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.

@antelopevalley I agree that the UK situation is problematic, but there are so many people suffering that I don't think we can wait until we have a healthcare utopia. Getting rid of the Tories would be a good start though.

I was on that thread but you are misremembering or misinterpreting my position on abortion

The NHS, mental health care and social care are so underfunded, it's awful. Desperate shortage of care workers and awful conditions for them. Trying to get mental health care is so difficult, even for serious cases.

I can't find the reference now, but I am sure at the time I read that the Belgian 23 year old who was euthanised due to PTSD after a terrorist attack had been admitted to a psychiatric hospital , where she was raped, whether by a fellow patient or an employee I cannot recall or find. Following all this she decided to commit suicide and doctors agreed and assisted her. A woman totally destroyed by repeated male violence and failed utterly by the medical establishment. With safe and effective care she could have recovered.

I’m in my 60’s so have seen a lot of the older generation pass away.
In almost every case it has been barbaric. For example my mum had dementia for the last six years of her life. She was in and out of hospital with numerous complaints and had her life saved on several occasions. She was in a pitiful state, didn’t know who anyone was and was scared and wanting to die.
We wouldn’t let an animal live like this why do we do it to humans?
Im getting more and more scared of the same. Does anyone know where I can get drugs to stockpile for a painless death when I need it?

I agree with all of that, but that is an example of how not to do euthanasia. I am not as familiar with the law in Belgium, but in the Netherlands this would not have been as simple as the patient demanding euthanasia and being granted it in this situation. There have been cases of euthanasia in mental health, but those have taken years to be concluded because the criteria involve confirming that the patient's suffering is both unbearable and unlikely to end. It's still not a reason to not allow euthanasia at all.

@chella2 I've just found your contributions on that thread. The problem I had with them was that you seem to lean towards ascribing personhood to an unborn child at some stage during the pregnancy. That isn't ok. The conclusion reached was that the law was a fudge - so would any euthanasia law have to be. But banning it in all cases promotes suffering and that is unacceptable. Saying that you are happy for terminally ill people to be given lethal doses of painkillers basically means you are OK with euthanasia, as long as it isn't legal and regulated. How does that make any sense?

@Fairyliz I am in my fifties and have seen people die a good death as well as a poor death.
Being in and out of hospital is itself not necessarily an issue. Some people live their whole life like that.
But it is about knowing when to say no to treatment and excellent pain relief. I have seen relatives diagnosed with cancer saying no to any treatment and dying soon after with excellent pain relief. But most people try and prolong their life.

@pointythings It is not euthanasia. Someone terminally ill should be given pain relief. In some cases that might bring about their death more quickly. But the primary purpose is pain relief, not to kill them.

@pointythings So why not just spend all that money spent on assessing people on giving proper mental health care?
Personally I am sceptical that actually happens. I have read about the detailed assessments that are supposed to happen for all kinds of things, but I know that already does not happen all the time.

Exactly.

@antelopevalley what reason do you have for being sceptical about the way things are done in the Netherlands, bearing in mind that I'm actually from there and have a relative who had an assisted suicide there?

I should also add that my father considered assisted suicide in the early stages of Parkinsons dementia and decided against it. When he later changed his mind because he was getting worse (but still had lucid periods) he was refused because he was deemed not capable of giving informed consent. So yes, those procedures are in place and if followed, they work.

The cost of capacity assessments in euthanasia is dwarfed by the cost of providing mental healthcare. Especially when that is to someone who does not want it because they are likely to need admission.

Your statement that giving lethal amounts of painkillers is not euthanasia is a fudge. Worse, it negates the person's autonomy - where is the procedure of taking consent for this kind of 'benign overdosing', and why is it better than having a proper regulatory framework for ending someone's life if they so wish?

The abortion discussion is a bit of a derail as it's not directly relevant to the thread, but if you do read what I said you'll see that my belief is that the law should stay as it is in the UK.

In my view personhood is not relevant as even if a foetus is a person, a person doesn't have a right to live inside your body. So arguments from pro life people about personhood are a red herring, because a woman has an absolute right to remove a person from inside her body, even if the side effect is that that person will die. It's a discussion with a lot of nuance which I would be glad to talk around on a different thread.

@pointythings People terminally ill are talked to about what level of treatment they want and what level of painkillers. I should imagine most people simply want to not be in pain, but some people choose to be more alert but in pain. If pain relief may hasten their death that is explained to them. So yes they do consent to it. Dying can be very painful if pain relief is not given.

Good mental health assessment would be extremely expensive. How do you know the person will not recover? How do you know proper treatment will not make a difference? And as posted most people who try to kill themselves and do not succeed never try and kill themselves again. They do want to live. And if life is so unbearable why have they not killed themselves already? Why go through what you claim is a very lengthy and intrusive assessment which itself would be difficult for someone with serious mental health problems to bare?

