Matthew Paris - assisted dying

[Noicant]

https://www.thetimes.co.uk/article/we-cant-afford-a-taboo-on-assisted-dying-n6p8bfg9k

This made me feel deeply uncomfortable, he has a point about aging societies and the fact that we haven’t come anywhere near squaring the circle. It does feel very much like “it’s a good think if people feel pressured to just cut their life short if they are a burden”.

I’m a bit conflicted about this, on one hand I have an only child and I’m keenly aware that I never ever want to be a burden on her personally. I’m also very much in favour of assisted dying. But the idea that social pressure is exerted to almost make someone feel shame if they choose not to euthanise themselves is really quite horrific.

I get the black and white cost analysis and I do think many people would resist it (I have had elderly members of my family being absolutely clear that they expected everything possible would be done to keep them alive, they weren’t ready, one of them was furious at the idea that treatment would be withdrawn even though it was doing more damage than good by that point). But there would be people who are very vulnerable who would struggle to say “I don’t want this”.

It puts me in mind of MAID, I think a journal actually looked at the cost saving of implementing euthansia policies. On one hand theres a clinical honesty about that (which I think is lacking in our current political debate) but it also feels immensely inhumane and brutal.

@rickyrickygrimes I'm sorry about your MIL, that is a terrible situation for everyone.

@Noicant.. Have you sat watching someone terminal ill 100 % die, in pain?

We don't let animals suffer like this we must be allowed to choose how we die.

My biggest fear is dying in long lingering pain. No one needs that.

The article begins by talking about the voluntary euthanasia of the terminally ill, but by the end is more focused on our ageing, heavily dependent population and the many social and economic consequences of non-working people regularly living well into their 80s and 90s.

I think shifting demographics will inevitably be a factor in the move towards legalisation. I'd much rather that people acknowledged that openly so that it can be argued against by those that want to, than have a dishonest debate in which certain things can't be said and so can't be rebutted either.

@Fahbeep

Endless different docs have to sign these things off.

They will also be struck off.

Until Canada I would have supported assisted dying I certain circumstances. I don't anymore, I don't trust our politicians not to focus only on finances. I've also been listening to debates on R4 and some point out that less is put into palliative care in countries that have assisted dying
I know from my work that people can live well with a terminal condition
I don't agree with prolonging death though. I have an aunt who has had dementia for years. She has been in a care home bed for 4 years now. Suction daily to remove mucus and has been treated for numerous chest infections. On a good day she opens her eyes for a short time. They feed her easy to swallow foods like angel delight to get calories in. She would have hated the thought of this.

Yes, I absolutely do want it on the table and personally I would probably vote for it.

Ignoring debate will not make it go away. Debating things can, however, see your opinion included on the table - even if your opinion is that it should not happen.

It's a bit like the debate on the death penalty. You'll be surprised to know I am against it. Doesn't stop me debating it!

I’ve got an incurable and degenerative disability I wasn't born with, and as a result I fear the social pressure in my future to 'do the right thing' and spare everyone else of the burden of my illness.

Of course they’d have a choice.
No ones talking about making it compulsory.

He makes a good argument and I agree with him.
Even if not terminally ill, I’d welcome the ability to end my life when I see fit. At present I’m in good mental and physical health, but there are circumstances in which I would prefer not to keep living.

But choices arent made in a vacuum. If there is lots of pressure and talk about being a burden you know you have no support. If people stop donating to the hospice because their relative didnt go there for their last few weeks and recieve care because they "did the right thing" your choice is now very different.

We are ultimately talking about paying people to kill people. I dont really want to be killed by someone who would choose to have that job.

I also don't want to get dragged into the beginnings of it by dint of working in a pharmacy. Give the district nurse the end of life care pack with a bit of extra morphine... or we are making it big business, so you can pay to go to a dignitas type place... let's all buy some shares in death... profits mean targets...

That's not true though is it? Parris's poorly constructed opinion piece does actually argue for social pressure to coerce people into euthanasia they don't want. This would not end with people suffering from advanced dementia (or whatever comforting lies advocates tell themselves and others, as if people with dementia have no value!). In truth, it wouldn't even start with them. Grabby for an inheritance? Hate your neighbour? Despise certain social groups? Sorted, and sortable right away.

And what about those that don’t want it? Would they get a choice?

as always on these threads we are talking over the top of each other about different groups. TBF the article does that too.

1. people who have capacity to choose - and want to stay alive no matter what
2. people who have capacity to choose - and would choose to end their life at a certain point
3. people (like my MIL) who do not have the capacity to choose nor any way to communicate what their choice would be, who rely on other people to make the choice for them.

For those in group 3 the argument becomes about who should decide for them?

Family members - who are deeply emotionally entangled and not necessarily able to separate their grief from making a hard decision for the benefit of the person in the bed? FIL cannot separate his desire for MIL to continue to exist from whether she actually has any quality of life more.

