Assisted dying bill (TW assisted suicide discussion)

[Onand]

I appreciate this is a divisive subject and a sensitive topic for many. Please avoid this thread if you find any discussion of suicide, death, trauma, terminal illness, cancer and faith triggering.

I’m curious to know how others are feeling about this subject, from what I can see there isn’t a lot of discussion, is this a MNHQ decision or an indifference from posters?

My opinion and views on this potential landmark decision are based on my horrifying experience of watching and waiting for my mum to pass from end stage cancer several years ago.

For over four years she fought advanced cancer, she took every treatment and trial offered to her. She endured major abdominal surgery, many blood transfusions, multiple rounds of chemo, lost her hair several times, her bones started to crumble causing excruciating back pain, severe abdominal swelling, double nephrostomy as her kidneys failed, multiple lesions on her brain that caused debilitating headaches and personality changes, her teeth and bones were decaying due to a calcium disorder, various hospital stays for infections, the list goes on.

Truly the most hideous nightmare cancer ‘journey’ anyone could ever imagine, it always felt like one step forward and two backwards and yet she carried on without much fuss or sign of fear to protect the family and herself from the true horrors of suffering.

She never wanted to die and so she never gave up or gave in- that was until the last few weeks of her life when she had no choice. The immense damage and toll cancer had done to her physical body was too much to survive any longer so the last infection she had took her consciousness and so began the final horrifying curveball that cancer has up its evil sleeve, this one is for the loved ones though, because now you have to wait and watch for the end to come. Anyone who has endured this knows exactly what I am talking about, a horror that truly brings home the meaning of hell of earth.

If the assisted dying bill was around whilst my mum was alive I know she would have never entertained an early death whilst she was still in control and able to fight, but I do know that her love for the family would have also meant she would never have wanted us to endure that final two weeks of watching and waiting for her body to shut down if it could have been avoided and she was able to specify what was to happen at the end. There was no possibility of her ever getting better or a miraculous recovery, death was very inevitable and a certainty but we still had to sit and watch, doing oral care and leaving the room as they checked for bed sores and did secretion suction. The only thing I could do to protect and help her was the make sure she was undoubtedly unaware of what was happening as she feared death and leaving us behind- the thought of her being remotely aware meant we were constantly asking the nurses for more and more sedation.

If this bill gives patients the choice to avoid the hideously evil ending of a terminal illness and the following ptsd that impacts the loved ones left behind then it is an opportunity I strongly agree with. Watching a loved one die an agonising death is soul destroying and something I hope no one has to ever endure if said loved one could choose to avoid.

How do others feel?

are these nhs doctors? Is it fair to ask them to do this? What if they don’t want to ?

I imagine, like with abortion, they won't have to be involved if they don't want to.

I used to be very much in favour of it but I have watched with growing horror what is happening in Canada with their MAID programme.

I am not convinced that there are adequate safeguards within the bill as it stands. I also have no trust in our country to run it well and therefore I am not in support.

I’m not in favour mainly because the right to die will inevitably morph into the duty to die - to spare relatives the distress of watching the dying process.

I think one can clearly see how vulnerable people could easily come under pressure to ‘do the right thing’ or ‘be kind’ to their family and submit to assisted death.

The current bill would allow terminally ill people with full mental capacity, who are not expected to live more than six months, to take their own life with medical assistance.

So it would not have helped your mother if she was unconscious at the end and would not have contemplated taking her own life before this point.

Are you advocating for a different bill altogether that would allow family to make the decision and a doctor to directly end a person's life?

This is something that bothers me generally about these discussions - people says things like, 'of course there would be safeguards' and then start talking about, e.g. dementia in the same breath.

Good point, well made. 👏🏻

Tbf Canada has a different system. I believe I'm right in saying that the changes to their laws have come through their Supreme Court. Our system doesn't work that way - our Supreme Court couldn't rule that the terminally ill adults bill must be extended to include other people.

IMO any involvement of the NHS in assisted dying taints it and sullies the medical and nursing professions. Professions that are about health promotion and life preservation should not be mixed up with any kind of positive intervention to promote death. I am not talking about keeping people alive at all costs. It is already possible for patients’ medical problems to not be actively treated if it is deemed to not be in their best interests. The field of palliative care aims to ensure as good a death as possible and I learnt early in my medical training of the doctrine of double effect: Relieve the patient’s pain. If the medication dose that relieves pain has the effect of killing the patient, so be it.

