Assisted Dying is Sexist

[lcakethereforeIam]

This is a facet that I hadn't thought of, now I'm thinking how could I have been so blind

https://archive.ph/uhGgX

https://www.telegraph.co.uk/news/2024/11/25/assisted-dying-is-sexist-report-finds/

I'm not entirely against people being killed by their Doctors, if that is their wish, they're going to die soon anyway and the alternative is unrelievable pain. My misgivings were from watching how it had played out in countries where it is legal, particularly Canada. I was also worried about coercion but somehow I hadn't thought how gendered that is. How it's usually the male sex that does the coercion.

its all very well saying patients should take responsibility, but a lot of people don’t know what they can refuse, or don’t plan for it due to being in denial in the early stages.

Both my parents are in care homes with dementia, neither would have wanted this but they were young and didn’t expect it. So now it’s constant rounds of antibiotics to treat UTI, yearly pressure to have flu and Covid jabs and disapproval by carers if you disagree. People are being kept alive indefinitely with fortified milkshakes when they refuse food, or instances of carers tapping their mouths with spoons to induce a reflex action of getting them to open their mouths and get food in, these people are shells of there former selves, when you take into account any pain they are experiencing but unable to articulate, it seems like torture to me. There was a man at my dad’s home who had requested not to be fed once he no longer wanted food, the carers caved in and fed him because they “couldn’t bare the see him waste away”.

Yes.

So glad to see this - Fiona here, the DT piece is on our research. I was so concerned with the lack of engagement with possible coercion into state provided death, and what assisted dying safeguards would need to do if this bill is passed on Friday. (It has more stages to go but there's minimal chance to amend it after this).

You can read our research below - love to hear more thoughts. And MPs really need to be thinking about this before Friday's vote.
https://theotherhalf.uk/safeguarding-women-in-assisted-dying

Already lots of good points in this thread which I hadn't thought of - I don't know why there's been so little discussion given the magnitude of what may happen. For instance, there's a fair certainty that women with eating disorders would meet the dying criteria as they have been everywhere else which has assisted dying for terminal illness. Even Oregon.

We don't allow the death penalty to avoid the monstrous outcome we one day put to death an innocent man - we should have the same level of concern for women who wouldn't have sought to die.

For balance you can also read why Dignity in Dying think assisted dying is feminist

All the way through this I noticed certain factors:

populist pushing using opinion polls and advertising on the tube (which doesn't allow political advertising on controversial issues - except, of course, the ones those running tfl approve of).

And conversely the group that are voicing concerns. These are groups that by their very nature should ring alarm bells.

My biggest issue is even if you think the principle of assisted suicide is ok and should be supported, this bill is either by accident or design utterly appalling.

This is such an important issue yet somehow they've already fucked up process. If it's passed there are going to be huge issues around it - due to lack of safeguarding but also because of lack of trust. There will be many who will not want to engage with help even when they need it, because they will no longer trust authority.

The law of unintended consequences says this is a disaster waiting to happen already.

If the bill isn't passed, look out for the degree of abuse directed against MPs.

And that's why it will pass - we have a generation of spineless MPs.

Am I right in thinking that both Labour and the Tories are giving MPs a free vote on this?

The death penalty is state sanctioned, and a punishment. The choice to die has to come from the individual, so they would have to make that choice by themselves to meet the 'dying criteria'. I can't see that analogy as comparable.

We see life expectancy but not quality of life.

I really admire Margaret McCartney who has long been pointing out the difference.

Stuff like looking at life expectancy for bowel cancer - and noticing that whilst screening might prevent death from bowel cancer, it's not necessarily actually extending life.
(In her book the patient paradox she highlighted how people die at the same rate just of something else at the stage age - because they've effectively hit a point where their body has given up so are going to die regardless). She argues that at this point intervention isn't necessarily the best thing because it effects quality of life.

