Assisted dying debate next week… To think this is a relief. So glad they’re finally debating this important issue.

[Mavenss]

We will be able to see which MPs are for or against assisted dying.

This Monday 29th April, assisted dying will be debated in Westminster for the first time in two years. An absolutely incredible 203,000 people added their name to the government petitionspearheaded by Dame Esther Rantzen to make this happen, creating the largest ever parliamentary petition on assisted dying.

There will not be a vote on Monday, but this debate will be the last time before the General Election that MPs have an opportunity to show you that they are listening to our calls for safe and compassionate choice at the end of life. A majority of voters in every constituency support an assisted dying law.

The debate starts at 4:30pmand you can watch it live online through the UK parliament website.

YABU- it’s a silly idea, why are government even debating it? Assisted dying is a terrible idea.

YANBU - I support the debate and assisted dying (under the agreed circumstances)

I’m interested in the MN feedback here.

The decision makers i.e. the politicians aren't interested in anyone's views when they are talking about Big Pharm because far too many policy makers have a vested interest in the drug companies and making money. It may not be themselves, but family members and influential friends and acquaintances who have shares and seats on boards, and they want as many people as possible to be taking as many of their pills as they can, so they can get as rich as possible.

The mark up of drugs to the NHS is astronomical when placed against the cost of manufacture. Obviously there are other factors to take into consideration such as the development etc, but even so when such a lot of money can be made for shareholders and directors of the companies it is not in their financial interests to foreshorten the lives of the patients, even when all hope is lost. I am not for one moment suggesting that treatment shouldn't be given and continue to be given for as long as the patient wants/needs it, but the only reason for treatment should be a medical one and finances shouldn't be a consideration.

So why would the politicians vote for AD when money is to be made by not having it. It is a sad fact that money is a driving force in all areas of society, either too much or too little depending on which side of the fence you are.

You only need to look back 3 or 4 years to the Covid fiasco where multi-million pound NHS contracts were being chucked around (again, in many cases, to family and friends) and yet there was a shortage of basic PPE and tests for frontline staff. In fact the whole debacle illustrated just how divorced from reality our politicians are given the number of parties they attended while the rest of us were taken down by a SWAT team if we dared to venture out for more than our allotted hour a day.

Unfortunately whatever the will of the people AD may be a long time coming as long as the decision makers are allowed to have financial interests in drug companies.

I haven't RTFT, but...

I am very against assisted dying.

Firstly, we need to be able to trust our doctors to 'first do no harm'. I know a lot of harm is ~being done~ by an underfunded NHS, but I am confident that it's not frontline staff who are not even trying to help us. Once that stops being the case, it only takes a little, and a little, to erode all of the trust completely. There's always going to be that haunting question.

Secondly, a lot of seriously ill people already feel like a burden to their carers, so it's a very very small step from 'right to die' to 'duty to die', even if that step is only within the person's mind.

This is reinforced by the idea that our worth is tied to our productivity, that having all our faculties and being in control of our own situation is so important. No, it's not. You were valuable when you were a baby and all you could do is sleep and poop, and you are STILL valuable as an older/frailer person if the same thing applies. If we lose sight of that, what humanity do we even have left?

Also, imagine what a soap opera would do with something like this. I know, I know, it's not 'real', but...it's only not real that it's not everybody. But there will be somebody somewhere pressuring an elderly relative to hurry things up, then turning around and telling the nurse how they're so devastated the person is in so much pain, etc... and bullying people to death isn't something I want to make easier. It only takes one unscrupulous relative, and suddenly we're murdering people. I don't like it.

@unmowngrass but you think only being able to look on whilst people in agony beg to be put out of their misery is ok? And you're fine with that happening to you when the time comes? Really think about it.

@Firefly1987 I think I've explained my shifting and uncertain position pretty well on this thread, but I'll try to one more time. I also think you'll find that people who've thought carefully about this generally are uncertain, because its difficult.

