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.

And before anyone brings up again how it's less risk than unassisted suicide - it really isn't and it's another thing that makes me uncomfortable that people naively think AD guarantees a pain free death when actually the complication rate is quite high.

Can you show me your evidence for that? I've been at the assisted deaths of many horses, who by virtue of their size are more difficult to kill with drugs than humans, and my experience would not support the assertion that assisted dying has a high complication rate that results in distress to the recipient.

Aren't there instances of complications arising when prisoners are killed by lethal injection in America?

Neither of my parents lived past their early 70s, so I find it quite hard to imagine me having a long life.

I work in a specialist mental health service for younger people, and even 30 years ago our caseload wouldn’t be anywhere near as big as it is. Care for people who have significant impairments has progressed so much that their lives are much longer now. Pressure mattresses and seating, thickened fluids and modified diets mean that people live much longer when they are entirely dependent on others (generally nursing home staff) to anticipate their every need. They no longer recognise their family members who can be extremely distressed at the progression of their loved one’s illness.

We euthanise our pets once their quality of life deteriorates- when they become in incontinent and immobile, in pain and distress.

I know it is a complete can of worms, but I would really like to be able to have an advance directive that means that my life can be ended if I should end up completely dependent on others, unable to communicate and with no recognition of my loved ones. If I ended up completely dependent on others but could still communicate, I would like to be given the choice.

I have a friend who had a TBI (extraordinarily fit and healthy prior to this) in her late seventies. Her care has been shocking as she’s been utterly written off and stuck in a dementia home, she does not have dementia. The cut off for decent rehabilitation was 60/65! So the system just stuck her in a completely unsuitable home up thread I saw the phrase ‘living hell’ and yes this is a living hell for her. She’s broken and potentially has years left. She would NOT have wanted this for herself and now cannot make a decision that I know she would have wanted. It honestly makes me so angry as I watch her suffer.

Untrained staff doing it. Medical ethics rules forbid doctors and nurses from participating in executions.

Assisted death and euthanasia for an animal aren't the same procedure and method and I think that's another thing that worries me is people don't seem to know the difference between AD and Euthanasia. Complications with AD have been reported anywhere between 7-14% which isn't much better than taking an overdose etc especially when it's being touted as a guaranteed peaceful death. Out of interest where you understand the impression AD was euthanasia with IV similar to animal euthanasia?

Managing the assisted dying process
Evidence shows the assisted dying process is uncertain, prolonged and not without suffering for the dying patient or their family. Recorded complication rates are up to 14.7% (including vomiting, seizures and a prolonged dying process) [7]. No drug regulatory authority in the world has approved assisted dying drugs and doses [7], GPs are likely to feel significant unease at prescribing unapproved and unregulated medications, something that is at odds with current clinical practice where prescribing is grounded in evidence. In a chaotic clinical day, where GPs are already working extremely long hours, dealing with multiple complex and emotionally charged situations, a home visit to deliver an assisted death will undoubtably cause additional stress. Some doctors in Australia describe involvement in assisted dying as ‘traumatic’, ‘anxiety inducing’ and ‘isolating’[8]. The potential for moral distress in GPs is not insignificant, this may occur when professionals cannot do what they believe to be the ‘right thing’, or when they are obliged to do things not aligned with their ethical and moral compass.

We euthanise our pets once their quality of life deteriorates- when they become in incontinent and immobile, in pain and distress.

I think this is a well intended but bad example.when brought up in AD threads. We euthanise animals when we wish to because they're property and don't have the right to choose their own care. I say this as a pet owner and animal lover. This kind of thinking is again leaning into the idea of when are lives are "unlivable" by other people's standards not the patients. Some disabled people are incontinent and immobile and in pain every day and have been extremely vocal that they are concerned with how much their experience is viewed and described that they would be better of deaf, when they're finding it hard enough to get the care and support they need to live because they don't want to die.

I think you are probably quoting stuff there that you have obtained from campaigns against assisted dying. If doctors don't want to do it they can't be made to do it.

I'd like to see research papers on complication rates, but I see no possible way that it will be greater than with suicide. Hanging without a neck breaking drop, the choice of many men, is a vile death and drug overdose, the choice of many women lands women in hospital on a daily basis.

Why do you think killing a 700kg mammal is easier than killing a 100kg mammal?

I thought there were three periods? This is what I’ve read and what I have observed.

There’s Theperiod when you retire and you’re fit and healthy and everything is fine because you don’t notice any difference.

Then you get the middle period where you notice you’re slowing down, you notice that things aren’t quite as sure as they were, you can’t do what you did before, but life is still ok.

Then there’s a third, final stage where you really are frail. This comes at different stages for everybody and some alllucky enough to avoid it. I vividly remember an elderly man telling me that he was now at that stage, he recognised it and he didn’t like it.

Which is why I clarified that I would like the option to make decisions about my life. I am not saying that other people would want to make the same choices, nor should they.

Yes, there are three categories. Young-old (age 65-74), middle-old/old-old (age 75-84) and oldest-old (age 85 and older.)

It's not unreasonable to see it as ideal, and it's not unreasonable for others to view it otherwise.

I've gone through having had a family member aggressively try to convince me to kill myself to make them happy and to stop me being a burden to them, resulting that I've spent most of my life having the thoughts that my death would make people happier than me living as I am. I've met other disabled adults who have gone through and deal with similar. I also grew up near where some of the horror stories in Canada around MAID have happened.

