Our world has changed forever - assisted dying bill

gentleshores

The timing seems wrong to me. There are still really long waiting lists for people, getting worse, because they can't get treatment. So there are more people needing assisted dying, simply because they can't get the care and treatment needed.

I've already felt thrown on the scrap heap at 66 after trying to get treatment for over two and a half years. And still in the system. This has now left me hardly able to walk and needing a mobility scooter and various knock on effects. So that when I go to A&E I am now assessed as "very frail". I am only "very frail" because I need treatment to get fit again. I do not want a DNR thank you.

I do not want a DNR thank you.

It's not a DNR, but make sure that your next-of-kin is aware that the medical staff can put DNR on your records without their knowledge when you are practically in a coma, as we well know.

My understanding is this bill doesn’t apply to children. Currently, the legislation covers children. There have been some heart breaking differences between medics and parents about the costs and benefits of treatments .

This is not a ruling to get rid of elderly. It is about suffering and moving on gracefully. This is a legal option for those who want to end their suffering, not for those who don't want to end their suffering. It's a choice - not for family but for the person ailing. If you don't wanty the option, write that in your last legal documents now.

I know it covers physical suffering but what about mental suffering? How does it cover terminally ill children or is that not included in this bill?

gentleshores

France passed an assisted dying law this year but it "stopped short of euthanasia" and stopped short of Doctors actively giving something.

This is the new French Law

"Under the new law, terminally ill but conscious patients may refuse treatment to prolong their lives. Seriously disabled patients who are not terminally ill may also request an end to treatment. Palliative treatment must continue, however, and the doctor may give increasingly strong doses of painkillers, even if it risks shortening the patient's life."

pmc.ncbi.nlm.nih.gov/articles/PMC534833/

gentleshores

... Palliative treatment must continue, however, and the doctor may give increasingly strong doses of painkillers, even if it risks shortening the patient's life."

When you consider that people's pain-thresholds vary, is there really any 'safe' dose of an opiate - especially if the patient's body systems are gradually breaking-down due to a terminal condition?

I once accidentally took an extra dose - 10mg - of a prescription opiate (I'd forgotten that I'd already taken it). I called 111 to ask for advice (having heeded all the warnings on the package leaflet). A doctor called me back and almost laughed at my concern - "oh, you might feel a bit woozy, but that's all, don't worry, it's a very low dose" (he said).

... yeah, right. I was flat out of it for nearly 4 hours.

Fast-forward, I'm now on 15mg a day for pain - and it doesn't even touch the sides.

How does a doctor actually know what is the correct dose in any given situation?

When I was hospitalised for the surgery that actually caused the pain I now suffer - they just titrated according to my response...

I hope I end up with a doctor who does the same during my final hours.

gentleshores

There's a brilliant documentary here by Liz Carr. It does show both sides of the views but also shows the concerns of how it has become a slippery slope in Canada with it being societal and unsafe for people with mental health or in poverty.

The Uk bill is just for terminal illness - and if it stays that way it is not a bad thing. But something Liz Carr said in an interview, is that the problem is, once it becomes law, the discrimination act kicks in and the reasons for assisted death become wider and wider as people can sue for discrimination.

It's well worth a watch as she's quite funny at times as well.

www.bbc.co.uk/iplayer/episode/m001z8wc/better-off-dead

Yes. I’ve often posted about this documentary but have had no feed back from those who support the Bill.
In Canada it’s not so much a “slippery slope” as “over the cliff” IMO.

The timing seems wrong to me. There are still really long waiting lists for people, getting worse, because they can't get treatment. So there are more people needing assisted dying, simply because they can't get the care and treatment needed.

I've already felt thrown on the scrap heap at 66 after trying to get treatment for over two and a half years. And still in the system. This has now left me hardly able to walk and needing a mobility scooter and various knock on effects. So that when I go to A&E I am now assessed as "very frail". I am only "very frail" because I need treatment to get fit again. I do not want a DNR thank you.

I’m relieved the vote was to support the bill to the next stage. I wish our parliamentarians would conduct business with such thoughtful, calm discussions more often.
My experience of end of life care for my husband, family and close friends has reassured me. In each case the care has been good, including care of family.we have been listened to and our wishes about no further intervention respected.
I have done LPA, my adult children know my wishes. I will get on with my DNR next

I feel pretty much like you do gentleshores, It is difficult because I also don't want anyone to suffer an undignified and painful death, but worry about the so called "slippery slope"

There's a brilliant documentary here by Liz Carr. It does show both sides of the views but also shows the concerns of how it has become a slippery slope in Canada with it being societal and unsafe for people with mental health or in poverty.

The Uk bill is just for terminal illness - and if it stays that way it is not a bad thing. But something Liz Carr said in an interview, is that the problem is, once it becomes law, the discrimination act kicks in and the reasons for assisted death become wider and wider as people can sue for discrimination.

It's well worth a watch as she's quite funny at times as well.

www.bbc.co.uk/iplayer/episode/m001z8wc/better-off-dead

Are you joking. The comparisons to Nazis on any subject are thrown around like confetti, way too late to complain about that now.
Crikey 'far right' is basically now short hand for someone I dont agree with. It is a term that I ignore whether it is invoked on discussion of Israel, gender or immigration.