I am not attempting to weigh one set of people's sufferings against another, because suffering is not quantifiable. That's one of the fundamental flaws with utilitarian ethics. Suffering is not the kind of thing you can measure, and no-one can fully access the suffering of another person. I agree that there are many individual cases in which assisted suicide would be the preferable option, and many scenarios in which I would want it for myself. But I also believe that handing that power over to a) the state and/or b) individuals working within the necessarily dehumanizing system of a hospital is instrinsically dangerous. As a human, I'm concerned about the effect on individual clinicians; as a sociologist, I'm even more concerned about effect on organizational cultures. I'm less concerned than some people about the expansion of assisted dying to those with mental illness who wish to die, because I'm not particularly sanguine about capacity assesments - I want to know according to what right do we determine that another person has or has not capacity, and what gives us such authority - but a person who is not physically ill likely has the ability and certainly has the right to end their own life should they choose. Suicide is not illegal and hasn't been for a long time. Therefore, under this government, which has run the NHS into the ground and proven repeatedly that it values economic imperatives and the preservation of its own class above all else, I would reluctantly vote against the legalization of assisted dying and/or euthanasia.

That is a far more eloquent answer than is deserved for what will amount to yet another snotty response that will attempt to paint you as a monster.

But at least you never used a metaphor 😁

Just watched the Liz Carr documentary yesterday.

The thing that jumped out at me from a Canadian doctor who signed off on it and a British lawyer activist both made an interesting comment.

They said that people who chose assisted dying had a number one reason to do so. And it wasn't about stopping pain and suffering or dignity. So that argument which has been used many times on this thread doesn't hold up.

The number one reason was control. That's a luxury and a comodification of death. It's reflective of a consumer society. That is something I find particularly concerning.

The points you make are absolutely right, I agree with most of them. My conclusion is different. Yes, it is difficult.

‘No-one can fully access the suffering of another person’, and no one should have the right to tell them that they have to stay alive if they don’t want to.

Luckily Labour (the probable next gvt), are also for AD. I would vote for AD with little hesitation.

I don't think the issue is with the dying (and as we know, suicide is not illegal) but with the assisted part. So to say no one has the right to tell someone else they can't die at the right time for them - well rights don't involve other people having to act in a certain way. Once you are bringing in other people to help you you are in a whole other ethical ballgame, as you have their rights and also their motivations (which might be good or bad) to contend with.
A utilitarian wouldn't necessarily be in favour of this either as the consequences may not produce the most happiness.

"First do no harm" is an ideal, but is harm being done by keeping someone alive artificially when it is no longer in their interest? If someone is dying, and has been given days or weeks to live/exist, why put off the inevitable. Surely dignity has to come into play at some point. A person who has lived an independent life, being able to do what they want, when they want, being reduced to being spoon or tube fed, having to use continence pads as they no longer have bladder and bowel control and having all aspects of their lives dictated by others feels vulnerable and worthless. When I was unable to stand and walk, my main goal was to be able to go to the toilet on my own. Until you are in this situation you cannot begin to imagine the indignity. I was lucky in that my condition was not permanent and with hard work I can now walk and have regained most of my independence.

Of course being in control of your faculties and situation is important. I would have thought having control of your life choices is a fundamental right.

You talk about humanity, what is humane about allowing a person to die in agony, both physical and mental, just because it offends your sensibilities?

People are being murdered all the time by unscrupulous relatives, often in very brutal ways and contrary to that person's wishes. Isn't it better for those who want it, to be euthanised humanely.

@VeryHappyBunny “People are being murdered all the time by unscrupulous relatives, often in very brutal ways and contrary to that person's wishes. Isn't it better for those who want it, to be euthanised humanely.”

I don’t think this is the argument for assisted dying you think it is.

People being murdered by unscrupulous relatives is an argument for a better justice system so that criminals are brought to justice for their violent crimes and for better safeguarding of the vulnerable. It’s definitely not an argument for making it easier for unscrupulous relatives by bringing in assisted dying!

I am astonished at the number of people who have not seen the Liz Carr documentary but are still not reflecting on it.

I agree @RedToothBrush and there is a vibe of an undignified, incontinent, or dependent life is a worse fate than death when there are millions of people who are fully dependent on carers and they do not view intimate care or incontinence aids as so undignified, they’d rather be dead. Humans are pretty resilient we can adapt to alot. But the “oh I couldn’t live like that” often becomes “we can’t allow you to live like that” and then people get pressured into AD or their relatives get pressured into signing off on AD of the person is away with the fairies some of the time but quite happily lucid other times.