My impression from working as a healthcare assistant and junior doctor is that many people struggle to see their relative greatly diminished and want the process to be sped up. The patients were usually calm with symptoms being treated to the best of the clinician’s ability but dying takes time and I’m afraid I don’t see why relatives need to be spared the discomfort. Dying is part of living. The duty of the medical professional is primarily to the patient. Assisted dying will just contribute to the current tendency in the U.K. for illness and death to be regarded with distaste. ‘Die quickly, die quietly’ just about sums it up.

The bill will eventually pass, if not now then sometime in the future and then scarce resources will need to be diverted from patient care. The only way I can see it working practically is for each NHS trust or group of trusts to have a dedicated team for assisted death referrals so that would mean extra salaries to be paid, premises to be found, for a start. Any other arrangement would create havoc and division among medical and nursing staff.

I support it. I think it is an important choice to offer. We don't allow animals to suffer in the way we allow humans to, because we recognise it would be cruel.

Also a nurse and totally agree. OP I understand where you're coming from. You are talking about the last two weeks of your mum's life when there was no hope and she was suffering. I'm so sorry she, and you, had to go through that. But my worry is that it's such a slippery slope, would people not ready to die feel coerced into it? So many people talk about the elderly "bed blocking" and taking up so much of the NHS resources. And some families (NOT you OP) can be unscrupulous! And there's the question about mental capacity and the ability to consent. I'd just be worried what it could all lead to in time ..a bit too Logan's Run for my liking!! I'm probably being way too over-dramatic but I feel very uneasy at the thought of it.

Citation needed.

Canadian law has been expanded to a degree that I personally don't agree with, but as I understand it the US and Australian states which introduced assisted dying for people with a terminal illness have not extended that to other people, even where the legislation has been in place for over a decade.

Agree. My mother was told "Weeks, not months" and lived a further 9 months. She fought to live with every breath she took.

My biggest fears about this bill are realised in looking at other countries like Canada and Holland, where lobbying has systematically brought in other 'categories' of people.

It's pointless to say "There will be strict safeguards" because once the bill is passed, amendments can be tabled at any time - which is precisely what has happened in this countries cited. Holland now allows assisted suicide for perfectly health 75 year olds who "feel their lives are complete". It takes a nanosecond to work out who might encourage that category.

I absolutely support the bill, and I resent the fact that objectors are denying my human right of choice. Of course strong safeguards need to be in place, but should I make the decision to prevent suffering for myself I don't expect another's religious beliefs to prevent me from self administering a lethal dose. It's all well and good saying we need better palliative care, which we do, but palliative can often be unsuccessful at relieving pain and suffering.

Amendments can't be "tabled" to legislation which has already been passed. That's not how it works at all.

It’s pretty polarising, I personally am in favour. I’m not keen on a long drawn out end but would respect the choices of those who want to hang on till the die naturally. I have Dutch family I think they are more pragmatic about death. Even with the family people make different decisions, my great aunt lasted well into her 90s and she died naturally. She did suffer a lot with pain/ various illnesses for last decade. Her sister opted for PAS when diagnosed with lung cancer in her 70s. It wasn’t awful we had lots of last moments and reminiscing then when she was ready the doctor came to the house with the drugs / instructions then left.

For example it’s been 1997 for the state of Oregon it’s still limited to PAS for people with a terminal illness who have less than six months to live. Maybe that slope isn’t quite so slippery?

*Stickytreacle · Today 14:53

I absolutely support the bill, and I resent the fact that objectors are denying my human right of choice.

No one is stopping you or anyone else from committing suicide. You can argue that if you want to die, anyone who helps you, like a relative or friend, should not be subject to criminal prosecution but where do you get the idea that it is a human right (or should be) for you to demand that a medical professional kills you at your request?

Medical professionals are not robots who do whatever the patient wants. They have a certain ethos, a defined area of practice and this bill seeks to fundamentally change that. So the views of clinicians is very relevant.

I would personally leave the medical and nursing professions out of this completely and create an entirely new profession of Licenced Death Practitioners, regulated by the Health Professionals Council. Unfortunately this
won’t happen.

My second post states how I think had she been offered the choice beforehand of avoiding the agonising, dehumanising utter abomination that was the last few months and weeks of ‘life’ I believe she may have been of the opinion that death on her terms and not when the cancer decided or when her heart finally stopped was a far better alternative.

I’m sure many of those suffering with incurable terminal diseases that rip from them every shred of their dignity and control would seriously consider it as a viable option rather than waiting to see what fate has in store for them.

