Assisted Dying Bill tomorrow.

[TooBigForMyBoots]

I really hope this goes ahead.

I'm from a family who die from cancer. It's a genetic thing. Over the years I've watched numerous loved ones die from this cruel and ravaging disease. It has taken a massive toll on us. From PTSD to immense guilt, complicated grief and fear of the future.

Not all of my family would have accessed Assisted Dying, but I know some did want it and requested it in the weeks / days leading to their death. They should have had the option of shortening their suffering. Having witnessed what they went through, I want that option for myself.

I want it for my mother. For the past 20 years she has told me when she wants out and how I will have to help her achieve it. I don't want to. She apologises for putting it on me. She shouldn't have to.

No one will be saved if this Bill is stopped, but fear and suffering will be reduced.

I would support the principle of assisted dying but find this Bill so flawed in its safeguards and practicalities that it feels less risky if it doesn’t pass at all tomorrow. This thread has some really interesting points on that

https://www.mumsnet.com/talk/womens_rights/5217789-assisted-dying-is-sexist?page=1

I agree. I also think some people are misguided in the assumption that assisted dying means a peaceful or fast death.

I agree with this, I wonder why more people are not questioning why there is an increase in governments legalising this?

I agree and if the Bill succeeds tomorrow, there will be wider scrutiny at each stage. Success tomorrow does not make this actual law. There are many stages before that happens.

I hope it won'tbe passed. It isn't the answer.

What safeguards and practicalities are you specifically concerned about @Slothtoes ?

Equally, some people presume misguidedly unassisted death as a result of illness is peaceful or fast
Not so

It absolutely is the answer for many. The whole situation is a shit sandwich. Even with the world's best palliative care, you absolutely cannot alleviate significant suffering in many cases. We aren't getting great palliative care or the things we need to improve end of life. Saying no to this does not equal greater palliative care provision. That makes no sense.

I don't believe for one minute the Government cares, the NHS cares. No institutions care. All institutions are out for themselves. Yet, I still support it. People want this. People choose this. Do posters feel that all these people using MAID in other countries are being dragged to the clinic by their greedy children. These greedy children will already be sucking their vulnerable relatives accounts dry without this legislation.

I have not read the specifics to confirm whether IV is an option. I understand some posters may be concerned about the experience via oral ingestion. Dignitas has been doing this for years. If everyone was writhing around dying in agony, it wouldn't be carrying on. I'd rather take my chances on that than say a cancer eating your digestion up, vomiting feaces. Nothing and I mean nothing will relieve that agony.

No one thinks this

I understand some posters may be concerned about the experience via oral ingestion. Dignitas has been doing this for years. If everyone was writhing around dying in agony, it wouldn't be carrying on.

Dignitas is the £10k private version and uses the hard to secure more expensive formulas to bring on death that have a lower rate of complications. In this economy, the NHS is likely going to go for the cheaper, less gentle, less effective and efficient formulas as used in Canada which carry a higher complication rate.

The rich & privileged aren’t going to stop going to Dignitas.

I understand the legislative process. Private members bills have less opportunity for discussion than other forms of legislation. This is why I say that my preferred outcome is for the bill to pass this stage but with an amendment requiring some form of widespread public consultation - which is not the norm - as part of the subsequent legislative process.

Really? are you sure?
I’m simply putting the contrary view. I read and hear unassisted death being discussed as somehow more natural,not tainted no intervention.

The language shifts in the bills. So while two doctors sign off on the declaration & consent, and a doctor must prescribe the drugs, the language shifts to allow a registered medical practitioner or registered nurse to deliver the drugs and then to a mere assisting health professional to prepare and give them to the patient plus waiting for ingestion and death, which can be in another room from the patient. Could be done at home or a clinic or in hospital. A doctor would have to confirm death & record time of death for the certificate of death, but they can be called in to do well after the fact.

Could quite literally be two doctors doing the declaration & consent, GP prescribing, and a Boots pharmacy assistant delivering and attending the death…

Its left very vague and open. Most countries have doctors doing the procedure. The downgrading to “assisting health professional” for the administering and attending means the risk of assisted dying having complications, going horribly wrong or failing entirely would imho be higher than in countries where a doctor is attending.

Unassisted death that is accompanied by severe pain usually involves a medically induced coma so that the dying person isn’t suffering, but the relatives who insist on watching it often do.

How are you defining "severe pain"? I am not familiar with anyone being offered an induced coma.

No
Induced coma requires monitoring of respiration and vital signs as person has IV is intubated and is sedated. It is not treatment for pain control and isn’t used usually used to manage pain

Usually For brain injuries,

Here is the Institute for Government, on what is wrong with the current legislative approach:

www.instituteforgovernment.org.uk/comment/government-privatemembersbill-assisted-dying

I am concerned about this bill. So many of my patients would consider assisted dying as although not pressured by anyone, they would feel like it would be better for their family (not being a burden, save inheritance etc.) even when their quality of life is still good. I also worry that many people would begin to feel that it was just the right thing to do as a responsible person to prevent being a burden on state or family.

The 6 months thing is also a red herring as doctors are rarely accurate and I’ve seen many many patients live for years past their predicted death date. My own grandfather was told 3 months and became very low in mood as a result (understandably) and did this awful goodbye speech at a meal when we were all visiting but lived for a further 2.5 years.

The deaths are also not as peaceful and lovely as you might imagine. I was looking at some of the other countries where assisted dying is currently legal and some are recording deaths taking over a week!

