Very Interesting Kathleen Stock article

Because often they aren't suffering when they have agency, and by the time they are suffering they no longer have the physical capability to act.

My father had a degenerative illness, so under your argument perhaps he should have ended his own life while able to do so. But he was a long way from the end stage when he got sepsis (unrelated to his main illness) and went from partially limited mobility and OK quality of life to none at all overnight. He begged to go to Switzerland but was far too unwell to travel and certainly had no ability to organise the trip. The only ability he had was to refuse food, which he did for almost a month.

My grandmother was apparently completely healthy and walking back from the shops when she had a stroke. She recovered enough to be able to very slowly and painfully write a few words, but there was no way she could walk, leave hospital, or move from her bed. She refused food too, but they put in a feeding tube. She lived for another 6 months.

My friend had minor stomach pain, then within hours was immobile in hospital. She lived almost 3 months - sometimes conscious enough to speak, sometimes in a coma but still screaming in pain. Not for lack of treatment - there is some pain that no medicines will alleviate.

Anyone who can ask that question clearly has limited experience of illness and death.

But Blackbird, your argument assumes medication can always relieve the pain and suffering. My understanding is that this is not correct.

My own view is that assisted dying should only be offered at end of life, to shorten pain and indignity, when the dying person clearly and repeatedly requests it. I know Canada is apparently out of control in this (as in other things!) but assisted dying should not (of course!) be offered to the homeless, poverty stricken, mentally unwell etc.

Dr Stock is highlighting the use of language that is framing this debate precisely because it is the language that is doing all the heavy lifting here.

Dying with dignity. Gentle death. Peaceful death. Going to sleep. When in actuality killing someone whose body is not ready to die is much harder and less ‘gentle’ than being implied by the use of that language. Sometimes it is quite brutal. I don’t have faith that all these MPs have done their homework on this topic and in all likelihood are being swayed by these pillowy phrases as she puts it.

How can it be right that people should suffer in this way rather than be helped with extra painkiller?

It is precisely because we have medical professionals who don’t offer adequate pain relief (and women in particular are woefully underserved by doctors with respect to pain management) and an abysmal end of life care in the UK that we are faced with these calls for assisted dying. I’ve got doctor friends in Canada who see MAID being requested by pensioners without adequate incomes who don’t have enough to eat or can’t afford heating. How on earth is that right?

We all fear a painful death but better and more informed care for people dying would be a more humane approach in my view.

I agree with you on this. Irrespective of any debate on assisted dying, people should not be left in pain. Where is the compassion that leaves ill people (certainly at end of life) in pain like that?

@duc748 nails it.

I read the piece with interest, because the topic is one of several on which I've modified my views in recent years (see also prostitution etc). but whilst it's tempting (and easy) to give a good kicking to politicians seeking deeply sincere and empathetic sound-bites 😀, it seems to me the difference here is that views are sincerely held on both sides, often for the most harrowing of reasons. DocStock seems close to saying that people who support euthanasia are bad actors or gullible fools, and I don't think that's true at all. That said, I do conclude the risks are too great. And there will be cock-ups. And worse. It's not unfair to say, though, that if MPs have given this topic as much serious thought as they apparently did before they took leave of their senses and decided that men could change into women, God help us.

@CitrineRaindropPhoenix
My grandmother deteriorated very quickly. She went from bad arthritis to sepsis in every organ with 24 hours. Unfortunately the medical support didn't recognise this and failed to either treat her or give her painkillers. It took her nearly a week to die, screaming in pain until we finally managed to persuade the hospital to sedate her. They'd resisted even that and were scathing about how feeble we were for being unable to cope.

That is so shocking. Was that in a hospital in UK?

