Assisted Dying

[Nordione1]

I dont know what section to put this in. Im more upset about the vote for it than I thought I'd be. I feel like we have crossed a rubicon somehow.

I think this is a massive step forward. I recently put my cat to sleep and it was such a nice thing to be able to do it at the right time for him to prevent him suffering. I want the same option for myself and my family.

I'm glad.

My FIL died of cancer in his 50's. The last few weeks of his life were traumatising. Unable to control his bowel or bladder, spent every minute in agony trying to regulate his breathing fighting a drowning sensation as his lungs filled with liquid, as his family continuously drained them, couldn't eat, could barely talk. Did he want to die? No, he would have wanted to be cured and live, but since that wasn't going to happen, yes he would have accepted dying in a digniified way he can control rather than waiting for a scary painful death.

My grandma also died of cancer, she would have also fit the profile as she was given a poor prognosis of a few months, up until 48 hours before she died she could potter round her house, and enjoy a cup of tea with family as they visited, she got admitted to hospital with shortness of breath and abdominal pain, the evening of the night she died she was able to walk to the loo, and have soup in bed while talking to family. She died in her sleep that night. Would she have benefited from assisted dying? No.

If used appropriately and proportionately, then yes assisted dying would help many.

Sorry but who is saying you should die?

I don't support the bill now and i think we've opened the door that we won't be able to close. Much like the GRC and the subsequent cases coming to court now with obvious examples of law breaking. I don't think there are enough protections from medical staff who'll use it to badger vulnerable patients about bed blocking. My recent experience at a hospital with a family member has led me to change my mind.

Previously I was for the bill but now I'm not because of the way medical staff behaved. Plus, with the Lucy Letby enquiry still on going I'm right to be wary of the medical world.

Again, assisted suicide is no guarantee of a peaceful end. It really isn't.

People have died horrifically cruel deaths both ways. There is also a lack of evidence re: the muscle relaxants used, we can't even be sure whether those assisted are fully aware of themselves suffocating to death either.

The choice isn't between a 'peaceful' death and a 'horrific' one. You'll just know the date. There hasn't even been that much research into assisted suicide methods, and that should concern everyone.

Also, can you not see why this exact argument will put pressure on people?

In the past year I know three people who were advised by a vet to get their pet put to sleep and who opted to wait a few days or try a last ditch treatment before taking that final decision. In one instance the pet deteriorated and the owner decided to have her put to sleep but in the other two instances the pet made a complete recovery and is now absolutely fine. Obviously doctors dealing with terminally ill patients know their patients aren't going to make a miraculous recovery but it does perhaps show that medical prognoses are not set in stone and gauging when someone will die may not always be reliable.

Well as a single, childless, disabled woman I do not want to be held hostage by the hypothetical fears of some other disabled people if I find myself in a very real situation where my quality of life is severely diminished to non existent or I’m terminally ill and dying in agony. Of course safeguarding is essential but measures can be put in place and have been elsewhere.

I’ve worked with palliative care patients and dementia patients. There are many things far worse than death imo yet we seem to have this odd reluctance to admit that it’s a matter of when not if that we’ll die and an insistence that people have eke out every possible additional second even if it isn’t in their wishes or best interests. I’ve worked in care and watched confused and extremely distressed patients with severe dementia forced to take life prolonging medications so that they can have even more days of utterly misery instead of prioritising their comfort and minimising their distress and people who had full capacity sit and literally scream in pain, rage and terror over their(to them) intolerable quality of life. It felt like the very opposite of care. It was like watching someone being tortured and being forced to participate in it.

I’m hugely in favour of better palliative care too and of giving people who do want to have as much time as possible the ability to do that as comfortably and contentedly as possible but it isn’t enough for everyone. There are some things I’d rather not suffer longer than necessary no matter how good the drugs are.

Agree with every word of this.

Okay but does it matter? Does it matter that someone who was given 6 months to live could have lived for 9 months? If they want to die, why do those extra few months matter? And I don’t think I have ever heard of anyone miraculously recovering from terminal cancer (as in end stage, not stage 4), other than scam stories.

Usually, a pet won’t have the level of medical intervention and testing a human has. Using motor neurone disease, for example. There will be specialists involved, detailed testing and scanning and nerve studies. It won’t be the opinion of one generic doctor.

Excellent post, thank you.

not sure how the nursing team will feel about it all

Can you expand more on this? How often are people with MND reassessed and examined after a diagnosis? What prognostic indicators are used? Could you link to the clinical guidelines ?