There's been a trend in asking for ELCS after a previous traumatic birth due to secondary tokophobia (fear of birth after having previously given birth).

I've done a fair amount of reading on this as I had primary tokophobia (fear of birth having previously never had children).

There's similarities and differences between primary and secondary tokophobia which came up as I was doing my research.

My Consultant Midwife had a lot of experience with both. He reflected on it and the issue of control and did a lot of research. The primary group had certain pre-existing traits - they tended to be older, have a history of sexual abuse, issues with fertility and more likely to have gone through IVF etc. Research seems to show that if forced to have a VB anxiety seems to have had a physical effect and these women had poorer outcomes both physically and mentally.

The secondary group behaved differently. If given support and granted an ELCS in principle, a huge number changed their minds and had a VB in the end because that support and being listened to was such a massive thing and part of the problem. Because it was about control. It was about giving more involvement and choices and keeping patients informed as well as quicker access to pain relief if wanted. Stuff like that. So ultimately it was about standards of care and being in control of your own health.

The comments throughout the Liz Carr documentary therefore hit a nerve with me.

Disabled People are worried because of the effects on them from these changes and the implications for control of their own care.

What struck me was the complete absence of any disabled charity being supportive of assisted dying. Not one.

Then we get this narrative created by well and able bodied people which seems to suggest they are on the side of 'people who are suffering' but doing so by not amplifying the voices of the people in this position but instead talking about them or even over them.

The narrative of 'people who are suffering' is pointed out by Liz Carr to be fundamentally anti-disabled and I have to say I agree. It reeks of eugenics.

If you listen to people who have had life changing accidents or conditions it's interesting to hear the number who struggle terribly with depression before coming to terms with life being different to what they imagined but still worthwhile. And there being a period of coming to terms with it.

Once again it comes back to poor understanding and attitudes to mental health too and how we aren't providing adequate support and access to support where appropriate.

I, quite honestly, am going to tune out of all comments going forward from the most vocal on this thread who continue to engage with counter arguments and can't be bothered to watch the documentary. Because it says everything I need to know.

If you can not respond to and acknowledge the key arguments Liz Carr puts forward, then you are into eugenics as far as I'm concerned. If you do bother and respond accordingly, then I respect that. It's the total disregard for individuals who have chronic health issues who are genuinely (and with good reason) afraid of these changes that bothers me most. It's the arrogance of saying it's all about increasing MY choices without reflection of how that might reduce the option and choices of others that's tone deaf.

I'm not saying that it is an argument for assisted dying, but it is certainly not an argument against it. You said that it only takes one unscrupulous relative and suddenly we are murdering people. There is nothing suddenly about it, it happens regularly and has done for centuries, if not millennia.

Some loving relatives resort to murder because of the intolerable pain experienced by their loved ones and are asked by them to end it for them. How can anyone say they love someone and just stand by and watch them experience all sorts of hell when there is a humane alternative available?

Surely you wouldn't let a pet suffer in the way some people are expected to suffer and I find it incredible that in a civilised society people are doing so.

I have always agreed with the choice of AD and spending the last, nearly 2 years of my life in hospital and a care home has done nothing to change that view.

If you have no quality of life and spend your existence drugged and sedated, being fed through a tube and enduring the daily indignity of bed-baths and continence pad changes the sweet release of death cannot come too soon.

As I say, we EITHER have a right to life OR we have a right to die.

We can't have both.

One is about protecting and preventing harms. The other is about choice.

A right to die removes protections. And any safeguards we have are only as good as the law and inevitably have flaws which allow harms.

So we have to explicitly talk about how many vulnerable people we are prepared to sacrifice in the pursuit of choice.

What are those terms of reference.

This is the squeemish bit and the bit that people tend to try and avoid for whatever reason. But it's the most crucial point of the entire debate.

We can't have both.

Why not?

Of course we can have both. Not everything is black and white. The right to live and the right to die are not mutually exclusive. There are cases where patients with degenerative diseases have campaigned to STOP their food from being withdrawn as they are frightened of being left to die over days or weeks. This is something that happens now, and because the patient is not in a condition to tell anyone, no-one knows what pain they are in. The body starts to shut down, there is multiple organ failure and ultimately death, and this is okay, but a simple needle in the arm and literally seconds later you are dead is not?

