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would be done to keep them alive, they weren’t ready, one of them was furious at the idea that treatment would be withdrawn even though it was doing more damage than good by that point).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

The whole slippery slope argument. Well what’s at the top of that slope? People stuck in agony for years, bedridden, doubly incontinent, hallucinating untold horrors, unable to communicate any pain, unable to do even the smallest actions, existing in misery because we apparently can’t make one decision without applying it without nuance to every situation. I absolutely volunteer to be pushed off the top of that slope should I find myself there.

@SinisterBumFacedCat surely that’s the very reason why we should push for better treatments and palliative care??

Palliative care does not help people with stage 7 dementia, which is now the biggest killer of women.

Why can’t we push for both?

Paliative care and assisted dying. It doesn’t have to be one or the other.

Cost benefit analysis.

Why waste taxpayers money keeping people alive when (coldly) you can bump em off for less - they are dying anyway.

You can of course pay privately for the former.

It has to be both I agree.

But what I’ve been arguing in this thread is that it has to be great palliative care first because otherwise there is no incentive to offer great palliative care.

Yes! @SinisterBumFacedCat

I keep trying to make this point - it's dementia and basically lots of conditions that SOME people find too intolerable to contemplate as a day to day reality without actually killing you for a long time that really lend themselves to assisted dying in terms of what many people think of when they consider what they want for themselves.

This is where I really differ from @MarionMarion, because she keeps stressing palliative care and no hospice will be caring for someone who isn't dying relatively imminently, so there is a bit of a gap in what is being advocated for by her. It really needs to be both more and better palliative care AND assisted dying.

My own paternal grandmother's mind gave out LONG before her body - she was of failing mind for 10 years and incontinent for the last years. She was undoubtedly lonely, despite a daily visit from at least one of her kids. A bit of morphine would have done her absolutely no good. She did attend a family wedding in the last 5 years of her life and we have some nice photos of her there, but she was overwhelmed out of routine and the reality was that it wasn't amazing for her. It wasn't a great end of life, gradually regressing in terms of mental capacity to the point of total obliviousness and then starving to death (the dementia eventually gets your swallow reflex if something else doesn't first).

I am really hoping that genetic testing and brain scanning will in a few decades time be able to tell me whether I am on that pathway (the other granny was very sharp at 90) and if I am I fully intend to get myself to dignitas as soon as I feel I'm on the slope towards dementia - I don't want my kids' overwhelming memories of me to be a decade of dementia.

Because A) it's likely to be abused / paperwork can be falsified B) people change their mind and forget about admin C) how do you check with a person who has lost or is losing capacity whether their alleged historic consent to be killed is still active? You're advocating for a law to accept that an incapacitated person can be deemed to consent to put to death based on filed paperwork. If you're happy with that, you have more faith than me in people, English bureaucracy, and haven't really thought about the likelihood of family Court proceedings between relatives who oppose the process.

@YourNimblePeachTraybake you are so right. Truly vile article. How long ,if costs become a deciding factor, would it take for people to look at other groups in society with euthanasia in mind , groups such as the handicapped or chronically ill?
I read of a doctor who asked a Downs Syndrome teenager why she wanted a heart operation(common in Downs children). She wanted to live., she replied. He told her that wasn't a good enough reason. How.could such a child justify her existence?
How could an elderly man who asked for a stairlift (in Canada)and was.offered euthanasia instead justify his?.The 13 year old suffering from depression who asked for euthanasia in Belgium. I hope she didn't get it.

'Useless mouths' Hitler called the mentally handicapped (post natal depression and dyslexia were included as euthanisable offences)and had them put to sleep in their thousands.

People should.be more cautious about enthusiasm for mercy killing. It will lead to all sorts of places we really don't want to go.

Perhaps because they haven't actually experienced.otd reality

Do you volunteer to be pushed off the top of that slope when you are happy with your life but someone else decides it is time for you to go?

I have LPA for a 90 year old relative with advanced dementia. She's actually the happiest she's ever been in her life. She was quite a miserable person, the early stages of dementia were awful but now she enjoys life, you might think she has no dignity or quality of life but those who know her would disagree with you.