Rather than being taboo or shameful it may offer an undeniably tragic- yet nonetheless brave and fearless semblance of hope in those most hopeless of circumstances.

Lets also not forget the avoidance or trauma for the loved ones who stay until the end and then have to live with the recurring nightmares and visions of what happens in those situations.

My last post was in response to this point. Quote fail sorry!

When we say that needing help for personal care and to perform bodily functions is undignified, what does that say about how we regard disabled people who need this help? I think the concept of ‘dignity’ needs to be rethought in the U.K. I think British concepts of privacy, propriety, the stiff upper lip don’t help.

This has been discussed extensively on mumsnet previously and the opponents will try to talk it to death. Yes I can see why they think like that but no safeguards would ever satisfy them. It's a cruel point of view that wants to see people suffer.

Most people (73% according to yougov) support it and apparently it's higher in those who have watched a parent die recently.

I've watched a number of people die in situations where a vet would put an animal to sleep without hesitation.

I dont want to see any coercion, I do think the safeguards need to be carefully drafted. I'm eternally grateful to the doctor who asked if we wanted one cancer sufferer (who was by then incapable of expressing a view themself) to have adequate pain relief even if it would shorten their life. Nowadays some busybody opposed to assisted dying would kick up a stink and he would be more reluctant to ask.

there are issues in Oregon, it's easier to talk about Canada in some ways but oregon have had issues with

1. doctor shopping....if you look hard enough someone will sign you up
2. people with depressionand psychiatric disability eg Michael Freeland.
3. economic pressure and coercion (especially acute if private healthcare in USA taken into account) eg Linda Fleming/Thos Middleton
4. implicating others (eg disabled person unable to take meds himself so his relative administered) Patrick Matheny
5. legal erosion and changes in expected levels of conduct (Melcher, Avery and others). 6 ) medical complications/inefficacy taking lethal drugs by mouth is often ineffective in causing a quick and simple death. eg David Pruitt
6. Jeanette Hall of Oregon was diagnosed with cancer in 2000 and told she had six months to a year to live. She knew about the assisted suicide law, and asked her doctor about it, because she didn’t want to suffer. Her doctor encouraged her not to give up, and she decided to fight the disease. She underwent chemotherapy and radiation. Eleven years later, she wrote, “I am so happy to be alive! If my doctor had believed in assisted suicide, I would be dead. … Assisted suicide should not be legal.Unfortunately, not all doctors are like Jeanette Hall’s.

EOL and palliative care needs to be addressed, the provision is patchy and poor in my experience. Even if it were gold standard though, it doesn't get away from the fact that pain killers do not remove all pain in serious illnesses.

I don't know what the answer is. Definitely improved care is needed. I'm not sure if there an incentive for Pharma companies to find better pain relief.

I've watched two family members die, one in a coma on a morphine pump and the other just on oramorph. I try not to think about it tbh as it still upsets me nearly ten years on. It's not about the ones that get left behind though is it? I can say though, that it's not how I would want to die.

My remaining parent has a life limiting illness, they've talked to me about smothering them with a pillow and the one that died, wanted me to give them a morphine OD (I wouldn't and I didn’t). That's not right either is it? Someone should feel they have to ask their child to do this as there is no alternative.

I also had a family friend go to Dignitas when their Parkinson's became too much for them.

Perhaps we need a wider conversation about death and dying. It's not really something that we experience often anymore, it's not talked about or is discussed in euphemisms such as 'passing on'. Maybe we need to feel more comfortable and less afraid of it.

I agree with assisted dying when the person is medically eligible, makes the choice and can administer whatever is needed independently. I think my dad would have chosen this in the end stages of his COPD.

But, I also worry about it the wellbeing of anyone whose job it would be to "kill" a person who cannot administer themselves.

It is such a difficult topic.

I dont want to see any coercion, I do think the safeguards need to be carefully drafted

I'd agree with this, @anyolddinosaur, if it wasn't for the fact that what's laid down in bills and "safeguarding" and what happens in practice are too often very different things

Add to that financial pressures and a lack of accountability among those who'd instantly seek to wash their hands of any problems and there's a potential storm in the making, no matter how persuasive the initial principle

Perhaps we need a wider conversation about death and dying. It's not really something that we experience often anymore, it's not talked about or is discussed in euphemisms such as 'passing on'. Maybe we need to feel more comfortable and less afraid of it.

I agree but I don’t think the answer is to sanitise it, which is what assisted dying is about. Maybe we need to get more comfortable and be less afraid of the reality of death.