AIBU to see the government vote against assisted Dying, as preventing personal choice in how we might want to die?

Not sure how you.got that from my post. Of course in the run of things we should strive to help people overcome that feeling but I also believe that people do have a right to decide, after a decent interval (not the 24 hour pathway available in Canada) that that is their preference. We can also look at methods. In some jurisdictions, death comes from self administered oral medicine, in others it requires an MD to inject. If we as a nation felt more comfortable with the former, that may help.

Please could you cite your sources for this? I've seen and read many accounts of peaceful and calm deaths with relatives who have nothing but praise. I've seen people interviewed who have serious doubts about safeguarding but I havent seen accounts of botched endings.

I don’t think that’s what @charliehungerford Is saying. Facing a painful death when you have terminal cancer that is in your bones, or you have motor neurone disease is very different than suffering with mental health issues, a mother with post natal depression can be treated and make a full recovery, the condition is not terminal. If someone is given a terminal diagnosis they should be able to discuss the possibility of an assisted death when it all becomes too much. We’re not talking about someone who is just old, that’s completely different. Most people desperately want their loved ones to live as long as possible, but equally they don’t want them to be in terrible pain. Everyone should have the right to ask for an assisted death when they are already dying, there is no cure and they are in distress from the pain that often cannot be adequately controlled.

You are over simplifying this. Many people support assisted dying in principle but did not think the legislation being proposed was sufficient. It is desperately sad for those that want it to be available now, but it is more important that we get it right.

Many of the studies are cited here:
https://publications.parliament.uk/pa/cm5901/cmpublic/TerminallyIllAdults/memo/TIAB255
https://publications.parliament.uk/pa/cm5901/cmpublic/TerminallyIllAdults/memo/TIAB255.htm?utm_

Pertinent extracts:

The public may understandably assume that drugs for Assisted Suicide (AS) work reliably and that nothing can go wrong. They may not realize that when used for AS their safety and efficacy haven’t been studied, they are being used experimentally, and they are unlicensed.

4.1. In Oregon between 2001 and 2023, data on complications is only reported for 1093 of 2847 deaths. Of the 1093 deaths, complications were experienced in 7.7% of patients and included oral mucosal burning, nausea, vomiting, regurgitation and regained consciousness following coma induction Oregon DWDA Data Summary 2023.
4.2. In the Netherlands between 2013 and 2015, of 165 cases, 17 patients (10.3%) reported complications including retching, falling asleep before finishing the full lethal dose, muscular contractions, bad taste, throat pain and stomach pain ( Horikx 2016).

5.1. The time from ingestion of the lethal drugs to death appears to be highly unpredictable. In Oregon (2001 to 2023), of 2847 deaths, 1618 (56.8%) had a recorded duration. 103 (6.6 %) occurred more than six hours after ingestion of the drugs. The median time from ingestion to death was 35 minutes (range 1 minute to to 137 hours (5.8 days)).

another link showing the complications and problems mentioned in the Netherlands:
https://www.nejm.org/doi/full/10.1056/NEJM200002243420805?utm_

Sure, it prevents personal choice, but for me that then follows along with what issues do we have in society that affect that personal choice. None of this is happening in a vacuum.

I've no issue with AD becoming legal in theory, even expanding it beyond the 6 month limit that was in the previous bill. I find limiting based on things like that is to put in weak safeguards and ignore the major concerns around people being pressured by others and being clear on what consent to death actually means.

Alongside discussions to ensure the person isn't being pressured, that they full understand what the process involves, and ideally a evaluation into both psychiatric wellbeing and to cover any potential alternatives, the safeguards I would like to see in place would be the ones which prevent medical professionals, government officials, or anyone in a position of authority over the individual to be the ones to start the conversation. At the very least with medical professionals as there needs to be information shared across, we need the capability to have it in our records as opt-in only and discussion to only be brought up the patient without that. For someone who opts-in, these conversations can be a relief; for others like me (born disabled, grew up hearing how much better it would be for everyone if I died), it would result in an immediate lack of trust. Most of the most horrifying cases I've heard involve some HCP or government official making that suggestion first to someone who was asking for help with something else - that needs to prevented.