She then points out how research found that when armed with the most knowledge people who have capacity have been observed to make different decisions than if they've been given only some information over bowel cancer screening. They are more likely NOT to comply when they have MORE information. This ISN'T what you expect. It demonstrates that being more informed doesn't necessarily equal being more likely to have interventions - because they have an understanding of what intervention means in practice. And this poses a dilemma for authorities wanting people to hit targets and 'comply'.

And this is where I think scandal lies. And isn't solved by assisted dying. But by making sure people are fully aware of the outcomes that are likely at an early stage and are able to make decisions which don't lead to certain scenarios which could have been avoided by accepting death.

We don't talk about death enough. We have a social tendancy to assume intervention= the best outcomes. At end of life I don't think that's true.

I find this attitude horrendous. Contemptible.

No not everyone’s pain can be adequately controlled. It just can’t. No doctors don’t just provide a large dose that just happens to ‘prove fatal’. This may happen right at the end but people endure weeks and months of screaming pain and agony. I’ve seen it.

Not everyone can tolerate morphine or opiates.
People can vomit up their own faeces.
Drown in their own lung fluids.
Convulsions.
Increasingly rotting flesh with dressings changed daily.
Screaming in pain for weeks or months.

It’s utterly despicable to leave people like this. Unless you’ve seen it yourself and had explanations from medical professionals about why not much more can be done then you don’t believe it. This might not happen to most people - it doesn’t - but it happens to a significant minority.

The last 48 hours may be spent unconscious but the weeks and months leading up to that can be anything but. Absolutely, assisted dying is the right thing to offer anything else is pure cruelty and unforgivable.

it’s very easy to think of assisted dying as the less traumatic, less medically complex option, but that isn’t always the case, either emotionally or physically

Thank you for posting this it’s a very important point. Several people who support assisted dying have said they don’t want a painful death but don’t seem to understand the complexities of assisted dying.

This is such an important issue yet somehow they've already fucked up process. If it's passed there are going to be huge issues around it - due to lack of safeguarding but also because of lack of trust. There will be many who will not want to engage with help even when they need it, because they will no longer trust authority.

100% agree about this eroding trust in authority. Trust in professionals, but also trust in the intentions of own family. At the very time that calm, trust and support are most needed. I really can’t bear to think about the divisive, isolating and damaging impact this will have in fear and loss of trust for so many elderly and/or disabled people.

I've had a quick look at your site. Some of the examples you give are dreadful but, in their own way, they're as emotive as pp descriptions of how painful, undignified, and mentally tortuous dying has been for their loved ones.

The figures on how skewed the number of women seeking death for psychiatric reasons compared to the number of men is horrific though. How can anyone see that and not think there is something seriously wrong.

The lack of curiosity over deaths that appear to have been coerced. Perhaps I'm a cynic. If a gravely ill woman is told she's a burden by her loved ones (but kindly) and subsequently asks to die, the state shows no concern, takes no action, I don't think I'm wrong in thinking it's because they agree.

Do you think assisted dying is flat out wrong? Or is just this attempt to legalise it? Do you believe that a law could be drafted that would not metastasise as we've seen in other jurisdictions? Has your report been sent to MPs?

Thank you for the report. I already had misgivings but I hadn't considered this side of it. When I have time I'll have a more thorough look at your site.

Fiona your anti sexism is phenomenal thank you for everything you’re doing

Thank you @Slothtoes

Do you think assisted dying is flat out wrong? Or is just this attempt to legalise it? Do you believe that a law could be drafted that would not metastasise as we've seen in other jurisdictions? Has your report been sent to MPs?

@lcakethereforeIam am wrestling tots but have just tried to answer this in an LBC interview

https://x.com/OtherHalfOrg/status/1861816597607854472

Please do send to your own MPs if you think they should consider it - they're more likely to read your email than mine!

This is my thinking too.

It's a very simple comparison, she is saying that inappropriately killing someone is so serious a mistake that it requires very significant safeguards to protect against it. In the case of the death penalty, the safeguard is that it is no longer allowed.

In the case of assisted suicide, then, how far do we need to go to prevent the same kind of outcome?

