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.

@CrackSpackle That is horrific and totally unnecessary.

Isn't it just. An absolute disgrace. We need dignified assisted dying to be legal for terminally ill people if they so wish. Until you witness a loved one dying like this, you cannot grasp how inhumane it is to not legalise assisted dying.

@CrackSpackle I have witnessed close relatives dying from cancer and getting loads of pain relief. They were in no pain.

My experience is similar to @CrackSpackle's. The reality of end of life care on the NHS is what my family experienced when my DH was dying of cancer. There was ONE nurse on night duty for several wards. She tried her best but she had difficulty coping. DH was on morphine and when it needed to be topped up we had to search for the nurse to let her know.

I took in wet wipes when I realised that the coarse dispenser paper for drying hands was being used to clean DH's bum during diaper change. I witnessed him screaming in pain. Staff shortages also meant that diapers weren't changed as often as they should have been. No staff member was available to routinely do things like help with wetting lips/tongue, giving sips of water, and DH was too weak to call for help anyway.

For the week that DH was hospitalised, we as a family ensured that someone was always at his bedside, so we could help. It was still an agonising week of pain, morphine, sedation and being roughly handled by time short, overworked staff. When death came, it was a blessed relief for us all. Adult DC were traumatised by the experience and don't want that death for themselves. We have since discussed assisted suicide and the possible scenarios surrounding it.

It is all very well and good talking about ideal situations and how things SHOULD be, but we also need to face the reality of how care and staffing levels ARE, and what that will continue to look like in the future.

I am so sorry to hear this. My relatives died on the NHS as well and one of cancer earlier this year. It was thankfully very good care.

So OP perhaps you now understand that care isn't equal throughout the country. It's a lottery what you get, and this might inform people's desire to have a say in how they choose to die?

I’m sorry, but you sound very ill informed about the realities for some people. “A syringe driver should be used.” Do you think a syringe driver works on everybody with all types of diseases? It doesn’t.

Anaesthetists aren’t involved in pain relief in palliative care, I believe. There are growing calls for them to be. Patients often believe that the “sedation” they are offered will be like a general anaesthetic, when it is sadly nothing like that.

But that’s not allowed, though, and is never done.

I would like to challenge the idea that living with mental illness or dementia is always an intolerably awful experience for the person, and the idea that such lives are not worth living, or have no value. I think this attitude contributes to the fear and dread that people experience on diagnosis, and to the idea that elderly and disabled people, people with mental illnesses are less important, less deserving of investment or treatment.

Here is a man with dementia being supported by strangers and family to surf a wave. He is clearly experiencing joy and pleasure, and he is also creating opportunities for others to connect and express love.

www.surfertoday.com/surfing/man-with-dementia-fulfills-wish-to-ride-one-last-wave

Here is a woman with dementia playing piano and enjoying close connection and care from her daughter, who is so beautifully attentive to her mother’s happiness and comfort. The daughter and mother both describe their ongoing time together as a “treasure”. The older lady is also spreading joy to others and inspiring others to express themselves through music.

There is still a lot of life left to be lived and enjoyed for these people. A lot of our suffering in life comes not from the present moment, but from worrying about the past and the future. Consider the experience of a newborn baby. It has no concepts or memories at all. It is completely vulnerable and reliant on others, but if it receives love and attentive care to its needs, is the experience intolerable?

As evidenced by people diagnosed with dementia with advanced directives who have then changed their minds, when you actually get there, you might find that this is not such an awful experience after all, that joy and pleasure, the expression and receipt of love and connection, is still possible.

Here is man who decided to kill himself when he was diagnosed with schizoaffective disorder. He said that negative portrayals of mental illness in the media were involved in his suicide decision.

When he was standing about to jump off the bridge, a stranger saw him and understood what he was planning. Did that stranger turn away, and say, "I respect his choice"? Did that stranger assist his suicide and push him off? No, thankfully that stranger showed him love and reassured him that things would get better.

So the man did not kill himself, and is now extremely happy and grateful to the stranger who saved his life.

www.theguardian.com/society/2014/jan/30/man-reunited-stranger-suicide-attempt-london-bridge

Consider also the story of this American man with bipolar who decided to take his own life by jumping off a bridge. A woman saw him go over. Did she respect his choice and not intervene? No, she called for help.

Amazingly, he survived the fall and because of the intervention of that stranger, the coast guard arrived to save him. He began a path of recovery and is also grateful that people intervened to stop his suicide, rather than assisting it. He has gone on to lead a life of purpose and joy and meaning, despite a serious mental health condition.

For every link you find of a potentially incorrectly applied assisted death there will be many more of people dying after enduring long, painful and undignified illnesses.

I am 100% for assisted death and in some cases withdrawing medical assistance to keep people alive who cannot make their own decisions and have no quality of life.

My DSIL has someone in a bed in her care home, an ex alcoholic who has been bed ridden, mid 50s,with a feeding tube, unable to communicate for over a decade. She has no family who want anything to do with her, no visitors, she has spent the last decade in a room by herself staring into space. She even survived covid. As the old saying goes - you wouldnt do it to a dog...

We can learn from the failures, and successes, to improve the process and put in cast iron safeguards. Something needs to be done where medicine inappropriately keeps people alive with an attrocious quality of live, or when some need a safe way to die to escape unbearable pain.

Maid is simply an option. In Canada in 2021, 3% of all deaths were MAID. The majority of people with life limiting illnesses do not want Maid and that is completely their perogative and the norm. No one is saying that living with a mental illness or any condition is intolerable. Maid just allows those that want agency over their death to die with dignity.

The issue currently in Canada leading to the sensationalized headlines comes mostly out of the largest province - Ontario - but there are similar issues across the country. People who have a disability and are unable to work are on a program called ODSP. The single person supplement for rent and living expenses equates to 737 pounds per month. With current rental rates, gas prices, food prices, people are saying they cannot afford to live on their disability benefit check amounts. They are lobbying the government for more money. They are also complaining to their social service case workers and asking for more (case workers aren't in a position to do much and are getting very frustrated). So they are now arguing that if the government doesn't increase the ODSP rates, they will start applying for MAID since they can't afford to maintain their apartments or nutrition on the current rates and they would rather be dead than homeless or starving.

In Canada in 2021, 10,000 people opted for MAID. 97.8% had a foreseeable death. An additional 1600 people were approved but died before MAID could be administered. These are not people out surfing or playing piano. 66% had cancer (1- lung 2- colorectal, 3 - pancreatic), 19% had a cardiovascular condition, 12% had a neurological condition (ALS most common), and 12% had a chronic respiratory condition as their main conditions. 88% were receiving palliative care. Of the 2.2% who did not have a foreseeable death, 50% were neurological conditions like MS and Parkinson's. Less than 1% of all MAID cases had dementia as a primary condition.

Reasons for requesting MAID (can give more than one):
86% reported loss of ability to engage in meaningful activity
83% loss of ability to complete activities of daily living
58% reported pain
57% reported loss of dignitiy
46% inadequate symptoms control (other than pain)
35% burden on others
35% loss of bodily functions

Also the MAID laws in processes in Canada have multiple checks and balances in place, require more than one physician or nurse practitioner to be involved and to sign off, and have a list of inclusion / exclusion criteria and safeguarding measures built into the assessment and process. Of course, no process is immune to swiss cheese errors but it is a rigorous process, particularly if death is not foreseeable.

I found the following talk very interesting and moving, from a palliative care specialist who has been present at hundreds of deaths from different causes, and who seeks to educate the public about the normal, physiological process of death, dispelling misinformation, myths and fears.

Position paper from the Australia New Zealand Society of Palliative Medicine, which is against the practice of euthanasia, and highlights the differences between this and refusal of treatment and symptom control.

www.anzspm.org.au/c/anzspm?a=sendfile&ft=p&fid=1635983800&sid=

I'm so conflicted about assisted death.

It absolutely should be an individual's choice when to make an exit.

However , once legislation is passed, it then becomes the business of the state.

I think a legal fudge is probably the best option.

Whereby it's not legal but if an individual has actively sought to end their life and has needed assistance, the assistor won't be prosecuted.

I think all of these approaches are beneficial as many societies are not comfortable discussing death and dying and opening up that conversation is important.

My DSIL has someone in a bed in her care home, an ex alcoholic who has been bed ridden, mid 50s,with a feeding tube, unable to communicate for over a decade. She has no family who want anything to do with her, no visitors, she has spent the last decade in a room by herself staring into space. She even survived covid. As the old saying goes - you wouldnt do it to a dog...

No, it's not a decision that can be made other than by that person though.

She may have a rich inner life, she may be in torment. It's impossible to know.

Dogs aren't sentient which is why we make that decision for them.

It's a very troublesome path to start down.

Dogs are sentient.

I’m thinking more of the case in Belgium where the girl in her early twenties successfully requested euthanasia. You can say she consented and we should be content with that, but it’s too horrific to let someone so young die like that, when she could have been helped. Consent isn’t enough, as we know for a fact that those who unsuccessfully try to kill themselves rarely do it again. This is why we try to encourage suicidal people to step off the ledge, so to speak, rather than leave them to it because ‘it’s what they want’

I’m not speaking to terminal illness as I have little awareness of the issues but I’m quite sympathetic to your arguments here.

As evidenced by people diagnosed with dementia with advanced directives who have then changed their minds, when you actually get there, you might find that this is not such an awful experience after all, that joy and pleasure, the expression and receipt of love and connection, is still possible.

There is a reason why people with dementia can't sign off on POA. They aren't considered of sound mind.

As for your newborn analogy, that a straw man. People with dementia don't get better or create memories.

Well lucky them. There are many that aren't so lucky, including my FIL. It isn't just about pain either, it also has to do with the decisions that we feel we have a right to make for other human beings, about their own lives and their rights to face the end on their own terms.

You don't throw the baby out with the bathwater and not allow a dignified end because there may be questionable practices abuses in other countries: you put in safeguards.

This doctor is amazing - Dr Kathryn Mannix. I’ve seen her speak many times and she is so knowledgable and caring. Her thoughts on how we need to approach death as a society are really no nonsense and full of common sense.

@MintyFreshOne the question with euthanasia in mental health is basically 'how long is a piece of string?'. How long do we think it is acceptable to leave someone suffering while we dangle a carrot called 'hope of recovery' in front of them? There comes a point when enough has to be enough. If we accept that mentally ill people do still have capacity to make life and death decisions in many cases (and UK law makes it clear that we cannot assume that they do not) then when do we allow them agency and stop assuming they are incapable of choosing for themselves? The young woman in Belgium suffered for 6 years. How much longer would you have liked her to go on? I don't call that hope, I call it cruelty. I call it appeasing your own conscience.