That is a very good article which articulates very eloquently the problems inherent in passing this legislation. I have been very uneasy about the speed with which it is being addressed by the new government and the way that its supporters seem oblivious to the wider consequences. The comparison with the GRA is very apt. Both cross a line of legalising something which previously was unthinkable within the law: falsifying your birth certificate or doctors killing their patients. In both cases the focus was purely on those who would want to take advantage of the legislation with the wider impact on society ignored or minimised because of the safeguards built into the legislation (in the case of the GRA the tiny number of people who would use it). There is no way that anyone can be certain that the UK wouldn't go down the Canadian route or even further. The equivalent of self-ID would be the demand that it's a human right to be helped to die. It's interesting that Wes Streeting is apparently reconsidering his previous support for the legislation because of the poor state of end of life care and the pressure this might put on the vulnerable. I would much rather discussion was had on how end of life care can be improved and the vulnerable supported than legislation passed whose consequences we can only guess at at present.

the way the elderly were treated by government in the early days of Covid

'Let the bodies pile high' said by the leader of a government that let COVID run rampage through care homes. Compounded by members of the public who said that the elderly and vulnerable were going to die anyway so there was no point in protecting them.

The naivety of those who don't see any problems regarding this bill is astounding.

It's straighforward for me. Is it possible to create policies that have adequate protections and safeguards? Yes. Would we end up with these policies? Maybe.

Look at the way children have been prescribed puberty blockers and the way the elderly were treated by government in the early days of Covid and it's clear that neither the UK medical profession nor the UK government (the Tories will get back in at some point) can be trusted to do assisted dying properly.

So what we have isn't a choice between the status quo and the perfect system. What we have is a choice between the status quo and a system where people who could be helped to live a life they are willing to live end up dead instead.

It's an interesting piece by Stock, and to some extent I agree with her. But I don't completely.

I think what this issue boils down to is principle vs pragmatism. Unlike Stock (if I've understood her correctly), I do believe in assisted dying in principle. That is, I think if someone has an incurable illness that they find unbearable, they should be allowed to end their life with medical help. In practice, however, I agree that we have massive problems with defining unbearable, intolerable, pain and suffering etc, and there is a very strong danger of a slippery slope.

For me, I would absolutely hate a degenerative disease such as MND, where you gradually lose control of all your functions. It's not just the incontinence, it's the fact that you lose the power of speech, the power to use your hands or your legs and that you can't even swallow properly so risk choking. That kind of life feels intolerable, and I would want to end it. And at the moment, if you decided you wanted to end it you would have to travel to Dignitas in Switzerland before the point where it became intolerable, because after a certain point you become too ill to travel. So the current law against assisted dying is arguably counter-productive.

But how would you frame a law that allowed someone in that situation to end their life without running into all the problems that Stock outlines? I really don't know.

I think it is also possible to understand that the law proposed is like the one in Oregon rather than the free for all in Canada. Oregon has allowed assisted dying in people with less than 6 months to live for over 20 years and has resisted attempts to loosen it. Why do people immediately rush to Canada rather than considering the multiple jurisdictions around the world where something much more limited is in place and appears to be working.

I think that Kathleen’s point was that what politicians were saying is not exploring the issues in ant depth, just soppy childish sound bites

I disagree with many of the posts on here. But this is a deep and difficult subject, with sincere opinions on both sides, which deserves thoughtful, balanced discussion.

I respect the opinions of those who, unlike me, do not agree with assisted dying, so I will not use language like
queasily syrup-laden'
'lazy heartstring-plucking'
'a pillowy, feminine-coded assault.'
'happy to talk simplistically of kindness and cruelty as if they are in primary school'
against people who happen to take an opposing view.

This serious subject deserves better than name-calling.

Saying that this kind of legislation will bring the state in to involvement in death - the state is already involved in health care, palliative care, social care, setting laws around suicide, etc. It's misleading to imply it's suddenly getting involved and this is to be mistrusted.

And the argument that ill or elderly people worry about being a burden on family - we'll it's natural to worry about that, and some do become a burden, no point pretending that this doesn't happen. You don't necessarily need to think that argues for assisted suicide, but it's a poor argument to say this concern just 'should not happen'.