Yes my relative would have said she didn't want to live with advanced dementia, the truth is she loves her carers, she's stopped fretting about the things that made her unhappy, the first time I saw her in the residents lounge joining in with a sing song I felt upset as I know she would have hated that as her future. She's happy with it as her life. Other people might worry about her dignity, being incontinent, needing help with eating but it doesn't worry her any more than it worries a baby needing the same help. Who am I or anyone else to decide her lift isn't worth living.

I believe this is really about social care or the lack of it. Just returned from hospital and this issue about bed blocking for the elderly is absolutely true. The NHS cannot cope now.

Yes, one element. Good availaibility of paliative care too.

But 100% with M. Paris, Esther Rantzen and many others. People should have THE CHOICE, and without all the stress and cost of having to go abroad- and going alone for fear of relatives and loved ones being prosecuted.

I'd decided I wasn't coming back to this thread after Hitler started showing up but one more thing because I'm a glutton for punishment.

You say "who am I to decide her life isn't worth living" but you've made a decision her life is worth living. You've said several times how happy she is, how she loves her carers etc. while at the same time completely disregarding what you actually know about her which is that she would have hated this. You are deciding that her previous wishes, when she was able to make her own choices no longer matter just because she's lost the ability to make them.

To use a bit of a random analogy, if she had been a life long staunch vegan, cared passionately about animal rights but now had forgotten this due to losing capacity, how would you feel about her happily tucking into a ham sandwich? Would you say "she's happy! She loves ham sandwiches! She would have been horrified knowing she was eating meat but now it doesn't worry her any more than a baby so it's fine!" Or would you ask the care home to offer her meat substitutes instead because you know this would have been important to her?

When we make choices for a person who has lost capacity (as POA or family or professional) we need to do this in their best interests and a huge part of this is asking ourselves the question "if they could decide this for themselves right now, what choice would they make?" . If your relative knew they would be in this situation, accepting they would also know they would feel calm, and not distressed but would still need significant personal care, wouldn't have independence and would no longer be able to make choices for themselves- what would they want to happen? As we can never know for sure (unless of course they have left instructions) this is really the best way to support making choices on a person's behalf.

Why are we afraid to look at costs realistically?

I own my house and if I end up in care for years my money is going to to on someone wiping my arse and maybe abusing me, because there have been cases like this, and my children’s’ memories will be unhappy ones and all the money I want to give to them will be gone in someone’s pocket with no benefit to me or my family.

Fuck that.

The choice I've made for her is the home she is in and I'm happy with that decision thanks.

People change, as a child I'd have hated the idea of having to cook and clean and keep house, I grew up and wanted a clean home and food to eat and suddenly I wanted to cook and clean. When my children were babies I couldn't imagine life in a house without them, they grew up and left and I waved them off and enjoyed a tidy house where I knew what was in the fridge. I remember looking at my mother who didn't go out a lot, enjoyed her home and I thought how boring I wanted to meet friends go to the cinema have fun, now I'm 70 and I also like being at home reading a good book and going out clubbing doesn't appeal and there are some good films on netflix without the bother of going out. Life changes, we change, vegetarians decide to eat meat, people of faith lose their faith and people who had no faith find religion. My relative was an unhappy woman, she fretted and worried, she didn't enjoy things as she was worried about what she'd missed or what might be next. Now she lives in the moment, she loves it when her carer gives her a massage, she loves the animals they have in the home, she likes singing. She laughs and she hugs people. She is happy whether you like it or not. I don't want anyone to decide I should live on chocolate and hot dogs although at one point in my life I'd have loved that, we need to accept life changes and we change, I'm not the same person I was at 10 or 20 or 50. I am a 70 year old woman and I live a life that makes me happy even though it wouldn't have made 10 year old me happy and my 90 year old relative is happy, it is easy to see that and even though you might think that is worth something I do.

Sorry mentioning Hitler offended you, it is inconvenient for proponents of killing the people they consider unworthy of life but he's a great example of that route even if you don't like being reminded of that.

