Assisted Dying

[Marmora Man]

Travelling to a meeting today I caught the end of a radio discussion about Assisted Dying / Euthenasia. Basic argument was that with people living longer, how do we as a society make the right decisions about quality of life and when it might be right to allow assisted death for those suffering with no hope of recovery?

As someone who is now closer to the end of my life than its beginning (albeit I hope still a fair way off) this is a subject that is beginning to interest me.

I have made a living will ? but it only informs my relatives and carers of my desires, and has no legal force to allow me, or others, to insist upon assistance in dying if I am in a irreversible coma, or intense, insufferable and incurable pain.

Questions:

1. Should assisted dying be allowed ? by assisted dying I mean that an individual elects to die and is then given a painless and planned death to avoid unnecessary pain or suffering.

2. Should euthanasia be allowed ? by euthenasia I mean passing the decision for speeding up the process of dying to others, either relatives, carers, guardians or medical staff, because the individual is in a coma, unable to articulate their wishes, persistent vegetative state.

3. What safeguards would be required if either 1. or 2. were to be allowed?

[Keef]

1. Absolutely!

2. Not so sure, unless of course it is stipulated very clearly in a will. I think entrusting that decision to someone else is asking a hell of a lot of them. There is also the risk of people getting rid of elderly relatives for financial gain.

3. God knows, it'll be a minefild, and will need some very substantial legislation around it!!

[Peckhamgatecrasher]

1. Absolutely not.

2. Absolutely not.

3. not needed

[mockney piers]

I think number two already exists.

When my dear old gran was found to have a terminal tumour, having been barking mad for the est part of a decade, the medical staff, with the consent of her kids, decided not to treat it. She still took an aeon to die; strong as an ox she was.

[Brendan]

Bloody hell MM. As if grappling with the rights and wrongs of Thatcher?s policies, the nature of class, the worldwide powers of the Catholic Church and where next to meet for drinks isn?t hard enough.

A controversal and emotive subject, debate on which I think is going to lead to more grey areas than answers. My mind is a bit too fried with work stress at the moment to jump into the fray though.

[Moos]

1) I think many people who have seen the indignity and cruelty of long-term terminal illness would agree absolutely yes.

2) I waver, but would probably come down on the side of no... too many near-misses, too much risk of decisions being made for wrong reasons.

3) At the very least, an independent medical assessment of being of sound mind, and a 'cooling-off' period. How to get around the problem of pressure from relatives worried about how to pay for crippling medical bills or indeed the self-administered pressure of 'I don't want to be a burden' I don't know.

[*Bob*]

mockney piers Wrote:

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> I think number two already exists.

> When my dear old gran was found to have a terminal

> tumour, having been barking mad for the est part

> of a decade, the medical staff, with the consent

> of her kids, decided not to treat it. She still

> took an aeon to die; strong as an ox she was.

'Number two' exists but it goes somewhat further than turning that machine off, or 'deciding not to treat it'.

Ask you local GP, or terminal illness care special ist. Not that they'll admit it, of course.

[EDDW]

mockney piers Wrote:

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> I think number two already exists.

> When my dear old gran was found to have a terminal

> tumour, having been barking mad for the est part

> of a decade, the medical staff, with the consent

> of her kids, decided not to treat it. She still

> took an aeon to die; strong as an ox she was.

At present No.2 exists in a form - but the "not to treat" can mean everything from not giving drugs to prolong life to actually withdrawing food & drink - condemning the patient to die of starvation / dehydration, not a good way to go.

[*Bob*]

EDDW Wrote:

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> At present No.2 exists in a form - but the "not to

> treat" can mean everything from not giving drugs

> to prolong life to actually withdrawing food &

> drink -

You've missed one. Giving.. let's say.. an excess of drugs

[EDDW]

*Bob* Wrote:

-------------------------------------------------------

> EDDW Wrote:

> --------------------------------------------------

> -----

> > At present No.2 exists in a form - but the "not

> to

> > treat" can mean everything from not giving

> drugs

> > to prolong life to actually withdrawing food &

> > drink -

>

> You've missed one. Giving.. let's say.. an excess

> of drugs

The Shipman solution

[*Bob*]

Not exactly.

Not in a 'mass murder total nutter kind of way'.

More in a 'these are the pills, this is recommended dosage but if you feel more are required kind-of way'

[bignumber5]

An interesting topic...

the distinction currently made is the difference between withdrawal of treatment vs an act of intentional harm. Treatment can be refused at any point in illness, in which case the new treatment to offer is symptom management. CWALD may be the best person to help here, with that LD, but as far as I'm aware a living will can be arranged but only to state the circumstances in which you would want treatment to be withdrawn. In the UK, Medical staff can never take an act to intentionally harm, regardless of consent or desire - it's a legal no-no, and even if that was ever changed, it'd be a big ethical minefield for a lot of us in the trade.

[*Bob*]

Not wanting to press the point but..

You may wish to pretend that the medical profession are sworn to this or that and boil 'assisted dying' down to what's allowed and what isn't allowed by law.. to which end I'm sure the legals minds knocking about on't forum will be glad to advise. But, like it or not, there is something of a gulf between what might be a legal no-no, and what actually goes on. And it does go on.