Medical staff? Can we give them greater rights to decide - not just to advise - when even minor medical treatment should be withdrawn and the person ushered comfortably towards death? Or make it a requirement for them to talk to family openly and honestly about the quality of like that this person has, and why they - as a medical oriental - recommend no further treatment?

or Society at large, the tax payers who are faced with paying a huge and rapidly increasing bill for social care? I imagine it would be easier to be rational and dispassionate when several steps removed from the person in the bed.

The problem is it will become about money. Can you afford to carry on living when you are infirm, need help, or can't fund it yourself?

I think the answer will be no. Older age care is already very expensive. With serious medical considerations even more so. It is all very well being someone like Matthew Parris and his demographic which is pretty wealthy, and I see also Esther Ranzen on this issue too. These people are wealthy boomers who want some control over their lives. But those to come afterwards who are a lot poorer, who can't afford care, who have no relatives who will or can't because they need to work?

Difficult. I think we all need to discuss what a good death looks like.

On the face of it yes it seems barbaric however the only way to stop that going through really is to allow assisted dying to those that want it. It is no-one else's right to decide whether I should be able to end my own life safely with my lived ones surrounding me. I don't want weeks/months years if palliative care now that I'm running out of options for cancer. Again there is the consideration that the funding needs to change. So what do we drop to put more ki ey back I to keeping the bedridden, pain suffering, incontinent people alive - IVF perhaps?

Esther Rantzen has stage 4 cancer. She may not yet be terminally ill. Many people with cancer, wealthy or not, want control over their deaths, not their lives - because there’s no knowing how it will be for them. Even the best palliative care in a hospice cannot guarantee a pain-free death. A significant proportion will be in considerable pain. A friend of mine died, aged 30, recently of cancer and was in a lot of pain that was not relieved, despite relatives begging that she be put out of her screaming misery.

yes, this is also my concern. Basically, if there is an alternative to social care and medical costs being (and even state pensions) born by the state, it will be taken.
I think, and many people will disagree I am sure, that one of the consequences of abortion is to exert a social pressure not to have children until certain social and economic conditions are met (and these are increasingly difficult with the cost of living and childcare). It even comes in with the ‘why did you have more children?’ comments in some of the obvious LTB territory threads - like the responsible woman would have sought an abortion if her partner turned out to be terrible, never mind having children because she wanted them. So I don’t think we need to look far to see where assisted dying will go.
It is all very well people saying, well, I want that choice for assisted suicide, and it is assisted suicide, but this comes from a point of privilege, of assuming it will be a free choice and not one clouded by all sorts of other socio-economic considerations, not least cost and trouble to others.
I found the article horrible and reminiscent of early discussions about eugenics.

Medical professionals are not infallible or immune from group think. It isn't an adequate safeguard. Nor are they immune from corruption or, in extreme cases, criminality (Shipman, Letby).

It did used to happen that patients would ask doctors to help them end their lives. They were given morphine and the certificate fiddled. This was how Shipman got away with what he did, but many doctors of a certain age would be able to tell you that they did this when a patient asked. The problem is that not everyone is good or well motivated. And legislation of any kind will have a hard edge to it because you have to draw a line to make it work at all.

Difficult. I think we all need to discuss what a good death looks like.

Even just talking openly about and acknowledging the inevitability of death would be a good start. Chat GPT tells me that approximately 106 die in the world every single minute. It happens to us all, every single one of us. We should be making our peace with that right now and preparing mentally for it to happen to ourselves and to everyone we love.

Stoicism 101.

This. Even the debate is frightening for those who would suffer abuse. It isn't an area in which we should introduce a choice fallacy based on the false (probably unconsciously libertarian political) belief that we are independent rational individuals making all of our own decisions from a place of free will and independence.

This is my take on it as well, completely.

The thing is that whatever Matthew Paris writes, the UK is not going to enact that kind of legislation now or probably ever. The bill being put before parliament for debate is proposing to allow the terminally ill, with a life expectancy of no more than six months, to access euthanasia. That's all!

So someone with a dementia diagnosis, for instance, who doesn't wish to get to that awful end-of-life stage that means they don't know their loved ones and don't have control of their bodily functions and who has zero quality of life, will not be eligible, because at the point they only have six months to live they won't have the capacity to consent.

Most British people, from what I can tell through conversations I've had with friends and family, would like something MUCH more expansive, but that's not what we'll get. Any 'Dignity in Dying' bill will be so restricted that in reality very few will be able to use it.

Terry Pratchett did a good documentary on this when he was first diagnosed with Alzheimer’s. I always think of Tony Nicklinson’s horrific case, or Tony Bland who the courts allowed to starve to death . Assisted dying should be a personal choice.

Having done some digging, it looks as though the special PIP rules have recently been extended to cover people expected to live less than 12 months, because changes in care mean that people live longer with a terminal illness.

However, the article discusses general funding of care for the elderly, so the sub headline might be a bit misleading.