Assisted dying

[ivykaty44]

I have nursed terminally ill relative, it was a case where Im sure that they would have chosen to use he assisted measures and would have more comfortable for them. It would have certainly distressed me, but I would have been keen to follow their wishes

They were diagnosed with a terminal illness that had a 4 months average life sentence and they died 11 weeks after the fatal diagnosis and refused palliative care to give them a few more weeks

I do believe in some cases to be able to have assisted dying, with possibly intervention of a court to ensure the person wishing to dye isn't being pressured by anyone - would indeed be kinder.

Death even a good loving death can be traumatic and cruel by the nature of dying, whereas a controlled process would be kinder in the actual process of dying.

Someone rasping for 3 or 4 days for breath is not a pleasant for anyone (I had a friend that this happened to but actually he went on for 5 days)

With strict control to ensure their isn't pressure or guilt to die surely this is not unreasonable to ask? I do mean literally with a few weeks to dye and allowing the person to choose when they are ready - if ever

K123 you can make an Advance Decision to Refuse Treatment in specific circumstances

TBH a good GP will prescribe JICS …just in case meds …as long as the meds are justified ie pain ,agitation then there is no reason why anyone should die in pain or distressed.

you can have them sat at the end of the bed for the best part of 4 weeks but they aren't any use without someone to ok the administration of them and that someone needs to be a doctor

OP sounds great in theory but in practice patients will be killed. Look at what happened with the Liverpool Pathway. It was supposed to be used on patients who had days to live and with relatives consent. In practice some elderly patients were killed before their time. It was a national scandal. This will not be any different.

As nurse I’m following this with interest, but am very much on the fence.

As an aside, can I really kindly ask posters not to use the phrase ‘committed suicide’. It is outdated and harks back to a time when suicide was a crime - it was decriminalised here in 1961.

The Samaritans and MIND suggest phrases such as ‘ended their life’ ‘took their own life’.

Sorry to derail the thread for a moment, but it can be triggering and stigmatising for those of us bereaved by suicide.

@julieca

OP sounds great in theory but in practice patients will be killed. Look at what happened with the Liverpool Pathway. It was supposed to be used on patients who had days to live and with relatives consent. In practice some elderly patients were killed before their time. It was a national scandal. This will not be any different.

Wasn't that something completely different from an explicitly stated wish for a peaceful death?

Progressive and compassionate countries (and some US states) allow assisted suicide. Denying people the option of a good death is cruel.

Dignitas is a useful guide on how to do it well with appropriate safeguards including psychological checks.

From what I've read, the so-called 'Liverpool pathway' was in fact clinician not patient decided - and it certainly wasn't a good death (unlike physician assisted suicide). The 'pathway' involved leaving patients to die a horrible neglected death.

Every adult with capacity over the age of 18 should make a Living Will (to be amended at any time throughout lifetime).

*As a nurse..

Some people have talked about people terminally ill dying because food and liquid was withheld. That was the Liverpool Pathway and led to people being killed.

www.bbc.co.uk/news/health-23698071

When people are in the last few days of life, their body shuts down and they can no longer manage food and little liquid. So this was intended to support people in their last few days. Instead, elderly patients who were not just about to die, were put on the Liverpool Pathway, had food and liquid withheld, and were effectively killed.
I don't believe that a country that places so little value on older people can safely introduce an assisted dying scheme. If passed, I strongly suspect it will become another scandal that is exposed a few years down the line.

In practice some elderly patients were killed before their time. It was a national scandal.

A bit like 'living with' Covid?

I would like to say now in a legal document when I'd like to go.
I've seen and done enough to know exactly what stages and when I'd like to go
I've also been three weeks at the bedside of someone who died and was ready to go three weeks before.

Why on earth are we forcing terminally ill people into long long painful deaths? Why!!

With a legal document and mechanism now we can write, that can be followed at the right time.

@Tealightsandd Living wills sound great in theory and when I was young I would have promoted them. But my experience is people change their minds when they actually experience illness. They find there are things they still want to do, people they still want to see.
My father in his last weeks when he was feeling terrible would say he wanted to die. But then an hour later would say he wanted to live long enough to meet his grandson.

Letting old people die slowly and painfully also shows little value for their lives. The state of many care homes shows we don't know how to care as well.

I'd rather go thanks and choose for myself

I've been an NHS professional for 40 years and I'm outraged people can't make this decision for themselves.
I've seen scores of horrible horrible deaths, I'm sick of the prolifers who go on about how we should have great end of life care instead and let them suffocate in their own saliva.
People like this have never set foot in a hospital or cared for anyone when the drugs no longer work.

@Tealightsandd the Liverpool Pathway was absolutely about a peaceful death. It was supposed to take the learning from the hospice movement and make it available to every patient who was terminally ill.
Great idea in practice, but in an overworked NHS within a culture that does not value elderly people, it was doomed to failure and caused a lot of suffering.

