that I believe that the understandable fear of a terrible death is best migrated by the option of killing your self though, although I can understand why people want it as an option.

I strongly feel this needs more thought by a range of experts and plans for all aspects of end of life.

I don't have any other points really and I'm sorry for all of us who've had to witness this and for the people that it happened to.

My FIL was never suicidal for as long as I knew him, he was fully sound of mind and a logical reasonable person. His love for my MIL was undeniable, they both adored each other and had a beautiful home and lovely life together.

However the last few weeks of his terrible cancer suffering saw him constantly ask to let him die, I want to die, I can’t do this any more, I’m done with this, please let me go- screams of agony and tears of anguish. An off ramp to avoid that terror and fear would have meant he still had control until his very end on his terms and be able to say goodbye to his loved ones whilst he was lucid.

Instead he endured a hellish final few weeks as what can only be described as suicidal breathing corpse. Horrific.

OP posts:
NineDaysQueen · 25/11/2024 11:52

Girliefriendlikespuppies · 24/11/2024 13:48

I'm completely against it.

I'm a nurse abs the repercussions if this passes terrify me tbh.

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

Given how difficult it is to ascertain if a patient has full mental capacity now I have no idea how they can fully safeguard this for society's most vulnerable people.

Coercion, guilt and pressure undoubtedly will be used to make people feel they have to die.

It's almost impossible to control some pain, so you are being disingenuous.
Also, for me, the thought of being incontinent and unable to express my needs is worse than pain

FlameGrilledSquirrel · 25/11/2024 11:46

Onand · 25/11/2024 11:44

Like with many things there are opportunities for abuse, I think those who could abuse the system would more than likely already be looking to speed up their inheritance quicker with or without an assisted suicide bill. Also how many people are we assuming would be murderers or consider murder by using assisted suicide for nefarious reasons under coercion? I’d like to think we’re talking of a very tiny minority and not the millions of people this could potentially help.

We’re not going to suddenly see hoards of elderly folk being wheeled into their GP for the ‘end of life meds’ because the family are waiting for inheritance.

Probably not hoards as you say but we do have to look at the outliers on this one because it will happen.

Onand · 25/11/2024 11:44

FlameGrilledSquirrel · 25/11/2024 11:24

I'm very pro choice on this one. I've seen people deteriorate massively both mentally and/or physically and frankly you can sod that right off.

However, I'm under no illusion as to what utter cunts people can be.

If you're going to do this, you have to make sure the safeguarding procedure is long and subject to rigorous oversight at every single step.

The penalties for coercion and abuse of the system need to be punitive with sentencing on the level of murder because that's what it would be.

Can we balance dignity in the last days against potential abuse? That's sadly a very sticky issue.

Like with many things there are opportunities for abuse, I think those who could abuse the system would more than likely already be looking to speed up their inheritance quicker with or without an assisted suicide bill. Also how many people are we assuming would be murderers or consider murder by using assisted suicide for nefarious reasons under coercion? I’d like to think we’re talking of a very tiny minority and not the millions of people this could potentially help.

We’re not going to suddenly see hoards of elderly folk being wheeled into their GP for the ‘end of life meds’ because the family are waiting for inheritance.

OP posts: