Prue Leith and Assisted Dying.

[Jaichangecentfoisdenom]

I happened on this discussion earlier today, on LBC:www.lbc.co.uk/radio/presenters/david-lammy/prue-leith-makes-case-for-assisted-dying/ I've made it clear to my family that when the time comes, if I'm suffering from a terminal illness, I'm off to Dignitas in Switzerland - but I'm lucky, we can afford it. Religious reasons aside, what would you want for family and yourself?

For my family and myself, I would want a comfortable end. I begged the doctor to speed my mum’s end, it was awful.

But what I want for the health service/the law is not assisted dying. I think it is highly risky and definitely a slippery slope to people feeling they ‘should’ end their lives. It works across the Hippocratic oath. Hard cases make bad law and all that.

I want assisted dying. I think we spend a fortune propping up the elderly with no quality of life with endless interventions and antibiotics.

Dementia runs in my family it’s incredibly depressing watching proud, intelligent people fade away. Yes, they are cared for they are fed and toiletted and washed but they have no quality of life. It’s just a sad shuffling existence from bedroom to common room and back again.

I have Dutch family and they are much more pragmatic about end of life care.

@CaponeOnTax - I understand your reservations, but I believe the checks and balances on assisted dying on countries where it is allowed (such as the Netherlands, as mentioned by @Badbudgeter) are such as to make the slippery slope an uphill one, if you see what I mean. Also, isn't the Hippocatic oath "do no harm"? Isn't more harm done by keeping a suffering, terminally ill patient, alive, than by helping them to a peaceful, dignified, end slightly sooner than would have naturally happened?

I've just watched the Channel 4 documentary with Prue Leith and her son and it has only served to increase my support for assisted dying and my desire to have doctor-assisted death as an option here, as it is in Canada.

I fully accept that there may be risks of coercion of the vulnerable and the point was made in the programme that some people may choose assisted death because that is available to them where good quality care is not. Naturally it would be wonderful to live in a world where good quality care is available to all but I do not see why those who do not wish to be kept alive by the good quality care available to them are forced to do so. Perhaps there would be more care available to those who want it if those who don't are not forced to have it.

I believe in the right of the individual to die. Suicide is not illegal. Can it really be right that those who can afford it have to make their way to Dignitas while they still can to ensure a peaceful death earlier than they might otherwise wish, while those who can't afford it have to risk death by their own hand which may or may not work (and which may well traumatise others in the process)?

I'm in favour of assisted dying, too. If I ever got dementia, or got to a point where I needed round the clock care, I don't want to be here.

I haven’t seen what you’re talking about. But I absolutely support assisted dying. I have seen both my Mum and Gran die of bowel cancer, dying the most horrific deaths one can imagine even with all the syringe drivers and morphine in the world it was still absolutely dreadful and I feel traumatised as a result. I do not want myself or anyone else to experience that or witness that. So if someone can have a peaceful, planned death then we should support that. We do better for our pets than ourselves.

Assisted suicide should be legal for absolutely anyone who wants it. If I can't get it in the UK, I'll be going to Switzerland too. I think it's barbaric that it's currently illegal in the UK.

Difficult subject. Doctors are damned if they do and damned if they don't. People howling in outrage when they discover their frail dementia ridden parent has DNAR on their medical notes . My mum had dementia and it was horrific. If I have a dementia diagnosis in the future I'm off.
But of course there is also the threat of greedy relatives wanting to bump Granny off to get their hands on the spoils.
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What I don’t want is for people to make a decision for me regards assisted dying. We don’t with abortion. People in the position of needing one have the freedom to choose.
I don’t understand why the same freedom of choice isn’t given to assisted dying …. that those against it due to concerns about slippery slopes, coercion, religion etc mean that I have a painful and undignified end that I don’t want.

many other countries have it with safeguarding. No doubt a referendum would be for it… why can’t we have a referendum on it?

All of this.

DGM had often said she’d lived too long. Her mobility was poor and she was supported at home with carers and she’d had enough. For her then to develop dementia and spend 4 years, bed bound, in a home was a miserable way to end up.
DF is now in a home with dementia. He’d always said he’d rather be dead than end up with dementia like his mum. If he’d had an option early on for an assisted death he’d have taken it like a shot.
I have chronic, painful, health conditions and the future to me is frightening. I believe it costs around £10,000 for a dignitas death so that won’t be an option for me.

I have joined my decisions and made a living will making it clear that, if I do end up in a home, I don’t want to be given antibiotics. With any luck a bout of pneumonia will finish me off quickly, but that would be a horrendous way to go. Modern medicine is marvellous but there are now great lengths to keep people alive, even if it would be kinder not to.
mydecisions.org.uk

"Modern medicine is marvellous but there are now great lengths to keep people alive, even if it would be kinder not to."
Yes, this, absolutely. The appropriate word is indeed "kinder". Damn, that made me cry, thinking of each of my parents' deaths, 20 years apart, from different illnesses, but both alone on a hospital ward and in awful states at the end.

I absolutely support assisted dying. I have made it clear to the family that I want to be treated with the same dignity and kindness that we show to our dogs.

I support it too.

But the problem with things like dementia (which also runs in my family) is that we wouldn't be allowed to opt for it if we were in that situation, because we'd never be considered capable enough to make that decision if it got to the point where we didn't have much quality of life. And then you're faced with having to make the decision much, much earlier than you might otherwise have wanted to, just so that you're considered capable. I wish there were a way to specify in advance that if you got to a certain point, unable to do various things or meet certain criteria, it could happen. But that's unworkable I think.

'Difficult subject. Doctors are damned if they do and damned if they don't.'

Totally agree. I absolutely support anyone's right to end their life at a time of their choosing. We lost MIL to cancer last year. It was only a matter of weeks from diagnosis to death and even that was utterly harrowing, watching her fade away bit by bit. I cannot imagine that process being stretched out over months or even years

That said, I think it's a hugely complex area and it's not as simple as just changing the law and getting on with it

@Bimbleberries - you've hit the nail on the head, though I just now realised that I have always assumed that I would have stated in advance, before dementia had set in, at which point I wanted the end of the road to come. Thinking again, you're right, how workable would that actually be?

It's hard isn't it, because it's all well and good saying "if I can't care for myself I'm off to switzerland" but at that point you wouldn't actually be able to get yourself there, or possibly be classed as unable to make the decision.

So do people just take themselves off to Switzerland when they are well?

I'm looking at whether I can have a living will which kicks in a do not resuscitate as soon as I am diagnosed with dementia or alziemers (sp).

I’m fully in favour of assisted dying. My dad died recently and without going into too much detail it was nothing short of horrific at the end. You wouldn’t have left a dog to suffer as he did but we had to sit by and watch him go. I wouldn’t wish it on my worst enemy, there must be a way we can give dying people more dignity.

It's a problem having to do something early while you can consent. DH came close to taking his own life last year when he was very unwell & couldn't imagine getting better. I found that although I support assisted dying in principle i wasn't ready to let him go then (selfish, I know).
He then improved and has been well for several months. However he has a terminal diagnosis & I know we will have the same conversation again in a few months. I don't want him to suffer but I don't want him to have to go too soon.

Dementia runs through my family too ( dads side ) having watched him go downhill , knowing he would have hated living like that , I’ve told my children to push me over a cliff if I end up like that
Hopefully it won’t come to that , but I would like to be able to die peacefully, in my own bed at a time before I end up like he did ( he was bedridden , didn’t recognise anyone , incontinent and eating purée , not for me , oh no )

We’ve taped the Prue Leith doc , and will watch it this weekend

Even a do not resuscitate order with dementia is unlikely to help, as you can live for a great many years without any need for resuscitating or medical intervention (apart from acute medical treatment that helps you feel better from whatever you're suffering from at the time).

It is really hard thinking about the decision so much earlier than needed.

I agree - the dnr doesn't mean I won't live with it for a long time, but it's the easiest control I can have, that may help at some point, without needing others to do anything.

But actually pushing someone over a cliff or similar is another matter in practice. I sat with my dad for several days while he was dying & came very close to putting him out of his misery by putting a pillow over his face, but I couldn't bring myself to do it.

I’m in favour of assisted dying being legalised here.

The problem with the plan to go to Dignitas is that, for most terminal illnesses, once you’re ill enough that you want to die you’re far too ill to make the journey. So that route actually means ending your life before you’d otherwise want to- which may be a reasonable thing to do but not an easy decision. Much better to have safe legal euthanasia here.

I fully support assisted dying. We should focus on quality of life not quantity. I do not want to hang on for months with no awareness of what is going on as my gran with dementia was forced to.

As a doctor, my view on this was different before medical school (unquestioningly pro) and now I'd be the person ending someone's life (hesitant).

Family pressure is a real issue regarding inheritance. Especially if someone with their eye on the will has POA for both health and finance - could they then decide to end the patient's life on their behalf for their own benefit?

I would prefer proactive elderly care planning. That means DNACPR discussions constantly occurring once illness is present. Downsizing homes so they are more appropriate for adaptations needed for disabilities. Established ceiling of care for the frail and chronically ill (e.g. "will have oral antibiotics in the community but not IV in hospital if develops pneumonia", with as many specifics as possible). Often nothing at all is done until a massive health crisis and then the family says they can't cope, so an intense care package needs to be magicked out of thin air. There is almost always a long history of deterioration and not coping.

My hospital has over 300 elderly inpatients and most are awaiting a community care package. A lot will deteriorate and die before they get there.

We all have a responsibility to support elderly family members to plan for the future. Nobody wants to go into a care home but it beats slowly dying in hospital with a delirium, broken hip from a fall and pressure sores because we have no staff to turn you. That is the reality now.