@antelopevalley so it's OK for people to consent to being given pain relief that will hasten their death, but they should not have the option of choosing to die at a moment when they wish to do so? There's no logic in that.

In terms of mental health (I have worked in mental health for a long time!) it's always the 'yes, but they might recover' argument that is waved around. I think you probably know that the longer someone has a severe and enduring mental illness, the less likely it is that they will find recovery. And ultimately it is still up to the individual to choose whether or not they wish to live with that 'maybe' on the horizon, or not. It is infantilising to presume people with a mental illness are not able to make that choice. (I do also actually have an adult child with a severe long term mental illness, btw).

This is about choice. It is about autonomy. It is about treating people like adults, within a regulatory framework that is as good as it can be (albeit always imperfect). You may not like it, but the law where implemented works well in the Netherlands and in other places. The alternatives are worse.

I have money put away for a one way trip to Switerland because I have seen at first hand what dementia did to my parents. If that means I have to die younger, so be it.

@pointythings I care for a relative with schizophrenia. I am sure lots of people would prefer they die than give proper mental health treatment.
They will never be cured, but proper treatment does mean they can be stable so a kind of recovery. And people with enduring mental health problems tend to improve as they get older - over 50.

@antelopevalley but is it up to you to decide what level of misery is or is not unbearable? I'm not arrogant enough to think that. My DC is not quite 20. They enjoy life and live independently, but if they did not, I wouldn't be telling them 'well, it will probably get better in 30 years, so you don't have to suffer all that long'.

I don't understand the misty-eyed belief that life is everything. It isn't, not for everyone.

"Good mental health assessment would be extremely expensive. How do you know the person will not recover? How do you know proper treatment will not make a difference? And as posted most people who try to kill themselves and do not succeed never try and kill themselves again. They do want to live. And if life is so unbearable why have they not killed themselves already?"

The following is about the Belgian, 23, mentioned earlier on this thread, who had suffered extreme psychological trauma after being caught up in an airport bombing and was later an attempted rape victim. After six years of treatment she still wanted to commit suicide making it a question of "when", not "why". Hence the medical profession acceding to her request for euthanasia.

“She suffered such mental suffering that it was logical to accept her request,” the commission said. “She was hospitalized several times, took dozens of medications. Months, years passed, but there was no improvement. She talked about suicide. She could no longer live, her life had become hell for her. Psychiatrists after many consultations said her condition was incurable,”

The entire subject of demand led assisted dying is worthy of debate.

@pointythings Then people kill themselves. Why put them through intrusive and upsetting assessments to be given drugs to kill themselves?
Because anyone that mentally ill will find any assessment procedure that is meaningful extremely difficult to go through.

amp.theguardian.com/news/2019/jan/18/death-on-demand-has-euthanasia-gone-too-far-netherlands-assisted-dying

This article suggests the situation in the Netherlands is rather more complex than described. Particularly upsetting are the accounts of patients with dementia who have signed advance instructions to end their life, but when their doctor decides the right time has come, the patient disagrees. How can this be proper consent, when someone is held down against their will?

What some may see as "euthanasia done wrong", I see as essential problems with the practice of euthanasia full stop.

@logicisall She was raped when in hospital for treatment!! Please do not pretend she had good mental health care, she did not.

@chella2 That is incredibly sad and is not consent.

All these people who say they want it to be their decision, I take their point.

How is this dying going to happen; how are the powers that be going to make this a safe and painless way to pass on. I mean the actual mechanics of it.

How to Dignitas do it so that it doesn't turn into a complete traumatic shambles?

Genuinely don't know and worried for the future.

@chella2 in cases of dementia it is extremely difficult and I would argue for a change in the legislation stating that where there is an advance directive in place but the patient then withdraws his consent, that should be accepted at face value even if the patient is thought to be incapable of withdrawing consent due to dementia. That would have to be on safety and balance of probability grounds. This would mean that people with early stage dementia who are able to consent would find themselves forced to end their lives younger, but on balance I think that would be a price worth paying. It is certainly what I would do myself if I were to receive a dementia diagnosis.

I have read the article you linked there and see nothing alarming. It it logical and necessary that there should be review and realignment. Many of the cases mentioned describe the regulations functioning well. I have no time at all for the case of the son who didn't want his mother euthanised - it was none of his business, it wasn't his life and he should seek counselling for his inability to empathise.

Having also had a relative with schizophrenia who committed suicide (before the advent of better antipsychotics) I can state categorically that his death (he jumped from a tower block) hit far harder than my grandmother's peaceful assisted suicide.

@pointythings Trust me if your DC decided to kill themselves, it would not matter how that decision was made. It would still be hard on you.