Assisted Dying

[Tangled Metal]

As an aside, have you heard about the tube adverts promoting support for this legislation? If any of you have family involved in the rail sector you will know how bad it seems to promote the taking of your own life on the way in to catching the underground railway. A driver seeing the suicide victim will not be likely to work as a driver again. It is not good to have a link to a form of self determined premature death with rail travel IMHO.

Is this not a backfire on the campaigning organisation and TfL too? Sorry for this digression but it kind of shocked me.

[[XAP]Bob]

Sorry, you are proposing an amendment to the legislation before it is in place? Is that not a flawed method of writing legislation? Write it wrong knowingly then re-write it afterwards? I hope the Lords, for all the times it gets criticism, will re-write it before it passes (assuming it gets through the phases in the HoC first).

It's how laws are made, they have readings, ammendments as a result of those readings and then they bounce of the Lords for another round of ammendments...

You're really suggesting that all laws presented to parliament should be perfectly crafted first time?
Where do you get that analysis and expertise without wider debate?

[[XAP]Bob]

As an aside, have you heard about the tube adverts promoting support for this legislation? If any of you have family involved in the rail sector you will know how bad it seems to promote the taking of your own life on the way in to catching the underground railway. A driver seeing the suicide victim will not be likely to work as a driver again. It is not good to have a link to a form of self determined premature death with rail travel IMHO.

Is this not a backfire on the campaigning organisation and TfL too? Sorry for this digression but it kind of shocked me.

No - I don't use the tube any more - partly because I don't live in London, and partly because as a wheelchair user it's pretty limited... though actually less bad than it used to be: https://content.tfl.gov.uk/step-free-tube-guide-map.pdf
That map is pretty dense with information, so until I've got some time to look at it properly it's pretty hard to know what journey I can make.

Compare that with Barcelona: "The entire Barcelona metro network is accessible except for some specific stations (12 out of a total of 165 stations)."

"Stations due to be adapted:
L1: Plaça de Sants, Espanya, Urquinaona and Clot
L3: Espanya
L4: Verdaguer, Urquinaona and Ciutadella-Vila Olímpica
L5: Virrei Amat, Maragall, Verdaguer and Plaça de Sants"

And they mean it - it was brilliant when I was there. Also make it easier for people with heavy luggage, or minor mobility impairments, or pushchairs etc. The signage all says "let a wheelchair user go ahead of you", and people always offered to do exactly that - I told a couple of them that I was quite happy to wait (after all I can sit down longer than someone not in a wheelchair can stand).


As for adverts, feels inappropriate in this context anywhere.

[axel_knutt]

It's not for anyone else to judge another's reason for choosing suicide right or wrong.

That's why I'm against it.
It's not the patient's decision, all the patient can ever do is make a request, then it's those with all the power and control over the system who make the decision.

My own concerns over the possibility of people choosing suicide for the wrong reasons are largely allayed by the limiting of assisted dying to people with little time left

Yes, and who's deciding that? Will they prosecute a doctor for saying a patient's got 6 months left if he could have lived a year? Of course they won't, he'll already be dead.

theory there can be "wrong" reasons for choosing suicide. For example, I am not comfortable with the idea of someone choosing suicide to avoid losing the family home to care costs.

It doesn't have to be financial, people can just be put under pressure to "do the right thing", and mostly with hardly a word being spoken. There was the guy at Gosport who was killed just for being "difficult", and now that'll be "legalised".

I'm still not really sure exactly what they'd be looking to determine.

Forged records perhaps.

[pwa]

I get the feeling that the bill will pass, and we will get a very limited access to assisted dying. At long last. And I welcome the fact that it is such a small step in that direction, rather than a bold lunge.

Once we have a couple of years of this provision I hope we will have another look at it, removing any glitches. But I am sure that when we have got used to having this option, there will be no going back. The idea that palliative care can always remove the suffering some have to endure for weeks is false. And to deny a swift end to someone in that situation is barbaric. If the Archbishop of Canterbury had joined us at my father's bedside in his final days and explained why we ought not to want a quick end, we'd have told him where to shove his prayers. We knew what we needed and it wasn't available.