There needs to be better, and more honest, communication with doctors.

But the idea that the solution t this is killing people directly instead is crazy.

Are you in charge of your parents care? Why have you not asked them to limit interventions like antibiotics?

One of the big concerns I have is around the often heard idea that people want to die with "dignity".

What they seem to mean by that is they do not want others to have to help them with daily care. Feeding, bathing, being transferred - and they do not want to have their intellectual capacity lessened in some way.

Do people understand that what this is saying is that people who regularly need these kinds of help, or who live with intellectual impairments of some kind?

If we take that kind of argument, as a society, and say, sure, we see that people who live that way aren't living in a dignified way, that will affect how we see people with disability in general, how we judge the worth and quality of their existence?

And that is going to impact how they themselves judge their worth and lives because they will be growing up with the idea that these undignified lives are worse than death.

We really need to push against the idea that accepting care is undignified. It's natural to feel that way, especially at first, but it's not actually true.

https://www.ian-leslie.com/p/the-ad-that-radicalised-me?utm_campaign=post

This is a good and thoughtful article by Ian Leslie and echoes many of my thoughts.

As far as I understand the dignity in death argument, it is being able to die at a time of their choosing in a relatively controlled and peaceful manner while they have enough of their physical and mental facilities to do so. Rather than enduring their bodies and minds gradually giving up on them, bit by bit, the untreatable pain, the swelling up, the lungs filling with fluid, the double incontinence… And also knowing their loved ones would be watching them suffer, unable to do anything to relieve the symptoms, desperately trying to get help from chronically under resourced palliative/hospice care system and it would take a long time for their loved ones memories of their death to fade.

Sorry but I just can't accept that. I'm the judge of what I find undignified for me, personally, and I am not able to unthink my boundaries because of strangers who are living a completely different life to me. The value of my life is mine to define.

To me it's at least at much an equality, autonomy and access issue as anything else (though other aspects of the issue and other ways of looking at it are also important).

Suicide has been legal in England for over 60 years, and since whatever is not forbidden is allowed, killing yourself is one of the choices you're generally free to make for yourself (except when it's felt that your wish to kill yourself is the result of a mental illness, in which case you might be protected from yourself). The freedom to choose suicide may not be a freedom most of us appreciate, but it's an profound and important one.

When people want to exercise their freedom to make choices about things that are important to them, but are unable to do so without assistance because of a medical condition or disability, it's an access issue.

In the case of providing access to suicide, however, it brings up all the ethical, moral, legal and societal complications that people have been discussing. And I don't think that these are minor issues — implicating other people in the act of killing someone, the potential for coercion, the potential for policy creep, of course these are all really important and might be enough to mean we should keep the status quo.

But I don't think we should forget that underneath these issues lies a fundamental principle of equal access to important choices. If the ethical and societal difficulties are indeed so serious that we decide to continue denying people the assistance they would need if they wanted to act on their own choices about their own lives in a way that is legally permitted if you're capable of carrying it out unassisted, then we need to own that, and say that, to prevent other potential harms, we are choosing to restrict the freedom of some of the most vulnerable people to make choices that other people are allowed to make.

Suicide means bang goes your life insurance, doesn't it?

I hadn’t thought about the impact on the insurance industry

there are so many issues to be thought through I just don’t get this frantic rush to push this bill through in a few weeks

isn’t it better to do it right rather than quickly?

That’s all well and good for you, because you may have the the type of personality and intellect that can assert your wishes and make them known- many people out there are not of the same disposition and the idea of “dying with dignity” could be a very manipulative term.
As an example, think if you mentioned “dying with dignity” to someone with a learning disability and how they would perceive this comment.

Not usually. Generally there's a clause that stops it paying out if you kill yourself within the first year (or two) of taking out the policy. Aside from preventing people essentially defrauding insurance companies by taking out policies knowing they intend to kill themselves to get a payout, it also protects people by removing a potential financial incentive for suicide. But after that, as far as I'm aware, most UK policies pay out the same as for any other death.