To think Gill Pharaoh had the ideal end of life

[CurdinHenry]

Article in the Times about this woman who decided to end her life through voluntary euthanasia at 75. Huge outrage on social media as a result as various people missing the point entirely express fury because they think being very elderly will be great fun. I personally don't want to get older than that. I don't ask anyone else to take the same view but it stresses me out that the naive want to reduce choices available to the prescient. Euthanasia should be available to everyone without condition.

I didn't flippantly erase anything. I literally meant what I wrote and you have willfully chosen to misinterpret it. Some women don't want to be a mother but are willing to continue a pregnancy, give birth and then have the baby adopted. The fact that most women don't want to do this doesn't make my statement flippant. I have been pregnant and given birth myself multiple times. I understand how difficult it is but I also understand that pregnancy and birth are a separate issue to wanting to be a mother to a child. If a woman's concern was with the latter then adoption is an option for her and some women do choose this.

I would not allow an assisted dying request unless a person has tried medically recommended psychological therapy and any appropriate drug therapy. If those do not relieve the desire not to be alive then I would call the decision rational.

what's the difference between a depressed person who kills themselves at home and has it painted as a tragedy, and a depressed person who kills themselves at a clinic and has it praised as rational?

The clinics won't accept people who have not tried extensive treatments to alleviate their depression. Both situations can be rational and tragic at the same time, depending on the viewpoint of the observer.

Assisted suicide would by definition be allowed because the idea of assisted suicide has been normalised, it won't happen otherwise. . But if you believe as I do that there is no inherent magical value to life as one of 8 billion people, and that once you are dead you cannot miss or regret the years you might have lived but didn't, I can't see an issue with it except for the people left behind, who should respect their loved one's wishes.

The issues are all around how to protect the vulnerable.

Fair enough. So a DIY suicide where someone has tried to alleviate their depression over the years and has been unable to, would be considered a positive decision, but one that came out of nowhere, by a person who has never sought help, would be a tragedy? I guess that makes sense (although I still don't agree, personally.)

No, for the most part, people are questioning how safe and effective state assisted and sanctioned suicide could be achieved without it being a cloak for economically driven eugenics in the extreme.

People are also questioning the pragmatic disregard for human life in general which is seeping into discourse.

For years there has been an inordinate amount of work done to help people deal with and overcome obstacles and illnesses to give them self worth and foster mutually supportive communities. Are we now going to turn around and say that suicidal people who sound rational should be helped along regardless of consequences?

I live with passive suicidal ideation. I choose not to act on it because my son and friends have dealt with enough loss in recent years. All this talk of people being selfish if they balk at the prospect of a loved one deciding to end their life is so extremely individualistic but an inevitable reflection of modern life.

I do not want people to suffer horrible deaths when terminally ill; I also think the main reasons they do are down to systemic and economic policies in the main. This should be addressed as much as anything else.

Those so certain that enough safeguards would be in place to avoid abuse or mission creep are looking so hard at their personal rights and choice that they refuse to contemplate the complexity of the matter beyond their own lens.

Those discussing the pros and cons are trying to analyse the sanctity of both life and death and for many I suspect it's a deeply troubling and conflicting subject.

I did not say that!

You have now substituted the word "positive" for "rational" and the two are not the same.

I specifically said that it could be both rational and a tragedy.

I don't think being as simplistic as you persistently try to turn the discussion back to is at all useful.

And PLEASE stop putting words in my mouth!

I do not want people to suffer horrible deaths when terminally ill; I also think the main reasons they do are down to systemic and economic policies in the main. This should be addressed as much as anything else.

You are wrong about that and working in a hospice would show you how wrong you are. Don't bother asking serving staff though, there is an absolute conspiracy of silence in the industry about the uncontrollable pain and indignity of death through serious illness that does not render you unconscious.

But some people seem to view Gill Pharaoh's death as not just rational, but positive, even to be celebrated – hence why I used the word.

So are you saying that you don't think her death is positive, and you view her suicide as a rational tragedy?

(Additionally, I used a question mark in my comment – I wasn't putting words in your mouth, I was asking whether that was the case, and you've said it wasn't.)

Could you please explain why it is then? Why is hospice care so poor? Genuinely interested, as a family member is a long standing hospice nurse.

Gill Pharaoh’s death was a positive thing. She made a rational decision to end her life before she declined physically and mentally.

People are entitled to their views. I wouldn't celebrate her death. I am pleased for her that she was able to have a dignified death on her own terms. That ability to choose was a positive. Since her reasoning would also be mine, having a high risk of dementia, then I would describe it as rational. Since she died on her own terms when she wanted to after 74 presumably good years, I would be hard put to consider it a tragedy. If there is any tragedy it is that she had to travel abroad and probably choose to go earlier than she needed to because she could not give instructions in the UK that she should be helped to die when she became incapacitated. If that was the case, then the loss of time she would have chosen to live if she could have given that advance directive is indeed a tragedy.

Hospice care is not poor. It's absolutely exceptional, especially the one I worked in.

It simply isn't possible to control pain completely without causing loss of consciousness and risk of premature death and that isn't allowed.