I find the article hyperbolic. I'm strongly pro introducing legislation around assisted dying. I thought it might be interesting to read an argument with some insight from the gender/trans experience, but I don't find anything here. Yes 'unbearable suffering' is subjective, but death is biological reality - unlike trans-ness.

I had such an argument on MN a week ago. There was a woman who said she just wanted to die and had been depressed for years.

I argued that rather than kill her, society should better support her. That our mental health service is not fit for purpose and with the right treatment and support she could have the chance of a decent life.

I also pointed out that suicidal feelings are often transitory and I knew people who were leading decent lives who would be dead now. I don't believe that people suffering from mental illness have the capacity to make that kind of decision.

'Why don't these people who are suffering at the end of their life have agency, why didn't they end their life when they did have agency, nobody needs the governments permission or assistance to commit suicide.'

My grandmother deteriorated very quickly. She went from bad arthritis to sepsis in every organ with 24 hours. Unfortunately the medical support didn't recognise this and failed to either treat her or give her painkillers. It took her nearly a week to die, screaming in pain until we finally managed to persuade the hospital to sedate her. They'd resisted even that and were scathing about how feeble we were for being unable to cope.

If assisted dying is not to be passed, there needs to be serious investment in and provision for end of life care with hospices funded by the government and enough places for everyone who might need one. More funding for the NHS so they're not forcing people to be at home without any pain relief because no one can now be trusted with anything other than mediocre amounts of morphine in case of addiction in the last few days.

We all know that won't happen except for the lucky few. Everyone else will be left to muddle through as best or worst they can and hope the end doesn't take too long or they can starve themselves to death quickly.

I know, I'm the same. I watched my sibling succumb to a horrible, aggressive and rare form of cancer. She had chemo and radiotherapy and major surgery over 2 years but it still spread and she died just after her 25th birthday. It was awful and I remember during the last few months wishing she'd been able to have the pain and suffering taken away.

Now a good few years later I'm experiencing the sadness of seeing my DM in a care home and I see a lot of poorly residents yet at the same time they are happy in their own heads (it's a dementia home). They are well cared for and every day they get entertained and although I am amongst the relatives that will come and sometimes cry seeing my DM when she's having a bad day, I'd feel extremely uncomfortable at the state stepping in and euthanising them. They still deserve a life when it's theirs and I don't think it would be feasible to do assisted dying with those who have no mental capacity. Yet it's apparent that that is what has been happening in Canada. It has gone far beyond relieving the suffering of a person with terminal cancer like my DS and has now moved onto encouraging anyone with mental distress to do it, including homelessness! It's a final solution to what could be (with the right support and help) a temporary problem. How can we ensure the state euthanising lots of elderly dementia patients won't end up being like that too?

It's a tricky and emotional subject matter, I go back and forward on it a lot. But what Canada has ended up doing has really upset me, it's just not something I would want the UK to agree to.

In two of the cases I mentioned they were too ill - in the last weeks of life in a hospital bed. The third was too old (care home).

Kathleen Stock mentioned the recent case of a 29-year-old woman who was helped to die by Dutch doctors on the grounds of “chronic depression, anxiety, trauma and unspecified personality disorder”.

This is an article about this young woman which contains some disturbing statistics.

https://www.theguardian.com/society/article/2024/may/16/dutch-woman-euthanasia-approval-grounds-of-mental-suffering

Her case has caused controversy as assisted dying for people with psychiatric illnesses in the Netherlands remains unusual, although the numbers are increasing. In 2010, there were two cases involving psychiatric suffering; in 2023, there were 138: 1.5% of the 9,068 euthanasia deaths.

This article gives more detail about her life and her decision to die.

https://www.thefp.com/p/zoraya-ter-beek-dead-assisted-suicide

She seems to have had little support from her family for her mental health problems or her autism which was diagnosed when she was 21, and she was estranged from her mother and sisters. Her father had recently died. She had also suffered the trauma of her best friend killing herself by jumping in front of a train when she was 16.

Is this really the right solution for a mentally distressed young person? Should we really be giving up on people like this and just help them to die?