[Carlton green]

I get the feeling that the bill will pass, and we will get a very limited access to assisted dying. At long last. And I welcome the fact that it is such a small step in that direction, rather than a bold lunge.

Once we have a couple of years of this provision I hope we will have another look at it, removing any glitches. But I am sure that when we have got used to having this option, there will be no going back. The idea that palliative care can always remove the suffering some have to endure for weeks is false. And to deny a swift end to someone in that situation is barbaric. If the Archbishop of Canterbury had joined us at my father's bedside in his final days and explained why we ought not to want a quick end, we'd have told him where to shove his prayers. We knew what we needed and it wasn't available.

^^ That seems the logical and more likely way forward to me, but we’ll have to see what happens if the bill is passed and then used. Having lost people close to me and seen their awful suffering the religious and perfectionist views of some seem cruel to me. To those people I’d suggest that they ‘walk a mile’ in the shoes of others to better understand the situation that they talk about. There are dangers in change and I think it right that the proposed change is small. Terminal care can be very good, but far too often - normally even - the terminally ill die with far from perfect care and have to be grateful for what care they can secure.

[djnotts]

^ "The idea that palliative care can always remove the suffering some have to endure for weeks is false. "

This. And I very much doubt that palliative provision will increase/improve.

However, I strongly suspect that as with so many "difficult" problems the issue will be kicked into the long grass with a "review" and "consultation".

[tim-b]

This bill is a small step in the right direction
It isn't perfect, not by a long way, but it's an option for some who don't currently have that choice

I don't think that the Courts need to be involved, doctors make decisions on patient choices all the time, e.g. Do Not Resuscitate, and it's another barrier. You could argue that it's time for the patient to think about that choice, but include further counselling rather than a court

Six months is quite arbitrary and excludes people with longer-term illnesses
I don't think that there's a good reason not to pass the bill, the safeguards seem to be pretty comprehensive, but it will need development with experience

[axel_knutt]

Was anyone listening to Leadbeater on the radio this morning?

"There won't be any creep because the law can't be changed"
So astonishing are they voting on this Friday if it's not a proposal to change the law?

"It's about giving people choice"
Society won't fund proper social care as it is, so where will the incentive be once there's a cheaper option?

To those people I’d suggest that they ‘walk a mile’ in the shoes of others to better understand the situation that they talk about.

My father took about 8 months to die, by which time he looked like an inmate from Belsen, but even now I've no idea what the prognosis was, and I'm not sure the doctors did either.

[Carlton green]

Was anyone listening to Leadbeater on the radio this morning?

"There won't be any creep because the law can't be changed"
So astonishing are they voting on this Friday if it's not a proposal to change the law?

"It's about giving people choice"
Society won't fund proper social care as it is, so where will the incentive be once there's a cheaper option?

To those people I’d suggest that they ‘walk a mile’ in the shoes of others to better understand the situation that they talk about.

My father took about 8 months to die, by which time he looked like an inmate from Belsen, but even now I've no idea what the prognosis was, and I'm not sure the doctors did either.

You have my sympathy, you are one of those that have walked the mile and I respect you for that.

You’re also right in that it is a slippery slope and that incentives to improve care - which many would say have proved ineffective - now seem to be diminished; it’s all far from an ideal situation and so pragmatic choices are made. We’ll have to see how things actually turn out.

[Tangled Metal]

Sorry, you are proposing an amendment to the legislation before it is in place? Is that not a flawed method of writing legislation? Write it wrong knowingly then re-write it afterwards? I hope the Lords, for all the times it gets criticism, will re-write it before it passes (assuming it gets through the phases in the HoC first).

It's how laws are made, they have readings, ammendments as a result of those readings and then they bounce of the Lords for another round of ammendments...

You're really suggesting that all laws presented to parliament should be perfectly crafted first time?
Where do you get that analysis and expertise without wider debate?