The unpleasant thing is that this comes down to money. If you have money, the ability to pay for care, stairlifts, surgery, nurses, home help or whatever then you won't face pressure if euthanasia existed. Like anything else in life, you have control (mostly) if you have money.

The issue is the socialising of costs of care for the very old. You can already see younger people are struggling; they don't have the means to contribute to socialised care. The state is cutting back. If you are an older person of little means and a need to rely on public services then let us be real; human nature is not all nice, human beings are lazy, greedy and may not care - the fact that the state does some of this now is good, imo, but before there is any talk about legalisation of euthanasia the UK needs to sort out social care and how it is funded.

@Iwasafool

My gran was like that for about 2 years, before she deteriorated further and became frightened and overwhelmed and then basically a living vegetable.

I can see your point of view, but it's an agency thing. I mean, if the home said to you that she used to be distressed but they slipped her something to make her calm and happy and less aware of her surroundings, would you be ok with that, or would you see it as disrespectful or denying her current personhood?

I've got the cash, so I'll be planning the brain scan and dignitas route for myself, as I think agency and dignity is what matters to me. Would you honestly be happy to think that your relative's existence is in your future?

That might be your experience of dementia, but I’m sure you’re realistic that its not like that for most.
One of my relatives had Lewy Bodies dementia and the last 10 years of her life were an absolute tortured hell on earth. Please don't pretend it’s a pleasant or good thing. If it was such an easy and lovely change in her, you wouldn’t have shipped her off to a home.

@bombastix

Agreed with the general point, but the reality is even more complicated than that. Most of those who need social care DO have the resources to pay for it, they just don't want to. (And if they did pay, then others who couldn't could have better care) See how Theresa May's pretty mild proposal that people use housing equity to fund their care got shot down and so now we may be waiting another generation before we can address it properly.

All of the examples you've given of choices you've made though your life are ones you have made for yourself, with the capacity to do so. Of course people have the right and ability to change their minds and views, I was rather hoping you would consider at least the possibility of if not changing yours, at least seeing another side. I was talking about how we support people who are no longer able to do that for themselves which is a different situation.

I'm glad you have found a nice place to care for your relative and that her quality of life is good, I can agree she may well have a good quality of life even if it might not be what she would have chosen (but maybe it would have been, I don't know her).

I don't characterise anyone as unworthy of life. I think everyone is worthy of both a good life and a good death and to live and die in the way they choose, comfortable, and cared for.

I do find the Hitler references offensive, and the apology very mealy mouthed. I'm Jewish, and so I tend to find people trying to use the Holocaust as a way to win an argument on the Internet rather in bad taste. I'm sure there were other ways you could have made your point.

I'm not really sure if you genuinely think everyone in favour of the option of assisted dying is actually wanting to kill off vast swathes of the population for various nefarious reasons or this is just some weird strawman.

However! That really is enough of this thread for me. I wish both you and your relative all the best.

They should, yes.
My aunt had a conversation with her sister (my DM) years before any ill health and said she would want to be kept alive no matter what. She developed dementia and was actually happy, ate very well, died in her sleep before she forgot who we were.

I cannot fathom for the life of me why anyone would vote to suffer for weeks/months with cancer, vomiting their own faeces. Does anyone really, truly want that? and if so please tell me why?
If you do, then crack on you should absolutely be allowed to and make that decision whilst you are sound of mind.

My dad had an awful death, so did my grandmother and grandfather. I’d rather a day, week, month too soon than too late. Nobody is getting out alive, I want a say in how and when.

I agree with him totally.

I am 69, still, for my age, fit and healthy. I walk a lot, I holiday abroad with friends and, happily, on my own. I live alone and am independent.

If someone said to me today; 'You can choose to die, painlessly today BUT if you don't take the chance today, then it won't come again. You will have to live out your life with no chance of choosing to end it, no matter how much pain you are in, how incapacitated you are or whatever extent of dementia you are surviving with' (it's not living at that stage it's existing)

I would choose to die today. Unfortunately I do not have the choice (currently) now or ever.