I also think if the person at the time refuses, the processed should be delayed - the discussion cannot be around choice in death and then have people be held down to administer it because they consented earlier just because they have dementia. That's not how consent works, that is not the peaceful death many who discuss AD are hoping for.

To me, this framework could be applied whether it's AD done by the NHS or, if as a pp poster suggested, as part of the framework with other protective guidelines to protect if someone who wants their family member or other loved one to assist at particular time. I can see the issues previously mentioned of having the state involved, just as there are issues to having it privately. It's clearly something much of the public wants and I think the frameworks we build need to be less around how quickly/what are people dying of (basically picking which conditions make life not worthwhile which to me is more an individual choice) and more about how those with power over us act from the start of the process to the end.

Let her just top herself too? Its her choice right?

That is an area of concern. There have been recommendations to include a full psychiatric evaluation regardless of reason for wanting to go the AD route, as well as discussions around the evidence that most suicides from mental health reasons are impulsive - many are less than ten minutes from idea to action - so the idea is that any framework would have enough steps to catch those who can be support those where an alternative can be given; however, nothing we can make it likely to do that perfectly.

Thank you tbats helpful, I'll take a look at those. Overall though, just on the stats you've given, that doesn't seem overly prohibitive or enough to warrant a refusal to allow it. As with all treatments there are risks and these are balanced against the desired benefit.

This is exactly where I am. I used to be very much in favour but having read about other systems and potential problems, Im very fearful of this.

Au contraire, looking at Netherlands, Canada, Belgium and Oregon there is empirical proof of the slippery slope:

The slippery slope argument has been shown not to be a fallacy but rather to be a valid form of argument. In considering how it may be applied to the question of assisted suicide, as proposed by the Leadbetter Bill, the empirical form of the argument has been shown to hold, as those countries where assisted suicide has been legalised have seen rapid expansion in the numbers of cases, extension of indications, and weakening of safeguards. However, the logical form of the argument has been shown to be less applicable in this situation as, once the premise of taking a patient’s life at their request has been accepted, there is little logical reason to prevent this principle being extended to other similar circumstances. Hence, it seems to be not so much a slippery slope but rather a cliff edge. The medical profession, and indeed society as a whole, should be wary of this precipice.
https://pmc.ncbi.nlm.nih.gov/articles/PMC12042852/

Oregon is often cited at parliamentary committees as a challenge to the cogency of the slippery slope argument against legalization of assisted suicide. While acknowledging the main reasons for the citation’s plausibility, the present paper argues that there are features of Oregon’s evolving practice that evidences an empirical slippery slope – albeit one with a hitherto relatively low gradient. Empirical evidence of a morally interesting trajectory is ascertainable from increases in each of the annual case numbers, the percentage of assisted suicide patients citing burden-based concerns, the margin of error in misprognoses of terminal illnesses, and the reporting of qualifying illnesses that are not normally (or at least predictably) terminal in character. Part-explaining these increases may be two aspects of normative slippage worthy of increased attention. One is slippage from a sort of voluntariness contemplated by the initial public justification for assisted suicide, one which intentionally did not include burden-based concerns in its account, to a now widespread assisted suicide voluntariness that is motivated by burden-based concerns. Potentially, the slippage may even be to a newly evolved public justification: to one that affirms burden-based voluntariness in assisted suicide provision. The other aspect of moral-logical slippage raised by Oregon’s practice is expansion of the terminal illness ground to accommodate chronic illnesses effectively rendered terminal due to a legally protected right to refuse treatment. There are reasons to think that this de facto expansion has occurred in Oregon.
https://www.tandfonline.com/doi/full/10.1080/20502877.2024.2338317#d1e330

The problem with registering a choice well in advance is that people change their minds.

Why do the rest of us straightforward people who want this always have to be prevented by the “vulnerable”.

And it's that kind of remark that has led many people to have concerns about assisted dying...

@WestisBestt
There's no law against suicide.

People already have the option.

I've noticed this about the pro-AD crowd, they're a bit like little children stomping their feet because they want something, not a thought for those in the medical professions who have to do the assisting.
The idea that a person has to take the drugs themselves is splitting hairs.

Not a thought of unnatural it is to assist in killing another person.
Killing is something only the sociopathic do coldly.
Most kill in the heat of the moment or just snap after prolonged abuse.

