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would be done to keep them alive, they weren’t ready, one of them was furious at the idea that treatment would be withdrawn even though it was doing more damage than good by that point).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.

https://distribution-a617274656661637473.pbo-dpb.ca/241708b353e7782a9e5e713c2e281fc5ed932d3d07e9f5dd212e73604762bbc5

I found this report from canada’s budget office on the cost savings associated with MAID.

The reality is that, in countries where euthanasia is legal (I’m thinking Belgium or the Netherland here so no cost involved), people STILL rarely chose euthanasia.

Because, even though there is a lot of talk about quality of life and why would you want to live like this, when it comes to actually do it, people don’t. They still feel they have enough to live for, even when, from the outside they have an awful existence.

I mean, look at people who are quadriplegic, those on ventilators, those with ALS/MND, these people want to live. They aren’t choosing euthanasia but rather they are clamouring for better treatments. They are shouting to better care.

If anything was to be looked at, I’d rather have discussions on treatments amd quality of life.

eg when dh gran was getting older, she had dementia. She couldn’t recognise people etc… And yet, when she fell and broke her collar bone, the doctor didn’t want to prescribe morphine ‘because it might reduce the time she has to live’!!
Now THAT is a discussion we should have. It’s not about euthanasia. It’s about treating people with respect. It’s about, yes, quality of life rather than length of life. It’s about actually looking after people, discussing with them what makes their life worth living. It’s about caring for them.
We should be talking about palliative care and care at home.

But euthanasia should be coming way after that sort of talk.
But what we are doing with euthanasia (and what that article is hinting at), it’s short cutting these talks and jumping straight to death and then putting the pressure on those people (who should be encouraged to consider dying).

@Noicant that just healthcare cost though.

What you don’t have is social care cost, disability benefits, or pension (if they even have it there).
The true picture of ‘savings’ might be much more marked.

Esp as they have now introduced the fact that CHILDREN can be considered for MAID. (and ofc no children can’t consent to that so it will be for their latents to decide. Can’t imagine how heartbreaking this would be)

I don't think that's a good argument for euthanasia. It's a good argument for not keeping people alive when they have no quality of life, but there's a world of difference between that and exerting pressure on them to kill themselves.

I have a strong family history of dementia and if I'm diagnosed then I would like the opportunity to end my life when I'm unable to live independently. Not because I feel under pressure, but because I don't want to rely on others for my basic needs.

As it is, the best I can do is make an advance statement to refuse all life prolonging treatment in the event that I lose capacity to make decisions myself.

It’s really interesting that this is what you’ve seen, as all I seem to read about is people with things like locked-in syndrome campaigning for the right to die and the starving themselves etc. I’ve definitely read a few stories in the news about this over the years.

@MarionMarion

I get what you are saying, but there are quite a lot of people who do want to end their lives due to conditions - it's just that the timing of choice is unavailable to them. I'd absolutely want to kill myself if I got dementia in the way of my paternal grandmother - she had five years of undignified existing that was very sad to watch, but probably by the time it is noticeable and not just forgetfulness I will be assumed not to have capacity or I'll need the assistance of people who might be prosecuted if I get them to help me go to dignitas.

In your own post, you say that your gran should have had morphine despite the fact of it maybe shortening her life and want a focus on quality of life. I don't think anyone is suggesting that people should off themselves when they get elderly, even Matthew Parris (though I agree he comes closer than most). But, point is, we need a better way of working in quality than we do at the moment - either by supporting medics to make more quality based decisions (which many medics will feel uncomfortable about due to "playing god" and slippery slope arguments) OR we could have a form of euthanasia/assisted suicide where people set out in advance what THEY consider intolerable conditions and these are respected (and can be revoked , adjusted etc if the person is of sound mind).

This is going to end up like Logan's Run.

"Suicide is no longer illegal. Making it legal to assist someone to die does not give that person a ‘new’ human right – it provides a new immunity from justice for those who provide the assistance.
Killing is not just another medical treatment option, and it must not be made any part of routine health care. In these days of cost cutting in the NHS and social care, assisted suicide could all too easily become an attractive ‘treatment’ remedy."
https://notdeadyetuk.org/about/

@MariaVT65 You read about the high profile cases going to court. They make noise. If you think how many people die a year they are a miniscule proportion.

