Canada Assisted Dying Shitshow

[antelopevalley]

Anyone else been following what is happening in Canada around assisted dying? Lots of issues with mentally ill and depressed people being helped to kill themselves and assisted dying in some cases being pushed on disabled people. Below is a screenshot from the latest awful story.

This is what worries me about assisted dying, how it is implemented in practice. I remember how awful the Liverpool Pathway was that was supposed to make dying patients' last days more comfortable, and instead led to people who may have recovered being starved to death.

@hopeisathingwithfeathersx , that’s all very lovely, and some people may be so lucky. But my poor mother’s existence during her last years (she went on to 97). was pitiful. Doubly incontinent, not knowing any of her family, unable to hold any sort of conversation, no clue about anything. Her former self would have been appalled at the loss of dignity, never mind the rest.

I have seen far too much of dementia (both FiL and a favourite aunt also had it) and from experience - many years of visiting dementia care homes or dementia wings) this sort of ending-up is not at all uncommon. And IMO, any sort of ‘striving to keep alive’ - of such people is bordering on cruelty.

I would add that the distress I’ve witnessed can be dreadful - e.g. the poor woman of 80+ in my mother’s CH who was so often crying that her mother didn’t know where she was, and would be so worried. The staff were very kind and did their best*, but nothing could distract her.

*Obvs. it was no use telling her, however gently, that her mother was long dead, when it would only distress her even more, and she’d so soon forget anyway.

That is end-stage dementia and it is very cruel.
But people can live with dementia for years and be happy.

A friend takes her husband on holiday, he goes to the corner shop to get the newspaper, and chats to neighbours. He is not safe to be alone in the house, but the idea he should be killed is absurd. Many people live alone with early-stage dementia and many casual acquaintances would not know they had dementia. Go to a dementia lunch club or coffee morning with a crowd of people who seem a bit forgetful, but still enjoying life.

I am not romanticising, I know how dementia ends up progressing. But it is absurd to pretend no one with dementia enjoys life.

And many can live with dementia for years and be miserable the entire time. Take off the rose tinted spectacles.

My great grandmother lived with dementia for 8 years. For the first 7 she was anxious, aggressive and miserable. Only in the last year did she seem to experience any pleasure in life, but that was because she had mostly become a vegetable.

My DF had Parkinsons dementia and there was no joy in it at all. He lived with it for 3 years and they were all completely shit.

My grandfather had frontal lobe dementia. He became aggressive, depressed and violent towards my grandmother. He was lucky enough to have a massive stroke a year in, which killed him, but who knows what would have happened?

My mother was a slightly different case - her dementia was caused by alcohol abuse. And yes, she was miserable, aggressive and constantly afraid.

So in my family we have a 100% score of shit quality of life with dementia. As I've said, I have money put away. If I get a dementia diagnosis (I'm 54 and live a healthy life) then I'm off to Switzerland if the UK hasn't caught up yet. No rose tinted specs here.

Leaving aside the more nuanced cases such as with dementia or mental health issues, the primary and urgent need is for those of sound mind, with a terminal diagnosis, in intractable pain or suffering, to be given a right to end their lives with medical help, if they wish. There’s no excuse to make human beings suffer so at the end of their lives. It’s no good going on about the best palliative care, when even if you have the best, it makes little difference. It’s not just about being neglected on a hospital ward screaming, being unable to get a place in a hospice, as there aren’t anywhere near enough places to meet demand, or relying on a district nurse to come round once a day at home - all of which tend to mean you need family to help you and care for you - it’s about your fundamental right to bring your own suffering to a close - with help. Just as people are given help to give birth, or have an abortion. Just give people a choice. It may be that the majority of people respond well to palliative care and it removes their distress and pain, but for those it doesn’t, do we want them to go screaming in agony into death? They must have that right.

This thread has reached the stage where each side is polarised and the debate is just going round in circles.

@antelopevalley you are deliberately ignoring missing the points people with experience are making, regarding self awareness and quality of life for people with advanced dementia. You maintain that you know how the disease progresses but still seen unable to understand why some people may want to have the choice to decide how they want to die. This important debate requires empathy and a "there, but for the grace of God" understanding of the other side of the coin from yours. It is unhelpful to blithely say "well my relatives received good care" when confronted by others with a different experience.

My dm is 97 and lives abroad. No dignity, doubly incontinent, doesn't talk, doesn't walk, recognises no one. She exists because she can swallow pureed food but phlem in throat/mouth has to be manually removed daily. She has been in this advanced state for more than two years and as her dad passed at 101, it is entirely possible that she could live on for a few more years like this. Her carer is my exhausted ds - my dm was diagnosed with alzheimer's more than 10 years ago. My fear is that this could be my future too so I want to be able to have the choice of an assisted death.

She hadn’t even reached the age where the brain is fully developed. She was failed by the system (she was sexually assaulted in a MH facility) and then discarded again, this time permanently.

You believe suicidal ppl can consent to die. There are ppl that seem to think anything is ok as long as it is consented to (eg prostitution). But I consider Shanti’s case a grave error.

This is a good summation of the issues.

Exactly!
How can you say she would never recover at aged 23!
And she obviously did not have proper treatment when she was raped where she was supposed to have treatment. That this is being held up as a good example is appalling.