Unfortunately I think the advancements in medicine have led us to this point in many ways as now so many people have been kept alive well past the time they’d naturally have died by feeding tubes, medications, treating everything we can, giving vaccines to prevent flu etc every year, preventative medicines and yet everyone has to die of something so it often turns into a more painful and drawn out death as a result. 100 years ago pneumonia was called “the old man’s friend” but it’s not allowed to be any more. I would very much like to see investment into palliative care before assisted dying becomes normalised.

Let me ask you...this is being brought in by more and more countries...why do you think that is?

Because religion has less grip. There are more atheists and religious people who want secular laws.

Because medical advancements have been brilliant in extending the life of those with terminal illnesses.

Because of the growing belief in bodily autonomy.

OP you asked me What safeguards and practicalities are you specifically concerned about?

I’ve posted various concerns on the MN thread about sexism and the Bill on assisted dying. www.mumsnet.com/talk/womens_rights/5217789-assisted-dying-is-sexist?latest=1
I really recommend that thread for other people’s excellent points in either direction. Also recommend it to access links to important new research released this week, showing how vulnerable to abuse that women could become, under the Bill.

On practical concerns take for example the fact there is no conscientious opt out for doctors written in to the Bill. That to me, is a sure sign of either basic inexperience in these issues (or huge arrogance) by whoever drafted it. A sign of not thinking this through in practical provision terms from either a doctor or patient perspective.

To not have this opt-out on such an obviously divisive issue for the staff of the NHS also implies that in reality, the Bill drafters expect that the UK’s assisted dying service will turn out to not be an NHS service at all, but be set up as a private paid-for provision service. One where doctors opt in to provide it. And will be incentivised by being paid private-medicine level fees to do so. That excludes the majority of patients from the off, obviously, if they will have to pay privately. Private provision is absolutely the opposite of the humane ‘every person’s autonomy must be respected’ approach, that campaigners for this Bill say that they want. And that’s just one way in which the bill looks not fit for its own stated purpose.

Which is not to say that MPs might not pass it today. MPs haven’t been given enough time to really think through how it would work and can’t see yet how riddled with problems the Bill is.Very worrying. Some MPs don’t seem to grasp that they are being asked to vote for a specific Bill requiring specific things today. It’s absolutely not a referendum on whether they approve in principle of assisted dying or not. I support assisted dying in principle and I find this bill so riddled with problems that I hope it doesn’t pass. This poorly made Bill is putting Parliament in a terrible position.

Another example. The Bill makes no provision for what if things go wrong medically in the procedure, what doctors would be expected to do. So many major practical legal and ethical concerns just from that. Why are doctors being put in that vulnerable position?

There’s an article by Dominic Grieve (former attorney general to government) this week in the Times, saying that: The Equality and Human Rights Commission has said that the sponsors of the legislation have provided “insufficiently detailed analysis of the human rights considerations relevant to this bill”. That. Is damning from the government’s own watchdog for human rights.

He notes that lawyers have significant European Convention on Human Rights concerns about the bill, and have doubts that the bill could be compliant with the ECHR.

The former President of the family division of the High Court, has said that the bill “falls lamentably short of providing adequate safeguards”. Grieve also notes that Liberty, the human rights organisation, opposes the Bill, even though they support the general principle of assisted dying being legal, because they say the safeguards “are just not robust enough”. https://www.libertyhumanrights.org.uk/about-us/

Then as Wes Streeting the health secretary has noted, there is the fact that large numbers of people do not have access to good palliative care. No level playing field means that the choice to go for assisted suicide might not be truly free. As hospices are provided by charities not the state, places are not universally available. Depends entirely where you live. And everyone can agree that quality NHS care to die in hospital or at home isn’t available to everyone.

https://www.thetimes.com/article/16a7c2f6-d81b-4b33-bc14-7831027488be?shareToken=5b3c41a8602602343d9fe6cdf2afb50b

When I think about how rarely this issue traditionally comes to Parliament (not since 2015), the campaigners should have had a high quality and well consulted on draft Bill standing by immediately ready to go. Not as soon as it’s published, lawyers and doctors being massively publicly divided on it. Not respected organisations who agree with assisted dying in principle, lobbying against it. Clearly, the campaigners of principle haven’t been able to produce a practical draft Bill that settles these concerns, in almost ten years. Why is that?

Also recommended reading https://www.theguardian.com/commentisfree/2024/apr/07/conflicted-legalising-assisted-dying-sonia-sodha
HT jcakey

Completely agree @ParsnipPuree

@MrsSchrute of course there are many people opposed to this bill, when they haven’t experienced, been affected by family, friends, dying from a terminal illness.My father had a horrible death, years later my best friend, the memories will stay with me forever.They both, suffered, had painful slow deaths, when it was so unnecessary, inhumane.
My father’s organs slowly shut down had to watch him starve to death.My best friend also had a terminal illness, had a slow agonising death, regardless of the 'pain relief’
Until you have direct experience, you will never really fully understand.

I'm not a fan. If we had an ideal health service and social care system, I might believe it offers choice to those who want it. But, we don't, and we don't have the necessary safeguards in place.

My dad was very disabled and we had years of, 'do you have a DNR', being referred to as a bed blocker and generally being made to feel a burden. He was made to feel that his life, was a lesser life than others. This is not the backdrop to assisted dying. The answer is better palliative care.

Also, look into the history of the campaign group, Dignaty in Dying back when they were called Exit

The issue is complex, whatever the outcome today I do not think it will be the end of the matter. If it passes then there will calls to modify and extend and if it doesn't it will remain and return as a debate. I am fearful that it will be passed at some point if not today then in the future.

Not just doctors, pharmacists, nurses, etc will all need to opt in. I don’t personally know any healthcare processionals who are supportive of this private members bill. How on earth is assisted dying an option before we fix and improve palliative care services?