Euthanasie, dont legalise in UK.

[MrsMarkieParkie]

I just read that 8% of deaths in Canada last year happened via euthanasia. This doesnt sit right with me. Also, as described in the article, the protocol seems mostly the same as the US death by lethal injection.
Do we want this in the UK?

@LangClegsInSpace I would argue passionately for the withdrawal of consent to be accepted and taken as the end point of the process in patients where capacity is impaired at the stage where euthanasia is to be carried out. I don't think anything else would be ethical.

If advanced decisions aren't valid when you lack capacity what's the point in making one ? I'm horrified that something you have written down when sound of mind could be discarded. In late stage dementia I would not be the person I was because of the damage to the brain. She didn't know what was going to happen nor could she retain the information.

When she started to resist the doctor should have stopped , then come back another time and sedated properly instead of carrying on they should have been disciplined for that. That was bad practice but legally an advanced decision overrides when you lack capacity. You wouldn't let someone who lacked capacity sign legal documents as it wouldn't be valid.

It's most likely I will develop dementia as I'm female, I'm terrified of being agitated and scared 24/7. I would rather die than live for years like that. I've seen so many who are confused and terrified it's horrible. Even with the drugs and behavioural therapies it doesn't seem to help some people.

Advance decisions are valid when you lack capacity but you can only use them to refuse consent for medical treatments that you don't want. You can't use them to insist on any active treatment.

There is a huge difference between refusing consent for treatment that might prolong your life and demanding treatment that will actively end your life.

Surely you can see that? The two are not equivalent, legally or ethically.

I agree.

I just don't think it's safe to allow assisted dying by advance decision. Unless you have clear, valid consent at the point of death then you might be killing someone who does not want to die.

If you are evaluating whether someone consents or not to you deliberately and actively ending their life then you'd better be bloody well sure they consent before you proceed.

These stats are quite encouraging.

378,427 people receive palliative care a year in England.

The study itself says '378,427 people died in 2017 with palliative care needs' which is a useful clarification and allows this figure to be directly compared with the others given.

125,971 end-of-life patients receiving, or in need of, palliative care suffer from unrelieved pain.

This is around 33%.

16,130 patients experience no relief from their pain at all in the last three months of life.

This is around 4%

Even if unrelieved pain rates were the same as they are in hospices, there would still be 50,709 dying in some level of pain.

This is around 13%

5,298 would still experience no pain relief at all in the last three months of life.

This is around 1%

So the majority of patients experience effective palliative pain relief. With the best care, we could reduce the number of patients experiencing only partial pain relief from 33% to 13% and the number of patients experiencing no pain relief from 4% to 1%.

Regardless of what we do about assisted dying, we should do this.

@ChardonnaysBeastlyCat

And it was all fine GoldenAye, no one held you down, no one fed you benzos. You are still here to tell your tale.

Suzy’s statement is about someone’s clearly stated wishes. You had no such wishes, you did not express them, no one made you. And no one will.

No one makes you ask for assisted dying. Don’t do it if you don’t want it. Simple.

You are talking about a completely different scenario and you are unable to see past your own situation.

That's incredibly rude. I was discussing a situation I experienced when I couldn't communicate in any way for months in a medical environment and you think it's a completely different scenario? I was not able to state wishes. I could not advocate for myself. I wasn't dying, but I was extremely vulnerable. I was attempting to draw parallels for you as to how a dementia patient might feel - or someone who cannot find their voice to withdraw consent. I can see you didn't understand it.

@LangClegsInSpace

Advance decisions are valid when you lack capacity but you can only use them to refuse consent for medical treatments that you don't want. You can't use them to insist on any active treatment.

There is a huge difference between refusing consent for treatment that might prolong your life and demanding treatment that will actively end your life.

Surely you can see that? The two are not equivalent, legally or ethically.

Thank you - this is exactly what I've been trying to say.

I agree. I think we should have bodily autonomy

Of course it's different.

You had no Advance Decision. You had not expressed any wishes in advance,

And I don't know, or want to know what your condition was, but it does not appear to have been terminal. You are highjacking a situation that was different to yours to make it all about your opinion.

So, yes, you were unwell, but why you felt someone might decide to finish your days on Earth is quite unclear.

And it was all fine GoldenAye, no one held you down, no one fed you benzos. You are still here to tell your tale.

What a nasty thing to say.

How in earth do you see those stats as encouraging? Yes, of course the majority of people get effective palliative care. But what about the sizeable proportion that don’t? That’s the whole point.

@LangClegsInSpace those stats are NOT encouraging. Over 5000 people every years suffering unbearable unrelievable pain for 3 months? In whose world is that acceptable when a good laternative (if well regulated) is possible?

*alternative (haven't had coffee yet).

@ChardonnaysBeastlyCat

You had no Advance Decision. You had not expressed any wishes in advance,

No, I had no need to.

And I don't know, or want to know what your condition was, but it does not appear to have been terminal. You are highjacking a situation that was different to yours to make it all about your opinion.

I explained this. Did you read it?

So, yes, you were unwell, but why you felt someone might decide to finish your days on Earth is quite unclear.

I don't recall saying that I felt endangered in this way. What I did say is, because I couldn't communicate in any concrete way, I could not make my wishes known or advocate for myself as a patient or a person. If you haven't experienced this, it hard to explain the feeling of utter helplessness. I can imagine this is somewhat how patients reaching the end of life feel - particularly those with dementia.

I apologise if this makes you uncomfortable; just skip over my posts if so.

None of the painkillers worked for my FIL. Either he was allergic/ had severe side effects or they didn't touch the sides of his pain. He was in constant agony once hos cancer spread to several bones but thankfully sepsis put an end to his suffering.
Ditto DHs uncle suffered copious vomiting and diarrhoea as a side effect of his pain relief drugs in the final stages of his cancer.
The good death you envisage isn't always possible.

It is awful for doctors who currently have to prolong the lives of patients who are in terrible pain and want to die.

Yes, of course the majority of people get effective palliative care.

Reading threads about AD on MN (I've been on a few over the past several months) there is no 'of course' about it.

It would be very easy from these threads to get the impression that effective palliative care is rare and that the norm is for people to die in unmitigated agony. I never thought that was the case and I'm pleased the numbers show it's not.

But what about the sizeable proportion that don’t?

As I said, with the best care, we could reduce the number of patients experiencing only partial pain relief from 33% to 13% and the number of patients experiencing no pain relief from 4% to 1%.

Yes, I do find it encouraging to learn that we could massively reduce the amount of pain people are suffering without even having to wait for the law to change, simply by improving EoL care. Why don't you?

I have said nothing in my above post about whether I think AD should be legalised or not. If you read my previous posts you would know I am in favour with enough safeguards, one of which is good enough palliative care as an alternative.

Palliative care needs to be provided well everywhere. Both my parents got excellent NHS care. But I have heard people talking about long delays in getting pain relief for example.

Where did I say it was 'acceptable'?

If we can reduce the number of people dying with unrelievable pain from 16,130 to 5298 simply by providing the best EoL care then that is encouraging because we could do that now.

'It's encouraging that we could tackle 3/4 of the problem now' =/= 'it's acceptable that 5K+ people per year would still experience no pain relief.'

Can you not see the difference?

@LangClegsInSpace I absolutely can see the difference, but your description of the numbers provided as 'encouraging' when they clearly offer no hope for thousands of people every year is not great.

Death isn't pretty for a lot of people here's some pallative care emergencies. Catastrophic bleeding hemorrhage, total obstructions , spinal cord compression , vena cava compression , hypercalcaemia , neutropenic sepsis and there's others. So people should be left alive until the natural with things like this knowing there's no cure it's cruel to be honest. I hope it's legal by the time I die.

I would like the same right to die as my dog.
That when the quality of my life has deteriorated to unbearable and I’m in continuous pain and distress, either me or those responsible for me can decide to let me be euthanised. Without fear of prosecution.
DIY can be inefficient, ineffective and sometimes impossible without help.

I can't find the data for 2022 yet - it seems it hasn't been released yet. For 2021 is 3.3% of deaths.

I support it, with correct safeguards which do happen in Canada, whole heartedly.

No, what is 'not great' is your bad faith take on my posts.