I don't see this case as an example of good practice at all. But I would like you to think about how long you would force Shanti to continue living before you felt she had the right to decide to die. So 6 years isn't enough and her brain wasn't fully developed. What would you have said if she had lived to age 40 and was still expressing a wish to die? The point is not about individual cases and what happened, the point is about giving consideration to an individual's right to have a choice.

@MintyFreshOne UK legislation is very clear around capacity. I've worked in this field. It is not automatically the case that someone who is mentally ill is deemed to lack capacity. Even people who are sectioned can refuse medication, and a further section needs to be put in place to compel them to take it. People who are sectioned are also deemed able to consent to take part in research, unless an assessment of their capacity shows otherwise. Deprivation of liberty is (rightly) taken very seriously. You cannot therefore say that someone who is suicidal is automatically lacking the capacity of deciding whether or not they should end their life. You may not agree with this legal position, but it is as it is.

People with terminal cancer can live for a time (sometimes years) and be happy. Ditto mnd. This is a discussion about what happens when that phase of their illness is over.

That is so interesting- thank you for sharing 🙂

I don't think anyone has advocated for euthanasia for early stage dementia. It's the latter stages when people have no dignity and are all but a vegetative state in a home. My grandad spent 18 months alive but unable to really speak, could drink and swallow and eventually pretty much starved to death he was so thin. He wouldn't have wanted that life. He'd have gone 2-3 years earlier when he could walk around the care home.
It's nigh on impossible to legislate for the right moment. I don't know how it would work in practise and I can see the potential for abuse. But on balance I'd like the option.

For fucks sake. Once again, your experiences are not universal. A lot of people with advanced cancer have been on very strong painkillers for a very long time. The body gets used to them and they stop being as effective over time.

A lot of people die in a lot of pain and with very little dignity, even with the very best palliative care in the world.

You and your stone-age opinions can fuck right off.

@fdgdfgdfgdfg It is not opinions. It is my personal experience.

And your personal experience is what is known as 'anecdote'. It is meaningless. It does not in any way mean that a dignified and comfortable death using palliative care only is possible for everyone. We all risk being the one for whom that method doesn't work, and we should have the choice to not suffer that fate. That simple enough?

People do not choose MAID when they are happy and enjoying life. Nor would they be approved. If they have sufficient pain management and quality of life, MAID isn't an option.

There is nothing about MAID that anyone "should be killed", regardless of their suffering or lack therefore. It is a 100% voluntary option that someone has to apply for while in a competent state of mind.

That's exactly what I'm getting at. Your personal experience is that the people you know who've died, have done so peacefully and without pain. That is fantastic, and the way things should be.

But that doesn't always happen, even for people with access to the best palliative care in the world. Other people have witnessed their loved ones die in immense pain, with very little dignity. And you stating as if it's fact that that only happened because someone didn't do enough, that something isn't good enough, is immensely painful for those who had to watch members of their family suffer.

Your opinions on assisted dying are just as valid as anyone elses, it's a complex discussion and while I'd be on the other side of the debate from you, I'm not angry about that.

What I am angry about is that you're lying. Some people with terminal illnesses will die in immense pain, and without their dignity, and even the best palliative care currently in existence can't halt that.

Some might find this thread useful in putting context to the debate. Sadly, it is about a dm's suicide.

I've just read that thread. So incredibly sad. In my native Netherlands this poster and her mother would have had support and a proper goodbye. So sad the UK can't seem to understand this.

This is a depressing read, from those who do not understand about what palliative care cannot do in the U.K. Perhaps some should look at this by palliative care experts: www.ohe.org/publications/unrelieved-pain-palliative-care-england

In summary:

378,427 people receive palliative care a year in England.

125,971 end-of-life patients receiving, or in need of, palliative care suffer from unrelieved pain.

16,130 patients experience no relief from their pain at all in the last three months of life.

Some suffer unnecessarily because of variations in the quality of care.

Even if unrelieved pain rates were the same as they are in hospices, there would still be 50,709 dying in some level of pain.

5,298 would still experience no pain relief at all in the last three months of life.

Thank you @MaryMollyPolly for informing the debate with facts. Let's hope this will sort out the rose tinted vision some people on here have.

@MaryMollyPolly That is incredibly depressing. I have obviously been very lucky to see relatives dying with full pain relief and zero issues.

@antelopevalley I would like to thank you for starting this thread. While it probably didn't go the way you expected, I have learned so much. It illustrated how divided people are, and how much personal experiences influence our opinion on being given a choice on how we end out life.

@MaryMollyPolly from you, I now have the stats to strengthen my argument in any future debate.

I live in Scotland where the last poll taken in 2020 showed that 46% were in favour and 30% somewhat supported assisted dying. There are ongoing issues around autonomy and capacity (as we have seen ourselves on this thread) but in September, the final proposal was lodged on a Bill for Assisted dying for terminally ill adults

It will be interesting to see what happens next.

I agree it's really important to have these discussions.

I have read the pain report linked above and it is concerning.

However, I think it's important to note that even this report is not calling for euthanasia. It suggests referral to a specialist pain clinic, which is rare for palliative care patients in the UK, and an improvement in access to high quality care in hospices, which is where the best pain relief is currently achieved.

According to the report, the vast majority of palliative care patients do experience adequate pain relief, so it's important not to scaremonger and suggest that it's a normal experience to die in intolerable pain. If everyone had access to hospice care it would be as low as 1.2%.

What I would take from the report is that everyone should be able to access well-funded palliative care treatment in hospice , and beyond that a specialist pain service is needed and not currently available.