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.

This is a case from Belgium that was reported on in the Guardian.

The GP in question – we’ll call her Marie-Louise – is a self-confessed idealist who sees it as her mission to “care, care, care”. In 2017, one of her patients, a man in late middle-age, was diagnosed with dementia and signed a directive asking for euthanasia when his condition worsened. As his mind faltered, however, so did his resolve – which did not please his wife, who became an evangelist for her husband’s death. “He must have changed his mind 20 times,” Marie-Louise said. “I saw the pressure she was applying.”
In order to illustrate one of the woman’s outbursts, Marie-Louise rose from her desk, walked over to the filing cabinet and, adopting the persona of the infuriated wife, slammed down her fist, exclaiming, “If only he had the courage! Coward!”
Most medical ethicists would approve of Marie-Louise’s refusal to euthanise a patient who had been pressured. By the time she went away on holiday last summer, she believed she had won from her patient an undertaking not to press for euthanasia. But she had not reckoned with her own colleague in the practice, a doctor who takes a favourable line towards euthanasia, and when Marie-Louise returned from holidays she found out that this colleague had euthanised her patient.
When I visited Marie-Louise several months after the event, she remained bewildered by what had happened. As with Marc, guilt was a factor; if she hadn’t gone away, would her patient still be alive? Now she was making plans to leave the practice, but hadn’t yet made an announcement for fear of unsettling her other patients. “How can I stay here?” she said. “I am a doctor and yet I can’t guarantee the safety of my most vulnerable patients.”^^

i understand this. But it is not simply linear. You will get infections that will make you more ill. You will recover, or not. Weather will impact your respiratory function as will air pollution. You may do pulmonary rehab or physio that reduces breathlessness.

Right now? Yes. As my lung disease progresses, no.
This is the danger with people giving opinions online. I have highly specialist input and my disease is known to have a limited prognosis. I am, thankfully, not there yet.
Overall, there is a decline in my condition and there are in several well known conditions. Yes, you may fluctuate up and down. I know the difference between symptom progression and acute flare ups due to infection.

@BigManLittleDignity I know what I am talking about. Yes your condition is linear, but of course you have fluctuations. You can have extensive lung damage, but physio such as postural drainage can make a difference to your actual symptoms.

With respect, I think the poster probs knows more about their own illness than you do. Even if you are qualified in the field, the poster is living with the condition and taking advice from a specialist who has has the opportunity to physically assess the poster's condition and provide advice based on that.

Well said @GranPepper

You don’t know what you’re talking about with me though. I am under tertiary care, under the experts in my rare presentation. I have many criticisms of the NHS but this hospital is the bees knees and I am beyond grateful and appreciative I have access to such good care.

I know all about symptom management; I do it all the time and it helps my quality of life even though my CT scans are showing progressive. The physios I see have the term “highly specialist respiratory physiotherapist” on their badge. I have done pulmonary rehab courses multiple times. I can list of - and do - multiple types of airway clearance. I have nebulisers, an aerobika and I have been taught - and do - airway clearance (ACBT) twice daily. I exercise daily. This helps my current symptoms but the damage is progressive. Eventually, my lungs will fail. I am ineligible for a lung transplant due to another complicating factor. I have a strong drive to live and be healthy so if there was something to keep me alive, I’d do it. One day all my treatments won’t be enough. I have accepted this. I will die and it won’t be a fun experience. I hope I would be able to consider AD when my prognosis meets the threshold. In all honesty, I may not want it. I would like the option. For me, this bill gives a bit of reassurance that maybe I have a tiny bit of control? Psychologically, it helps.

I wish you well in your health difficulties

@BigManLittleDignity I do understand the lung damage is progressive and your symptom management.

Thank you.

This is absolutely it. It's like when abortion was legalised only in extreme cases. But now the majority of abortions are for unspecified reasons. Assisted dying will go down this path.

How do you know that the majority of abortions are for unspecified reasons? Maybe you'd be happier in USA choosing a state where women are denied abortions now. You have no evidence AD legislation would go down any path other than the one legislated for and to claim you do is just scare mongering.

You have no evidence AD legislation would go down any path other than the one legislated for and to claim you do is just scare mongering.

No evidence apart from all the other developed, western, democratic countries that have gone down the path ahead of us. Funny how those in favour of AD are all like other countries have this, we are so far behind, we can learn from them as they are doing it so well. Then when the dark truth is posted about how it’s not going at all well and there is serious concern to alarm, the it’s like oh, no evidence it won’t work, we aren’t them, we are British and so obviously we will do it Better, so nothing to see here.

If they don't have the capacity to say they don't want it, how do you know they changed their mind?

Why do women need any other reason than "i don't want to be pregnant anymore"?

I think it's absolutely right that anyone who wants an abortion should get one.

The problem is that social and palliative has fallen way short for many decades (coinciding, incidentally, with the beginning of privatisation of the NHS) now and has worsened. It is not getting better; quite the opposite. There simply isn't the billions of pounds that would be needed for it to improve or to offer people a 'package'.

I followed the story of former nurse Elaine Hudson, who had motor neurone disease, and who asked The Times to document her death by starvation before Friday’s vote. Her brother said before the vote “Our politicians are getting this one tragically wrong, trying to protect the one person that maybe [is] coerced … at the expense of the 99 that need to be able to choose a more appropriate death.” For Elaine, taking the “barbaric” and “only legal route” to a voluntary death available to her in Britain at the time, was her only option.

Before she refused food and drink, she WAS getting palliative care but even with that she was choking on her own saliva and was in excruciating pain, and shehad spelled out "I want pain free and dead" to the consultant.

We talk about having choices in life, and I for one would like to have the choice of shortening my death if and when the time comes.

And your actual evidence is ...?

@Dreammalildream just because some one has dementia doesn't mean they can't speak.

In the case I linked to the person made their advance directive saying if their dementia got bad enough that they needed a care home they wanted to be killed. Then I believe they weren't consulted again about it but when they would have needed a care home instead of being admitted to one they were sedated and when they woke up and started to struggle they were held down and killed.

That case made it to court. Rather than thinking hold on a minute maybe this is a bad plan they changed the law so that if you have made an advance directive then the doctor cannot be prosecuted.

So actually it wouldn't matter if you did have capacity. If you had a diagnosis of dementia and an advance directive saying you wanted to be killed if you developed dementia then you could be lawfully killed whatever you now thought about it and regardless of whether you now wanted to die.

I hope most doctors wouldn't do that but there would be no legal recourse if they did.

By capacity I meant that if you weren't able to read and understand legal documents anymore you might not be able to revoke your advance directive even if you were able to express that you wished to continue to live. You wouldn't even need to be told what was happening to you.

Do you have a problem with abortions?

And you know this because? (nb- you don't, you are scare mongering)

What a load of tripe (and that isn't a word I use lightly). My father had dementia. He made decisions while he retained capacity after he got dementia diagnosis and before his Consultant diagnosed he had lost capacity. Do you think family members would allow someone to hold down their relative and kill them in the circumstances you describe? And in any case, the Bill only permits an adult WITH CAPACITY and prognosis of 6 months or less to live to request AD which 2 doctors and a judge have to agree to. The Bill does NOT allow someone to give an Advance Directive and be given AD years later. Please stop scare mongering. It isn't helpful and it isn't an accurate description of the Bill

We are not the Netherlands

Yes, it would be funny if it was not so serious.

It’s not something I would ever choose to do ( although I’m saying that as a healthy person so who knows I. Future) ….but I’m still glad it got the vote