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?

How could people like the OP's mum have had a good death?

I think everyone should be able to make a decision about their own life or rather the end of it.

The main issue being it wouldn't just be the individual making an unbiased decision.

And this is why it’s absolutely terrifying that people think this issue should be put to a public referendum.

You criticise the fact that antibiotics are prescribed in end of life care when those very drugs can significantly improve the quality of life by reducing or eliminating pleuritic pain or the pain associated with UTI’s. Infection is a significant cause of delerium yet you dismiss attempts to treat and manage it?

And presumably your contempt for the safe and effective monitoring of blood sugars in order to identify hyperglycaemia and all of the distressing symptoms that can cause means that really, people at end of life shouldn’t be given steroids which often have an important role in pain control, management of nausea and vomiting and impact on reducing seizures, raised ICP and managing confusion and distress associated with primary and secondary brain cancers?

I think you have beautifully illustrated why the very last thing we need is a public referendum….

It's so hard - how can someone with dementia meaningfully consent when they no longer have power of attorney to control their own bank account? But they can still feel joy and have the capacity of a toddler.

In Canada, over time fewer and fewer applications get rejected, and, it has indeed created a culture of expecting people to do themselves in.

Where will the pressure be to improve palliative care if we're busy investing in assisted dying?

Gloriia · Today 09:36

I've known of people who are terminally ill suffering yet are still being treated. One gp wanted a lady with weeks to live have her blood sugars monitoring as she was on steroids! or given antibiotics to treat an infection. Just why. Yes alleviate suffering with opiates but ime it is GPs who need updates and guidelines on what not to treat to prolong suffering.
Government needs to throw money at end of life care.

I agree with this point.

If my mums last major infection had not been treated she would have slipped away and missed the last few weeks of utter hell. I remember being on the ward in the cancer hospital and the consultants and nursing team informing us she was very poorly and that things could start to progress very quickly but death can take weeks to occur.

She was still being given antibiotics to fight an infection which was a futile task considering we were preparing and waiting for her death- maybe the infection was her body’s way of trying to alleviate itself from any more pain?

Patients and families need to be prepared for what death from terminal illness can look like because the medical professionals (understandably) focus on the positivity aspect which lulls you into this false sense of security that you just slip away when the reality for so many towards the end of terminal illness is absolutely the opposite.

My FIL also died from cancer but in even more cruel circumstances because he was aware until the very end, resembling what can only be described as a living corpse. The poor man was failed by the palliative care and district nurse teams and endured a terrible death, begging to die for weeks before. His screams of sheer agony could have been avoided had assisted dying been allowed.

Infection causes pain. They treat the infection to make the patient more comfortable.

I don’t know why your FIL’s pain wasn’t treated. Clearly something went wrong there but I just want to note that shouting and screaming isn’t necessarily due to pain.

Yes this. Most infections make you feel terrible and should be treated regardless of life expectancy.

Please don't sneer and suggest people are too thick so a public referendum would be inappropriate. This is a highly emotive subject that I expect we all have experience of.

Distressing symptoms can be managed with pain control, not antibiotics. Patients should not be having fingers pricked to monitor blood sugars to tick a GP's box.

As I have said money and education needs throwing at GP services and of life care. Symptoms can be alleviated without unnecessary interventions like antibiotics that prolong the inevitable.

I personally believe antibiotics should be given unless otherwise stated for UTIs for the same reason as you would give them to someone with a dental infection, to alleviate pain and delirium. What I don’t understand is people with dementia in care homes being put on a diet because they gained weight sitting down all day. And yes, this is something I have witnessed! I think the primary importance is to keep them content and pain free. I have also witnessed the absolute horror of having both parents stuck in an angry or terrified state, which can only be temporarily relieved by drugs, and even then given sparingly. I would rather not live in a state of permanent terror.

Analgesia in end of life care controls pain. Antibiotics are absolutely inappropriate and prolong the suffering for everyone.

The suffering of the person dying is the most significant but you would not leave an animal to suffer the way we leave people to suffer in the end of life in some instances.

You haven’t countered any of the information I’ve given you. Your response is a ‘la la la la’ fingers in your ears type response.

Both steroids and antibiotics have an important and significant role in improving QOL at end of life. You can dismiss it all you want. But your dismissal of appropriate symptom control very clearly demonstrates why people need to be protected from this bill.

I fully understand why this is the case but the irony of her being made to feel more comfortable as she slipped into a coma to begin the cruel dying process of withdrawing liquids and food for 2 weeks whilst being pumped of every drug possible to ensure she wasn’t aware of what her body was going through. Meanwhile we had bedside seats 24/7 to spectate over the entire horror show that unfolded, holding her hand the entire time until she finally passed.

