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.

It has been the outcome in many (even most?) countries that have implemented similar laws. This is a fact.

People are not unreasonable to be concerned about the same thing happening here.

It's telling that the vast majority of disability groups were against thus bill.

This is incorrect, the original federal level Canada law of 2016 required the patient to be terminally ill with “unendurable suffering”, it had more safeguards than the current U.K. bill which has no requirement for any suffering at all.

”2.4 Conditions of Eligibility (Clause 3)
New section 241.2(1) outlines the conditions required for an individual to be eligible for MAID. Five substantive criteria, all of which must be met for a patient to be eligible for MAID, relate to the individual’s circumstances:

• The person is eligible for government-funded health services in Canada or would be, but for a minimum residency or waiting period (new section 241.2(1)(a)).

• The person is at least 18 years old and capable of making decisions with respect to his or her health (new section 241.2(1)(b)).
• The Department of Justice online glossary for MAID defines competence and capacity as follows:
• A person is mentally competent or capable when they have the capacity to understand the nature and consequences of their actions and choices, including decisions related to medical care and treatments.28

• The person has a grievous and irremediable medical condition (new section 241.2(1)(c)).
• The phrase “grievous and irremediable medical condition” is defined in new section 241.2(2) as requiring all of the following criteria:
• the person has a serious and incurable illness, disease or disability;
• the person is in an advanced state of irreversible decline in capability;
• the illness, disease or disability or the state of decline causes enduring physical or psychological suffering that is intolerable and cannot be relieved under conditions that the person considers acceptable; and
• natural death has become reasonably foreseeable, taking into account all of the medical circumstances, although a prognosis as to the specific length of time remaining is not necessary.”

Can you expand on timescales and prognostic indicators? What is defined as ‘later stages’ and which chronic conditions are appropriate for palliative care? Does this mean they can be included under the terminal illness criteria of the AD bill?

Canada's law originally only allowed assisted dying for people whose death was 'reasonably forseeable' - i.e. terminally ill. It was changed in 2021 following a legal challenge.

Here is the press release for the 2021 change to include the not terminally ill.
https://www.canada.ca/en/department-justice/news/2021/03/new-medical-assistance-in-dying-legislation-becomes-law.html

Immediately another amendment was filed to extend to the mentally ill…which also passed but the implementation date of 2024 has been postponed to 2027 due to the very real cases of abuse resulting in state sanctioned murder of vulnerable people, which were disproportionately older women in poverty.

Yes, I don't know if anyone here followed that awful 'don't screen us out' campaign a few years ago. They were anti-choice activists trying to get NIPT testing banned and I wholeheartedly disagree with them, but one thing their campaign highlighted was the lack of support for women with a down syndrome diagnosis who decide to keep the pregnancy. There was an assumption that they would terminate. I think changes were made after this - at least the NHS did produce a report with recommendations which I'll try to find.

Well depends on how terminally ill gets interpreted. Some districts interpret terminally ill to include illnesses that are terminal without treatment which means things like a UTI, or diabetes, or anorexia, or a brain bleed etc can be considered a terminal illness and in some cases within the six months to live window as well.

Who does the interpreting?

It's questionable as to whether they are reasonable in condemning other people to months of unendurable suffering when the opportunity to change that situation arises.

I don't agree people in favour of AD are not enthusiastic about palliative care but why do you think that's the case?

It's assisted dying.

Anecdotes aren't evidence. Watch or don't watch Blade Runner. It's your own choice

"as if the state is like Harold Shipman" (which it isn't but maybe the ironic reference is lost on you

Could you link to the actual post and context?

And perhaps refrain from your snidey comments?

This is a difficult, emotional but interesting and useful thread-it would be a shame to derail it.

No not always. Also the issues which distress the patient so terribly are not always due to pain.

Hugely relieved. As many of us will be in years to come.

Very sad it won’t apply to dementia patients who still face choking to death.

Is that dementia patients with or without capacity? Or does it not really matter?

The timescale is quite clear, six months to live

Our experience (hospices) is that there is palliative care up to the point where nothing more can be done.

Then at that point, the doctors take them off all the drugs and move to titrating morphine in line with the MoJ T of pain.

I think of all that as "palliative care".

I don't know anyone who works in palliative care who thinks that assisted dying is necessary. They all think there needs to be a massive funding of good palliative care

But of course that costs money ... easier if people opt for assisted dying instead ...

*in line with the level of pain

And what is that based on? Can you link to the guidance that has been used to inform this?

@BumpyaDaisyevna I work in care too and that's part of the problem ... funding. We are beyond stretched and I being realistic I don't see that changing

"unendurable suffering", "reasonable foreseeable natural death". It was not as tightly defined as the UK Bill. Everyone has a reasonable foreseeable natural death. We are all going to die.

@ThisAquaCrow can't you read???

I know what you mean. And I know that good palliative care and comfortable deaths are just not available to all those who need it.

But I don't think the answer is to jump quickly across a really significant ethical line as a way of reacting to a crisis.

We should instead leave the law as is and provide the necessary funding. Goodness knows surely one thing every human can agree on is that the thought of a long drawn out death is terrifying. So let's fund it, if it means a bit more tax then so be it. It's pretty fundamental.