Well he's no spring chicken, I wonder when he's planning on doing it. He's older than me so I'll hang on and let him lead the way.

@MariaVT65 that's probably because I’m disabled myself.

So I hear about the patient led initiatives, the ambassadors etc… that are fighting so hard to get treatments, to get support instead. Sometimes, at a great cost to their own health (and life).
The fact we dint hear about those people as much says a lot about ableism in our society imo.

@lemonstolemonade i think we are saying the same thing.

The difference is that you are hoping that we can acheive to have both at the same time an increase in care/focus on quality of life AND talk about euthanasia.
Whereas I think we need to talk about quality of life/palliative care etc first and foremost. Because otherwise it’s too easy to use euthanasia as a get out clause (that’s what they wanted) for poor quality care at the end of life.

There is a letter in the Times today in response to MP's article, pointing out that what's he's advocating for is a 'luxury belief' - one held by those with privilege and agency that will have untold costs for the vulnerable in society who have neither.

And given that this week parents were given the option of having class pictures with some children with complex needs removed, we're already making judgments about whose lives have more value.

I saw the mother whose little girl was left out of a school class photo, there were two versions so parents could choose to have her child in their photo or not. She was on GMB and was a very dignified woman.

For myself, I'd never ask for a doctor's advice on resuscitation to be overridden, because I know that it isn't the movies, and the chance of coming back (or coming back without catastrophic injuries) is low.

(But a doctor's advice, nobody else's)

But maybe for some people assisted dying is part of that quality of life? Knowing you are able to choose how and when you die, knowing you can do so at home, surrounded by people you love, rather than fearing you will lose your capacity and leave things unsaid or risk being taken suddenly or being in pain might be part of allowing some people to live the rest of their lives more peacefully.

Care has to encompass all aspects, surely and if it's important to someone to have some control over how they die that seems an important part of the discussion.

I agree it should never be an alternative to good quality care but palliative care should consider how a person wants to live and how they want to die and support them to do both.

@VerityUnreasonble

Well said, that's what I meant.

I think that a discussion about quality needs to have some basis for assessing quality. You commented on your relative's dementia being a factor in not being afraid to shorten her life. Which is your objective assessment. For those who have capacity, there will be a subjective element.

So it is both a medical and a personal question - if you are prepared to answer the question of quality in the context of when people should no longer be treated in terms of personal choice, then others who wish not just not to be treated but to die might also want to have their say on quality too.

And @MarionMarion

My grandmother lived 5 years in demented indignity with all the forms filled out - DNR, the lot.

Sometimes people take a long time to go, in circumstances they personally find very distressing to consider.

Not so long ago it was the norm for doctors to "give a little extra" palliative treatment to terminal patients to allow them dignity in dying, and no-one saw it as anything other than a decent thing to do, to end suffering, and a blessing, until Shipman came along.

So, now we need legislation and proper statements of intent and requests, to end our own suffering. That includes any request for euthanasia and in what circumstances. Get those letters written, and get your spouse and children to countersign, and witnessed, to ensure you don't get any treatment that you don't want.

As per my pp, you can add your own wishes to a Health and Welfare Power of Attorney. There is space for the purpose.

But any request for euthanasia will be ignored - because it’s illegal. It doesn’t matter what you put in your POA or who witnesses what. You can request no unnecessary treatment or palliative treatment only in some circumstances, but never euthanasia.

No, it absolutely wouldn't. I have a close relative who was a GP and he would do this for his patients, back when it was seen as a kind act to a dying person. But now it would be treated as murder, thanks to the likes of Harold Shipman, and no doctor would dare to do it for fear of being prosecuted.

My husband has morphine on a repeat prescription. If he wanted to take the lot at once that is his business. Someone else making the decision is a different matter.

This is euthanasia in the Netherland.
This is standing out to me:

Ter Beek is one of a growing number of people across the West choosing to end their lives rather than live in pain. Pain that, in many cases, can be treated.

https://www.thefp.com/p/im-28-and-im-scheduled-to-die