I and my children had to watch my husband die in absolute agony earlier this year.Nobody should have to endure this amount of pain& loss of dignity.We shall never forget the horror of these last days of someone we loved dearly have to end his life like that.If he could have had the choice of assisted dying he would have chosen to be allowed to die with dignity.

Aren't you in Australia nanna8 , where assisted dying is already legal? Have you all gone to hell in a handcart?

HousePlantQueen

nanna8

Going to hell in a handcart comes to mind on hearing this news. Visions of relatives seeking money, visions of doctors made complicit in murder, visions of the third reich.

good grief. I think perhaps you need to read the details of what has been proposed and passed. Your comment about the 'third reich' is particularly distasteful.

What an absolutely appaling statement nanna8- truly- I can't even begin to reply to such wantom, horrible, whataboutery.

FriedGreenTomatoes- we rarely agree, I believe. But thanks for having the grace to say that we do, on this occasion.

As for 'do no harm' - I'd say that letting someone suffer intolerably, begging to be released, knowing the end is not far- IS DOING HARM.

I don't mean to knock Doctors. There are some amazing, good and committed ones. But as in all professions there are some that aren't. Another aspect of this is the psychological effect on Doctors who swear an oath to "do no harm". If our Doctors are stressed by it - we need them in good mental health to treat us.

Just because the bill gives a 6 months period to an expected death doesn't mean that the individual has to make the decision there and then.

There have been several examples of people given 6 months to live who have lived longer. Surely it is up to the patient to decide when and if to ask for the necessary medication?

A friend of ours died from Motor Neurons two years ago. It was not good watching this previously lively, intelligent man deteriorate. In what turned out to be his last week he saw the consultant who offered more treatment which was refused. He returned home, refused food and died some time later. I'm not sure how long he lived but it was not a long process. Nor do I know whether, if he had the opportunity to take his own life he would have done so. But he would have liked the choice.

Apologies - it was fees for cremation certificates not death certificates - but I always thought it unseemingly that when someone in hospital died, a Doctor was trying to get a decision about whether they wanted cremating or not - so they could sign for it and get the fee. Currently £82 I think.

eazybee

At least the news of the result of the vote was received in sombre silence in the Chamber, unlike the group of middle-aged women identifying as supporters by unattractive woolly hats, capering about cheering and shouting.
Unseemly.

I agree, it was rather distasteful, given the subject matter

FriedGreenTomatoes2

Thank you Fleurpepper for your wise words and sharing your knowledge on this emotive subject. My husband and myself agree with you totally.

As do I.

While I appreciate that this is a very emotive and personal subject, I do feel the debate has not been helped by some against the bill who have used emotive, and incorrect terminology, such as an MP (on the news) saying that this would 'allow Doctors to kill you'

I don't believe Sweeting or any other Health Secretary will ever provide palliative care at the best standard on the scale actually required.

From what I understand there's quite a long way to go before this is law. There are several points still to be discussed - how is a very disabled person meant to administer the dose themselves; if two doctors and a Judge have to agree, who is to say that any of them can really know the patient well enough to make a decision and (this bothers me the most) why does it have to be an arbitrary 6 months? Surely it's worse to get a prognosis of years and to live out those years in distress than to 'only' have 6 months to go?

From a personal perspective, my mother lived out the final 2 years of her life in very clear acute distress with dementia. She was by turns distraught and terrified. However, she was profoundly deaf and couldn't communicate effectively and, most certainly did not have the capacity to make decisions, due to her dementia. I know she was in mental pain; I could see it in her eyes and hear it in her screams. Where would she have fitted into this?

As I said, my understanding is that there are points still to be discussed, hopefully including those I've mentioned. There are most likely others.

Yes, Dickens - I thought that myself about the "right" and "left" voting together!
It's interesting, but not surprising, that the "middle ground" is more in accord with the "public view".

Regarding the French decision that the doctor may give increasingly strong doses of painkillers, even if it risks shortening the patient's life I think that's what we have already (in reality).
My mother's death was quiet and at home. I was half asleep on the floor by her bed and she just slipped away.
Her GP gave her one dose of morphine (not sure of the "brand") and left me the bottle. He said to offer more "if she needed it" but, in not exactly these words, warned me that in helping her it may be easy to overdose.
She didn't need any more.
It was many years ago and I expect he couldn't just leave a bottle with someone's daughter these days.

What a pejorative comment eazybee. Perhaps those middle-aged women in unattractive woolly hats had seen friends/relatives die in pain and suffering. If they wanted to express their happiness, why on earth not.

France passed an assisted dying law this year but it "stopped short of euthanasia" and stopped short of Doctors actively giving something.

This is the new French Law

"Under the new law, terminally ill but conscious patients may refuse treatment to prolong their lives. Seriously disabled patients who are not terminally ill may also request an end to treatment. Palliative treatment must continue, however, and the doctor may give increasingly strong doses of painkillers, even if it risks shortening the patient's life."

pmc.ncbi.nlm.nih.gov/articles/PMC534833/

Dickens

gentleshores

It does concern me that it is indeed economic. The same day as this bill was passed, the bill to fund hospice care for children was turned down.