There is no way to preserve your dignity if you are unable to leave your bed to use a toilet or have lost control of bodily functions and you can't bath or shower yourself.

With the best will in the world, death from serious illness is often unavoidably painful and degrading.

You won't hear many people involved in end of life care who will talk about this, though. They know it would upset people to hear it. Especially not hospice workers as it would affect their donations.

Alright. The same logic would apply to many suicides from incurable depression, or trauma, etc. I think it's interesting to see the push to turn suicide into something that is positive more often than not, and to be facilitated, rather than something generally negative, and to be avoided.

I nursed my mother for the last month of her life during lockdown; she had ovarian cancer and it was as brutal and harrowing as you describe. Bar district nurses there was little support and an added layer of pandemic induced obstructiveness from other branches of the NHS, but conditions were extreme so I'm not going to whinge about that, although it still rankles.

On the subject of restrictions around pain relief, this should definitely be addressed. When someone is actively dying and consciousness is elastic at best, I see little point in prolonging the agony to avoid perceived complicity in the process.

It's not a push, it's a pull from people who want it. Nobody needs to change their own point of view.

I don’t think suicide is a negative thing. It’s devastating for the family and friends left behind, but for the actual person it means an end to their suffering. It would be worse to be “forced to live” so other people don’t suffer.

If my surname was Pharoah, I’d definitely ensure I was expensively mummified. Missing a trick otherwise.

I'm so sorry about your mother. That sounds absolutely horrendous. I was with my grandmother every day through her final eight weeks in private hospice while dying of breast cancer, and they were amazing at making her comfortable, but most people don't get the benefit of private hospice care and it must be awful.

I absolutely agree it makes no sense to restrict pain relief in terminal patients - in my opinion, when someone is actively dying they should be given (the option to have) enough pain relief to completely eliminate the pain - and if the side effect is an overdose that kills them more swiftly, it makes little difference at that point. The aim shouldn't be to kill them, but there should be priority placed on pain relief regardless of the risk of overdose.

Thank you for your kind words - and likewise solidarity on the loss of your grandmother - I am glad such a tough experience was made more bearable due to the care and attention from the staff.

I do think that an apparent disparity in care due to economics is a very sad thing; I am probably hopelessly naive but I don't see why the last few weeks or months of a persons life in such circumstances should be so heavily influenced by number crunching. We are most vulnerable at the beginning and end of our lives, and care and compassion should be of a gold standard for all.

And yes, the relaxing of restriction of pain relief in such circumstances should be a good starting point for how we facilitate a "good" death as far as we can.

This is bullshit. We're lucky (very lucky) to live in a society that doesn't abandon its older citizens. I'm over 70, not well off, and live in a housing association flat with the rent and council tax paid by the council. Medical treatment courtesy of the NHS.

Living on the state pension isn't exactly luxurious but it's definitely life!

One thing you don't realise until you get older & sicker is that your mindset changes as well. Most of my life was very exciting - good and bad - and I used to view 'contentment' as a kind of third prize, the best you could hope for if you couldn't be 'happy' or living life to the max. Turns out I am contented and this is what I want!

There's a bit of an odd transition, well documented on here - and then you take a look around and think 'Yes, I like this. I feel safe. It's all okay.'

Harold Fucking Shipman screwed that up, aided & abetted by later healthcare murderers putting older patients (mainly women) 'out of their misery' on the sly.

I totally agree that pain relief should be available as needed. I imagine the safety protocols are under review; have no idea how that's going.

Yes, I don't know much about it admittedly, but I have heard that. I really don't think it should make a difference once people are in hospice care and actively dying, but I understand it can't be a simple thing to try to safeguard patients from murder, while also allowing other patients to be given enough pain relief that they might potentially die of it.

@MistressoftheDarkSide I do think that an apparent disparity in care due to economics is a very sad thing; I am probably hopelessly naive but I don't see why the last few weeks or months of a persons life in such circumstances should be so heavily influenced by number crunching. We are most vulnerable at the beginning and end of our lives, and care and compassion should be of a gold standard for all
Very few people in this country receive gold standard healthcare at any point in their lives unless they pay an awful lot of money to access private healthcare. I have recently waited for 4 hours in A&E with people who were visibly in a lot of pain and have struggled to get a GP appointment for an issue that is going to obviously worsen without timely attention. I have family members that have been on waiting lists for years whilst their quality of life has been impacted. People are routinely denied expensive life saving treatment and drugs because they are too expensive.

In this context, I would suggest you are hopelessly naive. It's hard to justify money being pumped into keeping someone alive that doesn't want to be alive at the end of their life whilst we are unable to meet the basic needs of those that desperately want to live and remain healthy. There is an opportunity cost to everything. We also can't focus resources heavily on the already dying and ignore treating everyone else. We need to have mature conversations as a society about how resources should be apportioned and what this means for all age groups.

I agree with this too. I’ve already said it on this thread, we have a massive shortage of doctors, nurses, midwives and carers in the UK and it’s getting worse. If people want to die, they should be able to in a safe way (assisted dying.) This shortage of medical personnel isn’t going to magically change.

No, but to write them all off as the OP has is just as disingenuous.

How did they write everyone over 75 off?