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would be done to keep them alive, they weren’t ready, one of them was furious at the idea that treatment would be withdrawn even though it was doing more damage than good by that point).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

No not euthanasia.

But if you have a living will/RESPECT form, this can include for eg a DNR.
So basically you are selecting to not have an intervention that could save your life and chose to die instead.
Not quite the same but close.

What about it stands out to you?

I read the article. It's very sad. It's a young woman who has endured years of suffering and doesn't want to do it anymore.

Could she be treated? Possibly. How long might it take to find a therapy or a medication that would be effective for her? No one can say. No one can even promise that we will.

Could she find a way to live with her pain and make a meaningful life? Again, maybe. It sounds in many ways like she has done, she has a home and a partner but she is still making a choice that her pain is unbearable.

It's not up to any of us to judge how much pain she can or should live with.

If a person has a treatable condition, say some form of cancer or something requiring blood products, but declines the treatment, we wouldn't force them to have it. We might or might not struggle to understand their reasons but fundamentally we'd allow them their choice even if it meant they were choosing death. This person is just choosing death in a more direct way.

I have an illness that has such poor quality of life that the suicide rate is very very high.
Regularly, you hear about people who ended their life, some planning it to the last detail including messages scheduled to be received just after they had died (to friends/family) or even parcels to be delivered.
Some have chosen to go down the euthanasia route (Canada, europe).

Imo the only difference between suicide and euthanasia is the fact the later has been ‘validated’ by professionals.
So in case of a suicide people talk about how help/support need to be more available and it shouldn’t be like this whereas in the case if euthanasia, it’s all about how this was the right choice for them etc….
In reality the issue in both cases is lack of support, an ableist society, gaslighting from HCP, lack of access to some medications etc…
Lets not forget too that, when people try to end their life and fail, a lot of them say how they deeply regretted to have even tried…

I agree that in SOME cases, this is the right decision. And everyone will have their own boundary for that.
But what I have an issue with is to become complacent and say ‘oh well. That’s what they wanted 🤷‍♀️🤷‍♀️’ (which is how your post came out to me) and then ignore why those people have reached their limits (because of all the hurdles that have been put in their way).

This article simply highlights how such law on euthanasia can go, moving from ‘this person is terminally ill’ (and all the talk about dementia, awful pain, cancer and the likes) to people who would normally be seen as someone that needs help rather than someone who has reached the end.

Btw the example of refusing treatment and dying because of that is not the same. Unless you want to conflate a DNR with euthanasia too.

The difference is obvious, in one case someone dies of their illness. In the other, they are actively seeking the end of their life (aka being killed).

It’s not the least bit close.

She could choose suicide. Is it right that doctors become executioners?

Earlier in this thread it was all about terminal illness and only six months to live but that isn't what seems to be the outcome, how long before we are killing babies because we don't think their quality of life will be good enough, how long before the elderly or infirm are expected to do "the right thing" so they aren't a burden.

Well Canada is well on its way re babies and children as they are now eligible for MAID…

@Iwasafool @MarionMarion I'm going to reply to you both at once because I think it will be a similar reply.

Marion, an apology first, it certainly wasn't an "oh well" and I'm sorry if that's how that read.

I'm a nurse, I've worked in both acute psychiatric settings and neurological illness. I've supported people who have wanted to end their lives at various times for various reasons and supported many people bereaved by suicide. Sadly, it's also something I have personal experience of. Similarly, I've been with countless families through journies from diagnosis to death, living with conditions that impact every aspect of who they are and how they live their lives and watched people in my own life go through this. I also live with chronic illness, both SMI and pain. I say this because I want you to know I don't sit looking at this with no skin in the game and no understanding of the impacts these things might have.

"She could have completed suicide". Is there a difference between completing suicide alone and doing it supported by a medical professional? In terms of outcome no but in terms of risk yes. If you know you want to die, it seems much more sensible to do so with the support of a person who will ensure you are not in pain, that the method chosen is going to work and not leave you alive and in distress or worse.

Marion, I understand the difference and perhaps it was a poor example (I'd argue DNACPR is slightly different for a number of reasons that don't really matter) but I guess the point was there are lots of people who choose to die when they technically don't "have to". I just wonder why we draw such a strong line between a passive choice - refusing things that will save us and an active choice - choosing things that will kill us. Really what makes those so different?

I am a huge advocate for high quality care, both for mental health and physical health. For access and parity of services. But I also think sometimes people can make a rational choice to say they no longer want to live the life they have or will have in future and however many promises we make them that we will keep trying, that we will be there to support and we can plan ways to make things as positive and hopeful as possible is not going to change that. In those circumstances I think it is the right thing to do to support people to have a safe, comfortable and dignified death in the manner and time of their choosing.

But it happens now anyway.

Even young people in Japan are getting fed up of all the old people. And the Japanese are the most respectful of old people.

I want to die when I want to die.

It really annoys me that in all this talk about assisted dying they always say that it will not affect people with dementia, but most people are worried about getting dementia and would want to die as soon as they can.

But what an earth is wrong with that?

If someone doesn't want to live then they should have their choice.

@IMustDoMoreExercise no one is stopping you from ending your life whenever you want. You dint need an euthanasia law for that.
I mean you don’t need an authorisation to decide to put an end to your life.

Have you ever tried to put an end to your life?

It's not as easy as you make it sound. Why should people suffer and DIY their death when there can be much more humane solutions for that?

@VerityUnreasonble , my point though, that I’ve made upthread is that this law is an extremely dangerous thing to have WITHOUT first having in place a full proof system that gives support to people who are ill and/or disabled.