I have a vision of less treatment options being available - why care for you when they can just let you opt to die instead.

Funding good end of life care and hospices would cost a fortune. If people die it's less strain on the NHS.

While I accept some people like the option and feel it gives them choice, I think it could lead to laziness in caring and charities taking the strain.

I have visions of it being a new vocabulary - another option offered - like the annual flu jab. I hope no medical person ever offers me that option - if there are alternatives that could help me. Just because it would cost too much.

I don't really trust Doctors either that much, certainly don't trust policitians or most care homes.

It may be the right thing for some people but it does seem a convenient money saving exercise.

I rather fear we've crossed the Rubicon as far as state funding for healthcare is concerned.

As long as we operate under the small-state economic model there will be huge gaps in the availability of end-of-life care and it will continue to be something of a lottery for tens of thousands of people who do not have the funds to engage private-care. Not knowing whether you will be one of the unlucky ones is enough to make anyone consider the option that this bill might make available.

Norway - which I've mentioned previously - appears to be able to manage both a robust market-economy and well-funded health and welfare services (I lived and worked there for 12 years).

But then, Norway does invest in its people, in their welfare - because they are the key to a continuing successful economy.

The North Sea oil boom of the 80s created mammoth revenues for the UK and Norway. Basically Norway invested theirs for the benefit of everyone whilst we plundered ours to bankroll unemployment, the destruction of manufacturing and the 'big-bang'.

So here we are, with a totally different mind-set. We've fallen for the big-money-trick and believe "there isn't enough money" to fund the services that a huge swathe of the population rely on (or would, if they could).

Against this backdrop, like others, I too am uncomfortable with the decision on AD. Though in principle I also believe that each individual has the right to choose the manner of their 'passing'.

Difficult, isn't it?

Thank you for two excellent posts looking at the wider picture.

It is difficult. The way I see it is, we are looking at the topic of assisted dying "as things stand at the monent" - ie the way the world is at the moment.

But my thoughts are that if this bill becomes legal "as things stand at the moment" will change. Not sure I'm explaining that well. A shift in treatment options (or lack of them).

Until this bill, everything was about research, trying to find treatments (some of which are there but not available on the NHS and cost a fortune), donating to cancer charities for research, opting for cancer treatment trials (free treatment) some of which have been very successful - especially for pancreatic cancer.

Everything has been about care, cure and options for improvement of quality of life.

Hospice and palliative care includes education and talking to people. Someone mentioned earlier about relatives saying please don't die. Good nursing teaches relatives to understand that the dying person needs permission to go. They actually do have some control - when to give up and go and when to keep fighting.

I know that is very general and doesn't apply to some of the awful sad stories of people screaming and wanting to be put out of their misery. I am assuming most of those cases are in hospital and not with hospice care. I don't think hospital is the best place for palliative care.

There is a soul element to all this - about caring for the emotions, feelings and soul of the dying person and their relatives, in a time that is quite clinical sometimes. About dealing with the fears.

To me another aspect of dying is about freedom from fear and distress. Now I know that's an argument for taking a potion - feeling in control. But what if the person just wants the pain to stop and not to actually die and feels distress at the idea that the only solution offered is to take something to die?

People are all different. So my concern is - not enough other options will be available.

Will people bother to keep donating to cancer charities if they know they can just end it? Will the current end of life care become deprecated because everyone thinks there is that easier option?

If the world changes so what we know now, is no longer the same, then the idea of AD becomes prominent - one of the only options perhaps.

I know I'm not explaining that well, and I'm trying to think of an example or analogy.

How about. Travel to another planet becomes normal and affordable - there are regular flights and people can go for holidays and even extended periods of time - and they enjoy it. Part of that enjoyment is knowing that they can always go back and the world will be the same as when the left it. But if so many people do it, the world left behind changes because lifestyles have changed and when they come back they see that they were part of that world that no longer exists - because so many people went to a different world.

Still not a good example!

I do see the principle that for some people this might be a blessing. I am not keen on the idea of Doctors having to agree to this way of doing it. Many Doctors will opt out (they are allowed to conscientiously object). So it will be a case of Doctor shopping perhaps.

I hope there aren't benefits offered to Doctors. For example Doctors get a fee for signing death certificates (or did when I was nursing) and it was always unpleasant seeing some Doctors wanting to be the ones who were the ones involved with the death so they could be the one to sign the death certificate. After quite a few death certificates, it was a good sized fee.

NotSpaghetti

This is an interesting post from Peston:

It talks specifically about the vote, who voted what and what happens next:

x.com/Peston/status/1862529688687518153?t=T879IJFJyzKdcu6yWnhtag&s=19

The overwhelming majority of the shrunken new parliamentary Tory party, led by Kemi Badenoch, voted against. And they included Badenoch. Farage voted against. Corbyn and most of the Corbynista left voted against, whether still in the Labour Party or ejected (John McDonnell was an exception).

It's not often that the Right and Left are in unison, is it?

Of course, it's for different reasons, and that's the point.