I am scared by the example of MAiD in Canada. It started in exactly the same way as our own Assisted Dying legislation: as the introduction of the right for people who have less than 6 months to live to choose to end their lives at a time they choose (with legalised medical intervention). Then is expanded, after public pressure, to include individuals who may not be 'terminally' ill, or who had more than six months to live, but who experienced 'unbearable suffering'. Then it expanded, after public pressure, to include people with psychiatric illnesses that caused 'unbearable suffering'.

MAiD was introduced in 2021, and I believe there are statistics that show there have been considerable savings since its introduction to the public healthcare provision. Obviously these savings could be used to provide more effective palliative care for people who do not wish to use the system, but it is still the case that an economic argument has arisen after the introduction of MAiD.

Our health care system is massively overstretched, our mental health services are almost non-existent in some places. We have a government that is already associating disability and poor mental health with lack of productivity (perhaps with good reason) e.g. in their 'Get Britain Working' white paper.

In fact, whilst I can appreciate that in its present form the Assisted Dying Bill seems to have the necessary safeguards an limitations to make it facilitate choice for people who are at the end of their lives, but services in this nation are broken, and people with poor mental health and disabilities already face unintentional discrimination, and I fear that the repercussions of this legislation could be devastating for some of the most vulnerable and marginalised people in society:

How Medically Assisted Suicide Went Wrong in Canada — NH Coalition for Suicide Prevention

https://apnews.com/article/euthanasia-ethics-canada-doctors-nonterminal-nonfatal-cases-dfe59b1786592e31d9eb3b826c5175d1?utm_campaign=TrueAnthem&utm_medium=AP&utm_source=Facebook&fbclid=IwZXh0bgNhZW0CMTEAAR3bBhFPCwskgcoKjDbMELv5zdsj979ZhD8XnSWplgR4P0hxX59waC3wfHU_aem_8wlijVYTPMQ6l49uPN7sEw

“He had zero quality of life. How can you argue with a straight face that it is OK to force 3 years of suffering like that onto a person?“

I would like to know this as well. Surely in such an instance it’s just about compassion?

And I find it pretty disgusting that I now feel the need to say that. I want to live

Maybe those who feel like this should be more considerate of those who may be responsible for them when they can no longer express their wishes.

If this discussion and bill prompt more people to clearly discuss and ideally write down their wishes that will be enormously helpful. DH was 90% sure his dm would much rather not have been carted off to hospital for treatment when she had various medical crises while in a nursing home. But as she'd never actually had the conversation or written anything down, he didn't feel he could ask for her to just be kept comfortable with the familiar staff who actually knew her name. It was horrible all round. (Her condition was so poor all bills were being paid by the state, btw, that wasn't in any way a factor) .

The presumption is, and I'm pretty sure will remain, that people 'want to live', but it'd be much better if it was explicitly known.

https://www.health.govt.nz/system/files/2024-11/review-end-life-choice-act-2019-nov24.pdf?

New Zealands recently published ( November 2024) 166 page review of their 2019 act. Particularly relevant for those who argue that this is a simple process to get ‘right’.

Though as it turned out, protecting the vulnerable didn’t actual need most of us to put our lives on hold. It wasn’t about the elderly or vulnerable at all - it was the scaremongering, with scant evidence, that we were all equally likely to be affected. It would have been far better to ring fence and protected the vulnerable, while letting the rest of us carry on as normal, making our own risk assessments to as to what we were comfortable with. Which, to be fair, many intelligent people actually did.

But it will be quick, much much quicker than potential months or weeks of agony. That's what people want, at least they know it will be quick.

No. People who are suffering and cannot get better should not be denied basic bodily autonomy just because of hypothetical ‘what ifs’. It’s a bit of a moot point anyway considering that people can already choose to die by suicide.

‘As it turned out’ ?

What would the death rates have been if restrictions hadn’t been in place?

As the statistics from around the works show, pretty similar

Can you link to those you’re referring to please?

I’m a bit confused as to what you are asking. MND is a terminal diagnosis. Progression is varied. When swallowing and breathing is significantly impaired, this is a sign of concern. Swallowing can be assessed at the bed side by observation, barium swallow and video fluoroscopy. Recurrent pneumonias indicate aspiration but there are tests that can observe it- the ones I mentioned. There are lung function tests, oximetry, CO2 testing etc.
I do not have the guidelines to hand, I am sure you could google NICE.