So let’s say, end of life care. If you have an euthanasia law without having a very strong hospice care, what you end up is patients that are in pain, struggle like hell and decide to go for euthanasia because their life is awful when it could easily have been eased of with proper hospice care. And the days/weeks/months theyve gain through proper care might mean let’s say they can be there for their daughter’s wedding for example.

As I said above, I live with a condition that has poor quality of life. I know first hand what it means to have a condition that impact every aspect of my life.
I also know first hand that there is fuck all support available.
I am lucky that I have some support (dh). But I know many people who are severe, struggle to cook a meal for themselves and get no help at all for example.
And that’s wo talking about the gaslighting from doctors etc… the difficulty to get or renew PIP etc etc.
I mean just think. You are bedbound. You’ve just lost PIP. You have no support around you. What will you do? People die already. Of suicide. Of malnutrition/hunger. If a euthanasia law is coming in, what ‘choice’ do you think they will make?

Im not saying that there isn’t a place for euthanasia. I actually think there should be.
But experience in other countries shows us that it’s quickly moving from ‘it’s only for the terminally ill’ to all sorts of people that ‘will never get better’ to children.
THAT is the issue. That unfortunately, despite all assurances, it is likely to move towards pure eugenics rather than ‘avoiding suffering’

https://www.theguardian.com/film/2023/may/08/plan-75-ageing-japan-euthanasia-suicide

It reminded me of this, Janice Turner reviewed it a while ago, think I’ll watch it.

Yes they are. I want to be able to end my life in a stressfree, painless way when I choose to like people are able to in so many countries around the world. But I am not able to because I would have to comit suicide which is unpleasant for everyone.

There will never be a full proof system though.

We will never have the time, money, resources, ability to offer everyone the absolute ideal.

There will always be people who lack support for a variety of reasons, people who have less family support, less financial resources, less security, less advocacy, less knowledge, and understanding. Our circumstances will always contribute to our choices and our resilience. No choice is made in a vacuum.

I agree and as I've said before I strongly advocate for (I literally go to commissioners and fight for these services, I speak nationally about the importance of high quality support for people to live well) having high quality care and parity of care. I don't think anyone's choice to die (passively or actively) should be accepted without question of if there is something else or more we can do.

I'd certainly much rather starving or suicidal people were coming forward to medical professionals to at least have that conversation of if there was another option than just dying as your example above.

This is incredibly hard to read, and I'm so sorry.
I wasn't aware that people could go to Switzerland to end their lives, just because they wanted to - I genuinely thought there had to be terminal diagnosis.

Is there a link to this at all?

@JockTamsonsBairns A couple of items from the news
https://uk.news.yahoo.com/horse-rider-explains-decision-end-145600169.html?guce_referrer=aHR0cHM6Ly93d3cuYXZmb3J1bXMuY29tLw&guce_referrer_sig=AQAAANTiSbmRz8zRAVeHYxPAeQmxgte8-fSk6uZjukQxizLOdHdc1_zZ___OYjcCFAEsHP69OJ50_Kc-H2FcFxeJyLdRLd1Y_ZvURH91V1isJJ-vXUXUUjksvgr-s0tqXA6mUSdZHt6IxWZgm-CeBSJk8rnt7c0bwoIYqHZ8WanNcxpM

https://www.thetimes.co.uk/article/5b799088-ac9b-4cda-81f9-1bfd6f432daf?shareToken=9c0e8fbbd97b3cc02cbf8bf2f730b1ee

Years ago there was a series of programmes about end of life, probably before some of you were born. I vividly remember the wife who complained her terminally ill husband was taking too long to die, she needed to get out there and find another husband and he was delaying it. Or there was the baby who was being starved to death, I remember the mother visiting and lifting her arm and commenting that she wasn't losing weight as fast as they expected, the thing that finished me was when they decided to change the baby's name as they wanted to save that name for their next baby. The poor little thing wasn't even entitled to her own name.

People are often shocking in their selfishness and callousness. I think it is hard to place trust in people being decent, you only have to read some threads on here where people are moaning and bitching about "their inheritance" when their parents are still alive to see how dangerous this could be.

Once the taboo is lifted the justification for killing will start to expand.

https://www.mirror.co.uk/news/uk-news/caroline-march-who-died-assisted-32442308.amp

If it’s this one, then I cannot comprehend how anyone can question her decision and how they can talk about “repackaging” of the issues.

Who does that PP think they are, dictating now others should live their lives?

Exactly. And you can only do this if you have the £15k needed, which most people do not. It is so unfair.

@Fahbeep

But it was a legitimate personal choice for Caroline to end her life. She wasn't mentally ill, she just didn't want to live as a paralysed woman having previously been very active. It also doesn't speak in any way to what other disabled people should think or do. It's extremely uncompassionate of you to insist that she should have "made the best of it" and dug deeper to placate you.

Once the taboo is lifted the justification for killing will start to expand
I think you are right, the slope is far more slippery than most of us would like to admit, but that still leaves us in a very difficult position, there are no straightforward solutions here ☹️

There aren't any easy answers but once people accept killing people because they are old/disabled/a drain on society who will stand up for the vulnerable. Once doctors really are able to play God and end life without fear of retribution who will stop the next Harold Shipman.

I think Hitler started with eliminating the disabled, it progressed to children being killed because they had epilepsy or even persistent bed wetters. How did that become normalised? How much easier did it make the final solution, the elimination of Jews, homosexuals, Jehovah's Witnesses?

Truly a slippery slope.

I see we've reached the point of Godwins law.

It's always going to be a difficult and divisive discussion. Personal experience, moral and religious beliefs are going to impact, fears both real and imagined. But I think trying to keep some perspective and having a reasoned conversation with people at the heart of it is the most important thing, and that we keep talking as our health and treatments change.