I'm not against the fully informed choice for adults as long as they can withdraw or the action paused, if they refuse at the time up until the overdose is taken. I don't think anyone, even with dementia, should be held down to administer the medication no matter what they previously agreed - consent is only consent if someone can withdraw it.

I am strongly against people in position of trust and authority offering that choice to often vulnerable people - people can be informed of their options without their medical professional or a government professional involved with them giving it to them. At the very least, we should be able to have it in our records whether someone opts-in to having those discussion, and having that as the default to reduce the risks

I do think fully informed choice does include that death by overdose, even if given by a medical professional isn't always the commonly portrayed go to sleep, don't wake up. It will almost certainly make it faster than most conditions/natural death, which is part of the appeal - but that doesn't mean it is always comfortable or dignified. Most do, but not everyone reacts to those medications well and people should be prepared like in other medical procedures.

Why do you think killing a 700kg mammal is easier than killing a 100kg mammal?

Because we do not treat people like other animals, and biology isn't just about weight. No one is using pentobarbital or any other veterinary method for medically assisted dying.

In all process I know, it involves giving a combination of sedatives, an anxiolytic to reduce panic, and medication to paralyse muscles which are all used for other medical reasons. It's known that not everyone reacts well to those medications individually, but the medical team or individual may not know that before it's given how the person will react. The sedatives and muscle paralysers are used at dosages to kill, and the body can do some distressing things in that process no matter the means. We can make deaths quicker, we can get closer to, but cannot guarantee it being the peaceful death many want or appear peaceful to family members there. Those who work with the dying have been preparing families for the potentially distressing happenings of death before medically assisted dying, and it's needed with it as well especially in cultures where dying has largely been given over to medical professionals.

I think you are projecting a bit there, as her brain has changed you cant say what she is feeling now. I support assisted dying for the terminally ill but it's worth noting that you can a pain free death from cancer and age related illnesses such as dementia.

Quite.

I would add that you most likely will feel differently once you turn 70.

My life now is actually more fun than during many other periods of my life. I am extremely fit, I have a very wide range of interests and hobbies, and I have several like-minded friends. My husband is the same. I am very active and never bored.

Not everyone feels the same way as you. If someone has had enough of living (and it shouldn’t matter what age that is) they should be able to choose to die. Some people wish they had never come into existence.

74 is not very elderly...many world leaders and Popes have been past this age. Yes, I know Biden was gaga but there will always be exceptions.

Did Keir Starmer only have 9 years left before he was classed as very elderly? I rather think he hoped he would still be in power!

People can have very elderly physical or mental health at any age and others have physical health and youthful mental health when they are past 80.

My dad is 87, teaches art classes, is Chairman of the Village Hall, is Musical Director of a local choir, gives talks on the Tudor Period, walks with a straight back and much else. His second wife is 69 and in poor health-he is the one looking after her!

Anyway, this lady had clearly had enough and was dominated by a fear that may never have come to pass. If she wasn't influenced by others and had really had enough, that that was her decision to make and maybe, once, you're over the age of 21, the decision is one that anyone should be allowed to make.

I find this whole area quite ethically complex. My mum is in a prolonged state of vegetation really. Bedbound, incontinent and being kept alive by a feeding tube. I’d 100% rather be dead than live like she is now. It will be a blessing when the call comes that she’s finally dying and I wish she hadn’t had the peg.
she was fine at 80, living like a zombie at 81. My dad at the same age is active and has a good quality of life.

I am absolutely in favour of assisted dying for those with terminal conditions. I’m a bit more torn in the case of Gill. I think she’s actually been incredibly rational but as a consequence of that she may have lost a number of good years. I think the hardest thing about it is knowing when life quality is likely to decline. If I knew I was destined for a shit few years from 86-89 for example, I’d be happy to go at 85. I think it is very hard to justify that call at 75 not knowing when or if the decline would come.

So people who genuinely want to use it for themselves should suffer because others might abuse the system. Hmm can't agree with that

But the different situations about are not necessarily correlated to your age groups

75 isn't very elderly. My mum has had a (small) heart attack and easily treated cancer and is still going to hobbies, zumba and her personal trainer at 78.

Whilst I certainly don't advocate that 75 is at death's door and you should toddle off as soon as possible, you can't seriously believe you're not elderly. What age would you determine it's is if not in your 70s?

People seem to be in denial!! Of course 75 is elderly.

I Think once you are over 70, it’s the shocking speed that illness can change things. My friend, through a very physical hobby we share was going great guns at 70, then breast cancer, followed by hip replacement, shoulder OP, and now a spinal problem. I’d have said she would certainly make 100 a few years back but now I won’t be surprised if she’s gone before 75. You just never know whats coming.

I want to add, watching my friends experience has made me realise how rigged the system is against you over 70, it doesn’t matter how fit and healthy you were. The provision for decent rehabilitation after strokes or TBI was virtually nonexistent when we were looking, it was straight into geriatric care. It is just not the same at your options pre 65. So I can completely understand the fear people have.

You don't help your case OP by saying that 75 is 'very elderly'. It certainly isn't today and I could list many people I've known (family and professionally) who were driving, gardening, socialising and volunteering at 90+ and who died without prolonged suffering. Also equal numbers where serious illness and disability hit decades before 75, including brain injuries.

I can't say I'm certain what I'd do if I had a diagnosis of dementia and have huge sympathy for people with eg MND who very understandably want to avoid a difficult death. It bothers me though that society could develop a midset that after some arbitarily chosen age, life is not worth living .