I would hope that laws passing through parliament are close to being adequate with significant improvements being carried out parliament time first time around, such as during the scrutiny and amendment stage in the HoL. IMHO such a significant revision would be post assistance ./ event scutiny. That is my opinion that Coroner or other post event review should be there. The judge and doctors review pre assistance but then the assistance happens which is a significant part of the process I feel a need for post event scutiny. Was the waiting period carried out? Were the right medication and amount of it provided? Was it managed as required. Was there any negligence in how it was carried out? Even the pre stages could be double checked as they could end up being flawed in practise. There was a case in USA where an assisted death took 6 days of pain to achieve the death. If all the pre event procedures were applied before permission was given and this happened then I would hope that the coroner or other official post event review could investigate and any improvements needed be applied based on expert finding on what happened.

I guess that I can not get around the fact that this is essentially assisted suicide with state/medical/judicial involvement. Perhaps my cynical nature means I do not trust any of those three on their own word.

[Carlton green]

I guess that I can not get around the fact that this is essentially assisted suicide with state/medical/judicial involvement. Perhaps my cynical nature means I do not trust any of those three on their own word.

I rather think that you’re confusing the choice of ending life before near to certain death with suicide. Suicide is a choice between continuing to live for as long as one’s good health allows, etc. and dying, whereas assisting someone to die slightly earlier merely moves forward the date of an otherwise imminent and unavoidable death. In such assisted circumstances there is no suicide because ‘nature’ has already taken away the choice to (continue to) live.

Are the state, medical profession and judiciary to be trusted? Well it’s rather a case of Hobson’s choice, and whilst I’m pretty sure none of them are perfect let’s be glad of the relative excellence that we have.

[Tangled Metal]

I guess that I can not get around the fact that this is essentially assisted suicide with state/medical/judicial involvement. Perhaps my cynical nature means I do not trust any of those three on their own word.

I rather think that you’re confusing the choice of ending life before near to certain death with suicide. Suicide is a choice between continuing to live for as long as one’s good health allows, etc. and dying, whereas assisting someone to die slightly earlier merely moves forward the date of an otherwise imminent and unavoidable death. In such assisted circumstances there is no suicide because ‘nature’ has already taken away the choice to (continue to) live.

Are the state, medical profession and judiciary to be trusted? Well it’s rather a case of Hobson’s choice, and whilst I’m pretty sure none of them are perfect let’s be glad of the relative excellence that we have.

One is ending life due to it being unbearsble due to terminal condition and the other is ending life due to it being unbearable to them for some other reason. It still ends up with a personal choice to end a life before it happens without choice whether naturally or unnaturally (such as car accident). A difference but not much of one IMHO. It is still down to the individual to choose. It is just as correct to describe them as asssisted and unassisted suicide. That is what it is the act of killing onseself intentionally.

[pwa]

Assisting someone to commit suicide when they don't have a terminal illness in its final stages is illegal and will remain so. For good reason.

But assisting someone to take their own life when they are already in their final weeks, but want to avoid a drawn out process, is something I would take part in myself as an act of kindness. It is just speeding up the inevitable.

I was listening on the radio, yesterday, to a Californian nurse describing her work helping terminally I'll people to die. She spoke of having just given a very elderly patient a fatal dose for her to drink. Within minutes she was drowsy, then unconscious, then dead. The nurse described it as a calm ending. Given a choice, I would rather have that than a month or two of discomfort and drugs, with inevitable decline and death anyway.

[djnotts]

^pwa: "The nurse described it as a calm ending. Given a choice, I would rather have that than a month or two of discomfort and drugs, with inevitable decline and death anyway."

+1. And it's often well beyond "discomfort". I am becoming increasingly pessimistic about the legislation passing even the imminent first stage. The cost implications are being brought front stage - it will adversely impact other NHS functions. No doubt MPs can see the headlines, "helping old people to die a bit early while not treating young cancer patients...." And the terminally ill ain't gonna vote....