Let's hope that you (or yours) never have to find out.

[gerry]

This is an interesting debate because the rights of the individual to decide what they want are very seldom taken into consideration.

A living will is the document which comes close to protecting those rights. Its then up to the family and the medical team just how they will carry out the wishes of the individual.....if anyone knows anything different, please comment. I've seen it work very successfully in the states, not sure how it works over here.

[citizenED]

Out of expediency, doctors have to take the "...for what I have done and what I have failed to do..." approach to those that are slipping away. They can act to do something or omit to do it. Either way , as *Bob* says, doctors already take decisions about the deaths of patients.

[SteveT]

If I was in pain and no chance of improvement I would consider a whiff of gas for permanent sleep, or injection of morphine the way to go.

I was told 'never to be afraid of death' because you die every night.

I have never felt that life is that good to hold on to at all costs, if I were in uncontrollable pain give me the termination pill and let me go. I hope and pray for a doctor who is worldly wise enough to recognise that to give me a good send off.

[lozzyloz]

Own up! Who dropped the cyanide capsule in my . . es . . pre . . uh . . o o!?

[PeckhamRose]

1 Absolutely

2 Absolutely

3 Safeguards mean that your friends and relatives (in my case in THAT order) would have to be the ones to help me make the decision and give the doctors the say-so to go ahead. I think we should have to put on line on a dedicated website names and addresses (not visible to everyone of course) only visible to those need to see it at the time, of our friends and relatives we want to contact should such a time occur. To be updated yearly. Then the disc with all this info on can be left in someone's car and stolen and used and blah blah

Hey - I have not thought this all through because I am supposed to be working but it seems like a good idea!

I worked for a funeral directors and saw relatives and friends who had had to witness unnecessarily long painful deaths of their loved ones which made everything so much more unbearable.

[Marmora Man]

Peckhamgatecrasher Wrote:

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> 1. Absolutely not.

>

> 2. Absolutely not.

>

> 3. not needed

This is a very absolut-ist position and differs from the bulk of postings.

iI'd be interested to hear and understand your reasoning .

[*Bob*]

(From memory) Peckhamgatecrasher is religious.. hence..

Correct me if I'm wrong, PGC!

[Jah Lush]

I would assume you're correct there *Bob*, most religious people are pro-lifers. What other reason would there be?

On a personal level if I was dying and in constant pain or had lost my marbles I'd want to go out in a morphine haze.

[Bookworm]

My father died in January after a long and towards the end very painful death. He couldn't do anything for himself for several years and it was down to the strength of my mother that he died in comfort at home. She refused to allow him to go into a home (apart from a few days of respite care a year, for her own health and sanity) because she had heard terrible stories of people like him being starved or not properly looked after. Because her council would not pay, she had to use her savings to have carers visit several times a day, as it was a lot for a woman in her seventies to do. I live almost 300 miles away with a young family, so could not provide daily support. We watched him slowly deteriorate and at times, I hoped he would go out of pain peacefully but it didn't happen for a long time. That did not mean that I wanted him to die, but it was hard to see him barely existing. My father was not in a position to be able to change his mind had he put something in writing legally, to ask for euthanasia. That in turn would have put tremendous pressure on my mother and I and would have been a terribly hard decision to make. If I had made that decision, I would always have wondered if it had been the right one. I had always been in favour of assisted death for the sake of the person suffering, if that was what the wanted but when the situation arises when the person involved is incapable of communicating, the decision becomes more difficult.

[bignumber5]

*Bob* Wrote:

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But, like it or not, there is

> something of a gulf between what might be a legal

> no-no, and what actually goes on. And it does go

> on.

I've been in the medical biz for a while now, including palliative care, and i'd have to say not in my experience. I'm not so naive as to totally deny the practice exists, but i have never seen evidence of it. regulation on practice, particularly post-shipman, is pretty good, and the professions are currently changing the culture around whistle-blowing, rather than the old medical "closing ranks" approach.

Unless, *Bob*, you have a very personal experience that you are drawing from, then I think we'll just have to agree to disagree on this one, because my personal experience is entirely unilateral.

[*Bob*]

bignumber5 Wrote:

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> Unless, *Bob*, you have a very personal experience

> that you are drawing from, then I think we'll just

> have to agree to disagree on this one, because my

> personal experience is entirely unilateral.

I don't know what to say now, so agreeing to disagree is probably the only option.

[Peckhamgatecrasher]

Hey MM, I am that religious nutter. See my stance on the abortion thread - at least I'm consistent.

It's a v. emotive subject and I certainly am not advocating that a person should suffer, I'm assuming some sort of palliative care would be taking place - we're not on a John Wayne battleground where a coup de grace is administered (but also not necessarily floating on a cloud of morphine induced haze that Jah is imagining as I think death is [am not actually going to try and explain what I mean right now cos Cheltenham is taking my attention and I'm out of nictotine and this one needs serious contemplation] )

Re 2., I do have some experience of this and I do know some medics collude in the practice, but my concern is that euthanasia is for the benefit of those who have to watch the suffering and can't bear it.

I will try and make sense of this rambling later - promise.