Our world has changed forever - assisted dying bill

It's a total fallacy to think that all pain is controlled by medication, that's not even to mention the other indignities people can, and do, suffer.

I've seen and heard a parent and in law spend weeks in terrible agony despite medication and would not wish that on anyone. Seeing loved ones in that much pain and anguish has long lasting effects on those left behind. Decades ago the trusted family GP would know when the pain had become intolerable and administer a lethal dose of morphine but that all came under scrutiny after Dr Shipman. I'm very glad about the decision. We all die and this gives us choices.

Gentle Shores, I wonder why you and others like yourself don't understand that the choice is yours at all times. Nobody wants to euthanise you!

Gentle Shores, if you choose a swallowed medication to euthanise yourself you will get an initial medication that stops you feeling nauseated or vomiting.

PS you choose to suffer painful deaths may continue to choose to do so, but my choice is my own business. Thank goodness this has now been recognised in law!

FriedGreenTomatoes2

^If only it were possible to sign a waiver that allowed a doctor (or whoever) to administer the dose of an opiate that would - t least - deaden the intensity of the pain... I'd take a chance on it killing me days or a week ahead of when I would die anyway^

This is EXACTLY what my husband said this evening Dickens. “By that time addiction won’t be a consideration anyway”.

I believe that sort of thing happens with good palliative care anyway. Morphine is the usual pain relief. The dose is balanced between avoiding you being unconscious and having some sort of daily life - and the patient has a say in how much pain they will tolerate to have a daily life or whether they'd rather be more semi conscious and more pain relief. If morphine needs to be increased, it is increased and it does speed up death.

My Mother had hospice care at home. She was given a pack of things needed and had District nurses as well. She was on Oromorph which she managed herself. She was active up to the last couple of weeks of her life then basically fell off a cliff edge and was barely conscious and needing carers four times a day and a special bed. The hospice staff would come out if called - even in the middle of the night.

She was on stronger pain relief the last couple of weeks - and had no pain. She had no pain when she was on the Oromorph - and it was a nasty cancer. I know cancers vary but for her she wanted to keep up as normal a life at home as possible until it was no longer possible.

That to me is good palliative care. She refused to go into a hospice and insisted on staying at home. She didn't want to die, she wanted to live.

People in hospital don't always get good palliative care. We need more hospices and they need to be regulated. That is assisted dying in my view - keeping someone in control and virtually pain free until they accept they need something stronger that means they'll be virtually unconscious most of the time.

I'm concerned about the drugs used with this official self dying thing. One of the MP's today said the drugs can make them vomit and then are not effective. I don't think it's as simple as just going to sleep and not necessarily quick either.

Hospice care is very good. Now , pain relief can be strong enough to stop any agonising pain . The side effect of adequate pain relief is sometimes death sooner rather than later. There is every indication that best hospice care can now include adequate pain relief when the patient chooses to take the medication.

My 'Living Will' says I want adequate pain relief even if sufficient medication to stop the pain kills me.

I will maintain my monthly DD to Dignity(in Dying) .

HowVeryDareYou2

I was a care worker for 20+ years, and I saw MANY people who had terrible pain, also LOTS of patients with MS and MD - unable to speak, swallow, move their limbs, who were bedridden, obviously doubly incontinent, and PEG fed. I know they had awful, drawn-out suffering for years. Those particular people certainly would have preferred a peaceful death.

....and we must not forget the mental toll on those who can only "sit and watch" whilst someone is suffering like that - eg yourself.

That must have felt very harsh for you to witness even...wanting to help and knowing there was little you could do.

Fleurpepper

One of the leading activists of Dignity in Dying, Alex Pandolfo, was diagnosed with a form of Alzheimer's 10 years ago. He considered committing suicide, because he had seen the devastation the disease caused for his parents. But he then found about LifeCircle (now Pegasos) in Switzerland and went to visit them and got the 'green light' as he calls it. And he says it saved his life- because he knows that he will have the choice, before the disease gets too bad. 10 years later, he is still doing well. Some forms of memory loss, but fully compos mentis.

His true dilemma is, 10 years later, to know when to make the decision, as he can't wait until he can no longer demonstrate that he has capacity to decide, clearly- despite having his case approved. His other dilemma is about his partner- he doesn't want her to accompany him, for fear she would be prosecuted and treated like a criminal. If so, I will be there with and for him, as promised.

I agree. I find with pain that, you can bear it if you think there’s an end to it. Knowing that your illness is hurting you, but that you can stop that pain if it gets too much would help you to cope with it ( I think, anyway). What I don’t understand is why hospices are charities when they are so necessary.

One of the leading activists of Dignity in Dying, Alex Pandolfo, was diagnosed with a form of Alzheimer's 10 years ago. He considered committing suicide, because he had seen the devastation the disease caused for his parents. But he then found about LifeCircle (now Pegasos) in Switzerland and went to visit them and got the 'green light' as he calls it. And he says it saved his life- because he knows that he will have the choice, before the disease gets too bad. 10 years later, he is still doing well. Some forms of memory loss, but fully compos mentis.