How can this possibly be right?

It is about choice. You should have the right to choose how and when to end your life when it becomes unliveable.

Abortion was illegal until relatively recently, how many women died at the hands of backstreet abortionists before it was legalised and brought into the safety of a hospital or clinic where it could be carried out by qualified professionals. Logically it is preferable for qualified professionals to end the lives of the terminally ill who have made that choice and have no wish to continue with a living death.

We are not talking about it being made compulsory, or indeed rounding up thousands of people and sending them to death camps. It is purely for people whose lives have become unbearable through illness or accident and have no chance of recovery. I very much hope you never find yourself in that situation, but maybe if you were you may have a change of heart.

Have you ever been in the situation of having to rely on carers for everything, from being turned in bed to avoid pressure sores, to being spoon fed, to having bed baths and continence pads changed, because I have and it is fucking awful?

When people are "away with the fairies" hopefully they don't know what is happening to them, but when you have "full mental capacity" and you know exactly what is going on but do not have the physical ability to do anything about it, it is the most soul destroying, dehumanising thing you can experience. To have someone come into your room and push their hands between your legs to "check your pad" is total violation. I was in the position to complain about it and make a fuss but if you are "away with the fairies" can you do that, and even if you could would anyone believe you?

To be 100% at the mercy of carers is a very frightening thing. Some of the staff in hospitals and care homes have very little English and if I have difficulty communicating with them what hope has someone with slurred or limited speech and understanding?

Most of the care staff I have experienced are from other counties, mostly India and Africa and the majority have been lovely and helpful, but there have been some who have not. I think they are wonderful for doing what they do. I did it for my Mum but I wouldn't want to do it for anyone else, but without them we would be in a metaphorical and literal mess.

If your condition is temporary, as mine was - about 8 months before I could walk and look after my own personal care, you can just about get through it by switching off your mind and taking it somewhere else. If, however, that is going to be your lot forever then wishing to end it sooner rather than later is understandable.

Don't judge others until you have been in their position.

If you have the right to life, then by default you can't have the right to die because to do so is to take away the right and protections in law.

You remove the concept of 'do no harm' as a doctor because your principle is not to do anything to deliberately end life. You can do things to not to intervene to save life but thats different to actively administering death.

If you say, well in certain circumstances you can intervene, you end this priniciple. This removes protections from coercion for particularly vunerable groups purely because you allow these principle to change.

Liz Carr's documentary touches upon the attitudes of 'well I'd/you'd be better off dead' which can now be actioned which wasn't possible under a right to life being sacrosanct.

The two are legally incompatible in principle because of this.

We disagree. Do no harm isn’t prolonging life at all costs, sometimes that’s the greater harm. Right to live is exactly that, you want to turn it into a compulsion.

BOLLOCKS

I wonder why we allow DNRs? Surely they are subject to the same issues as assisted dying? How do you know an elderly person hasn't been coerced into signing one by their family when it's not what they actually want?

That is a total straw man. Firstly it isn't up to the patient and their relatives. They should be consulted when possible, but the decision of whether to attempt CPR is up to medical professionals. No medical professional is obliged to attempt a treatment or intervention they feel is inappropriate. Secondly, at the point CPR is attempted, the person is already clinically dead. The doctor has not caused their death. They have already died. No-one* believes that the purpose of medicine is to permanently prevent death. Everything that lives must die. We are debating the ethics of deliberately hastening that death, not whether we should prevent it.

*Alright, there might be a couple of fringe cultists in the world who believe this. Nowt so queer as folk, as they say.

There is a lot about this which is fair. There has been a certain amount of debate about it due to COVID and who was deemed 'worthy of saving' and who was written off with 'an underlying health condition'.

It is however different in the sense that you are not actively killing, you are withholding treatment. In this case the treatment itself may also cause harm to a patient that causes unnecessary pain when a patient is likely to die in the very near future anyway. The argument is that the treatment is unlikely to prolong life for much time at all. It's letting nature take it's course.

Assisted dying is actively deciding to go against the natural process and stepping in to end life sooner than it otherwise would occur.

That's different.

Assisted dying is actively deciding to go against the natural process

It’s not. It’s speeding up the natural process for someone whose death is imminent and for whom it will be a merciful release.