Its a terrible feeling to be sat wishing your mother to die faster. We were with her until the very end but it all felt hopeless and needless because we were taking up vital space in a private room waiting for the inevitable to occur. From the moment her syringe driver was fitted the waiting game began - there was zero chance of recovery because her body was shutting down. There should be a point where a team of physicians assess the patient and say as per their predetermined wish we all agree the patient may be administered the medication to end their life.

Being able to take control of the way it all ends may even have therapeutic effects for patients diagnosed with hideous diseases and alleviate that feeling of utter hopelessness and fear of the unknown. I know I would want to be able to say ‘ok if X happens and the circumstances are this and that I would wish for end of life medication to be administered’.

I think that this is alarmist. There can be measures and protections written in. There are measures to protect people from all sorts of coercions.

Any one who has seen a relative dying in a very close and personal way ( not a sanitised 30 minutes in hospice when all the dirty stuff has been done) knows who absolutely horrid it is.

i think that there are forces against this because frankly people make money out of dying people - there’s a whole vested care industry. How much will they suffer if life was shortened by 2 months here and there?

I never ever want to go through what my parents did. It was clearly and expressed to be hugely painful, distressing ( for them) and unpleasant.

It’s my body and my say. As it is I will have to read up on suicide and most likely botch it and have a far worse end. People only die at peace after several days ot weeks of intense suffering.

There has to be a way to see a lawyer and leave clear instructions of wishes that have to be followed.

in the meantime all MPs should be made to sit through a few deaths to see the harsh reality. Most MPs have not seen any.

Gloriia · Today 10:22

Analgesia in end of life care controls pain. Antibiotics are absolutely inappropriate and prolong the suffering for everyone.

How did you know the patient only had weeks to live?

This expresses everything and it can be even worse if they don’t fit w pump driver because the person dying was not in a nursing bed and still was dying from starvation and lack of fluids - my mother was given paracetamol! she was dying and all she had was paracetamol!

My father’s death was like a crucifixion with blood pouring from every hole out of his head.

I'm not sure what else you want me to say. I disagree with you. I don't 'have my fingers in my ears' please try and show some kindness and respect when debating such an emotive subject.

Imo pain due to infection should be treated with opiates and anyone with weeks to live should not be having 4hrly blood sugars checked just because they are on steroids. GPs and their staff in particular need more training in end of life care.

I really hope the bill passes. Just watched my dad die of cancer at home. He had excellent palliative care and died relatively quickly but it is still an awful experience for someone to lay there (albeit sedated and with morphine) whilst there organs shut down - no food, no drink, he couldn't shut his eyes or his mouth. I am really frightened of having to go through the same thing. Whilst there does need to be safeguards it is wrong that we simply won't consider it because of what might happen.

Absolutely this. There is a whole industry based on those weeks of dying so they’re not going to let their cash cow slip away.

There’s also the religious element which I am vehemently against but again loud voices will shout their disapproval.

End of life can be brutal for the patient and loved ones - unless you have experienced it you really have no idea just how insidious and despicable it can be.

You’re not debating. You’re dismissing the clinical indications for antibiotics and steroids in end of life care. With no logical argument for doing so. That’s not debate.

The slippery slope begins right there.

I mean this genuinely. If your mum was having a terrible quality of life, why was she consenting to treatment of all those life threatening infections?

Patients with capacity can decline any life prolonging treatment at any time. They can have all their care focused on comfort and symptom relief. This requires honest, gentle, compassionate conversations to be clear about options but surely this should be more widely practiced before we step into assisted dying as the only out?

I don’t believe the medical profession should always intervene just because it can. You and others think differently but what stands for me from this post is the duty you felt to be at your mother’s side till she died. She was insensible so it wasn’t comforting for her and it was tortuous for you, so why do it? Societal pressure? Societal pressure can be a useful force but it can also be a destructive one. There was no need to subject yourself to a ‘horror show’. She was being looked after so occasional visits (for your long-term well-being) would have been more than sufficient.

The logical argument is treating an infection in someone who is dying prolongs the inevitable and prolongs suffering. Yes give steroids to, for example, reduce icp in those with brain tumours but please don't make patients suffer more with unnecessary blood sugar checks.

Pain and distressing symptoms of course should be controlled but treating an infection is absolutely crazy and I would instruct any palliative care hcps not to do so with my loved ones. Though any palliative care professional worth their salt would not need instructing. Sadly, that is where the problem lies. End of life care is clearly variable in quality.

We know where PAS leads once it’s brought in. All we have to do is look at Canada.

Veteran seeking help for PTSD and traumatic brain injury was repeatedly pressured to accept MAID. 2 minute video