It's not as if all lives are valued in the UK. Obviously there's the lack of simple Covid mitigations - for example unlike many other countries we don't have a mask mandate. And also austerity (which was economically a failure) is estimated to have killed approx 50-60,000. In a far less pleasant manner than an assisted suicide peaceful pill. We also have little action on the public health housing and homelessness emergency. Despite the average age of death for a homeless person being just 40 something. If we cared that much about preserving lives, we'd be tackling that.

@Tealightsandd I agree with all of that. The action during the pandemic showed that we can end street homelessness.

The Liverpool Pathway was not about peaceful death. Starving to death is not peaceful. Nor was/is it peaceful in the sense of emotionally or spiritually peaceful.

My father spent the last year of his life in and out of hospital; a fall, but with history of a couple of strokes, heart attacks, diabetes...
His quality of life in that last year was negligible, he had no dignity.
I was asked about DNR when he went into hospital fifteen months before his death, and responded that yes, he would much prefer that - but the many medical teams never took any bloody notice.
I am angry on his behalf - and the NHS resources wasted in keeping him alive - for what? He was never going to "get better" even though their was no single terminal disease.

The right to commit suicide and availability to request euthenasia should both be every much a right as a womans' right to an abortion.

@Tealightsandd

The Liverpool Pathway was not about peaceful death. Starving to death is not peaceful. Nor was/is it peaceful in the sense of emotionally or spiritually peaceful.

It was supposed to be about a peaceful death. Withholding food is only supposed to happen at the end when eating can cause pain because the organs are already shutting down. In practice that is not what happened. Patients were starved. Death isn't always peaceful emotionally.

It amazes me that we allow animals far more dignity in death than humans.

Losing all mental faculties or suffer horrendous pain? Why is it OK for our species alone?

I'm not suggesting it's just instantly available as it needs to be controlled to avoid the very real threat of abuse e.g. elderly relatives "requesting" it when they're about to go into an expensive care home and such like or where there is a genuine question over mental capacity but the choice should be there.

The penalties for abuse would also need to be high.

@ThinWomansBrain the medical teams would listen to your father each time treatment was given. My father had a DNR, but each time he was asked if he wanted antibiotics or other treatment, he always said yes. It is not up to relatives, but the patient. And consent does have to be sought.

My grandad died of dementia many years ago
To watch my beautiful,brave,fearless,intelligent grandad wither into a skeleton was the worst thing I will ever live through
I love him so much-he was my world,and to watch him change so much and he didn’t have a clue who I was
18 months I watched this evil illness take yet another part of him until there was nothing left
I was 14 at the time and even now at the age of 43 I wish I could have just flipped a switch and allowed him to die with dignity
It was his worst nightmare to die alone in a care home-and we (or rather the adults) put him there
I’m convinced that at the end he knew-he certainly waited for me to come and say our last goodbyes
He should have been allowed to die at home,with his loved ones by his side-18 months before he did actually die

It is tricky. I have an autistic 17 year old dd who often asks why I didn’t have an abortion with her, she struggles with life so much and I think there’s a good chance that if she could end it all now in a painless way she could well be tempted. That would be heartbreaking as she is amazing and I’m sure there are brighter times ahead for her, she just can’t see that now.

The worry is with older people that they may feel like they are putting their loved ones out by existing and needing help, or spending money they’d like to leave to others on care. So not really thinking about what they themselves want, but not being coerced either.

Also people with dementia - that’s a horrible way to die and there’s a trend of it in my family so it’s a personal worry for me. But of course these people can’t be deemed capable of making the decision to die. I’d hope it would be possible to make it clear in advance that if I got dementia then I’d rather not be here. But at what point would they say ok she’s mad enough to die now? Not sure how that would work but it would be a shame if dementia sufferers had to endure life to the bitter end.

I'm not suggesting it's just instantly available as it needs to be controlled to avoid the very real threat of abuse e.g. elderly relatives "requesting" it when they're about to go into an expensive care home and such like or where there is a genuine question over mental capacity but the choice should be there.

In the end it was never necessary, but I could certainly have seen my DGF preferring death over a care home - he wouldn't have coped.

My DGM, who I had thought would cope, and even make new friends, was so miserable in her (expensive, very much the nice end of the spectrum) care home that she was upset when she moved in, looked miserable the one time I got to see her lucid a month later (I live a distance away), and died two months after she went in. I think she pretty much gave up, truth be told.

Dignity in Dying are a good source of information/explanation on the campaign for, well, dignity in dying.

As well as the physical aspects, we shouldn't underestimate the psychological and spiritual value that having a sense of control over death can give. Control and dignity.