I don't judge anybody for suicide, however, as the option's already there, nothing needs to change.

To be blunt, nobody's stopping anyone from taking their own life as things are.

I don’t think the war analogy is a very convincing argument.

Why? Both involve sacrificing their lives for the benefit of others. The difference is that in war its a split second decision and the soldier presumably would much rather live. In the case of AS the person actively and for a settled period has made a considered decision.

I also think the method is important. In Oregon, if I recall correctly, the method is a self administered drink, entirely at the time and place of the person's choosing. It is provided by a physician who is allowed to choose not to offer such services. This avoids medical professionals being asked to do anything directly, though those ive seem in Canada who do carry it out absolutely see it as part of their caring role.

Soldiers are brainwashed, you have to be to be able to kill other humans as well as be able to instinctively run towards bullets & death instead of away from them.

Yes, suicide is not illegal, but assisting is. If you commit suicide with your family around you, they will be considered complicate until proven otherwise.
So despite suicide being legal, you have to do it alone. Either take a load of pills at home and hope they do the trick, or jump off a car park or in front of a train.
The latter two will cause immense trauma for witnesses and drag other people into your attempt... the first will still mean a post mortem and investigations.

AD will allow people to check out on their own terms with their loved ones with them, with no fear their family will all be arrested and questioned afterwards.

I think we first should look at enforced saving of life - force feeding someone for example or pumping people full of drugs to extend life perhaps against their wishes.

We already have this in the form of Advanced Decision to refuse treatment (ADRT) and Last Power of Attorney for health and welfare, which are both legally binding, also TEPs and RESPECT forms which are advisory. The fact that you don't know this is a reflection of UK cultural attitude to death and dying and the fact that a lot of people, even health professionals, can't even talk about it properly - how many ways can you say some one has died, without actually saying the 'D' word!! We also need to educate health professionals to respect these documents/laws not ignore or bully the patient/ attorney into life extending treatment.

We need a public education campaign about what a normal death is and what health interventions are and what they mean. There are people on here who think DNRs are the be all and end all (CPR - is an emergency medical procedure designed to restart a suddenly stopped heart, not a medical treatment or cure for the natural, expected process of dying), but then you have the NMC once again dragging a nurse over the coals for not starting CPR in a clearly futile situation (as supported by the Resus council UK amongst other organisations).

The idea that we are suddenly going to move from a culture of over treating patients and routinely putting quantity of life over quality, to one of wholesale murdering elderly and disabled people if MAID was legalised is laughable, it just isn't part of the UK or NHS culture.

I don't get this rationale. The type of assisted dying that Parliament voted on was limited to terminally ill people with less than a year to live. There would be safeguards that would identify if patients were being coerced.

The sort of people that would put pressure on dying relatives to apply for assisted dying could just as easily put pressure on them to take their own lives.

But that's what people on here seem to think will happen, it isn't happening in other countries and it definetly won't happen here. They think either their relatives will wheel them in for euthansia to avoid care home fees/ access their inheritence, or that their much loved parents who are elderly but not suffering will volunteer themselfs for it so as 'not to be a burden'.

Its not worth getting into a big discussion about an analogy. My overall point was that there are scenarios when we accept people choosing death or highly likely death. I think the question of potential abuses and the question of libertarian rights are separate. Some on here agree with the principle of autonomy but are held back by the difficulties of safeguarding, others oppose AS on the grounds that we should not have autonomy to that extent. Those are two different debates.

What about people who are paralysed or who have a condition such as Motor Neurone Disease? How can they kill themselves without help?

@Che456yes but it’s a lottery getting high quality opioid pain relief, especially if there’s a way to go

But this is something that transcends personal choice. It's making something lawful that is currently statutory murder. In a parliamentary democracy our MPs get to make these decisions on our behalf, and they make them according to their conscience. I'm not sure what else would be a better system.

For what it's worth, I am currently living in a country where the government voted to approve MAID so it is now legal and commonplace. Colleagues talk about their parents and in-laws choosing MAID very matter of factly. The required paperwork and documentation is all in place in advance, and they are apparently assured they can change their mind at any time (thankfully!). I find it chilling. I will be back in the UK eventually and would prefer this not to be one of the options presented to me when my time comes.