His true dilemma is, 10 years later, to know when to make the decision, as he can't wait until he can no longer demonstrate that he has capacity to decide, clearly- despite having his case approved. His other dilemma is about his partner- he doesn't want her to accompany him, for fear she would be prosecuted and treated like a criminal. If so, I will be there with and for him, as promised.

Thanks, Fleurpepper
It helps to know these things.

MissAdventure

What if the terminal illness impacts on your mind, though?

It depends how it affects the mind. If the person is not totally compos mentis at the time of request and on the day chosen, then they will be denied. And of course, a request will not be 'enforceable' at all- if the person decides not to go ahead and take the drink or activate the drip, then it won't happen.

If only it were possible to sign a waiver that allowed a doctor (or whoever) to administer the dose of an opiate that would - t least - deaden the intensity of the pain... I'd take a chance on it killing me days or a week ahead of when I would die anyway

This is EXACTLY what my husband said this evening Dickens. “By that time addiction won’t be a consideration anyway”.

I always thought that a lot of the residents were depressed, unsurprisingly.
To me it is blatantly obvious that moving into a new, very different home, after what may have been a period of upheaval is going to take some adjustment.

It's all concerning, when you think of the myriad of circumstances people end up in.

I think the choice aspect is complex. Already care homes are notoriously bad at psychological needs and diagnosing depression - mainly because they don't have Doctors around like hospices do, and also because they are based on dealing with practicalities of care. It's well known that depressed people often choose to die, but if their depression is treated their outlook changes.

It's like saying - there is no hope.

I saw that, too.

Not whilst at work, but someone dying in agony because his catheter was blocked, and the nurse took hours and hours to arrive.

Enough to know that hospice care, home care, and palliative care can fall far short of addressing people's needs.

I was a care worker for 20+ years, and I saw MANY people who had terrible pain, also LOTS of patients with MS and MD - unable to speak, swallow, move their limbs, who were bedridden, obviously doubly incontinent, and PEG fed. I know they had awful, drawn-out suffering for years. Those particular people certainly would have preferred a peaceful death.

This oft quoted 'people will have a choice' only applies to a very select narrow group of people. You can be in awful pain for years without being terminal within 6 months, and these people aren't covered by the bill. Does anybody really believe there won't be calls for the scope to be widened, to not disadvantage this group before moving onto other groups? When there is this 'opt out' from pain and suffering what incentive is there to invest huge amounts into research for better pain relief and palliative care?

I'm still on the fence about it, but, as someone said, that's democracy.

Personally - I'm glad to see this has passed - though it sounds like a rather prolonged/cumbersome process involved to implement it if someone has chosen to.

As a lot of people have said - it needed to be passed - because otherwise there's income (and knowledge) apartheid going on. That being if one can afford £15,000 (to go to Switzerland) then you can get it. There's knowledge apartheid too (if you know how to do so personally should need arise - then a few £s and a few hours later and you've achieved the same objective).

But those who have neither the savings or the personal knowledge on this - why should they be left to struggle - when others of us (including me) can take another route and implement our own decision personally if it comes to it? I quite agree that if we can if we need to - then others without the money or the knowledge should also be able to if they need to.

What if the terminal illness impacts on your mind, though?

Misadventure - surely a change of mind would be respected, or a postponement? As the treatment has to be self-administered, control is always with the individual to change their mind at the last minute.
The new criminal offence of pressuring someone to end their life carries maximum sentence of 14 years,so it gives a vulnerable person some power over their abuser as they can threaten to report them if they raise the subject again.

gentleshores the case in Canada was a single employee who had apparently offered this to a few different people - which is pretty shocking.

However they have subsequently been referred to the police.

It was obviously in response to contact from the paralympian - who had been liaising with them for 5 years for a ramp! Obviously we don't know what was said by her to the agency (she may l have raised it herself by describing her situation as desperate for example), but it has been picked up and is thankfully being dealt with.

She sounds pretty cross but don't forget we don't know the whole story and haven't had sight of any correspondence.

Witzend

A friend of ours suffered dreadful pain from prostate cancer that had spread to his spine. He could apparently not be given sufficient morphine to control it, because an adequate dose was likely to be lethal. This was in Australia BTW.
It was beyond cruel.

And that is why, very often I believe, the pain from (as in your illustration) terminal cancer cannot be controlled.

Because the dose required to - at least mitigate the intensity of the pain - could be lethal. Or "addictive".

The doctor has to record the amount of drug administered, thus he cannot overdose, or he will be in trouble.

I think that is what some of us fear. Having watched my great grandmother writhing and contorting in her bed in pain, begging for release, I discovered I have had the same cancer that killed her. Times have changed obviously and so have treatments and I am now 11 years clear. However, there is no guarantee that it will not come back at some point.

I do not want to die like my great-grandmother. If only it were possible to sign a waiver that allowed a doctor (or whoever) to administer the dose of an opiate that would - t least - deaden the intensity of the pain... I'd take a chance on it killing me days or a week ahead of when I would die anyway.

MissInterpreted

gentleshores

I know people have different views though. But when I was a child it was a Christian country and this would never have been considered the right thing. Different people have different beliefs - moral and religious. I will be looking into a living will quite carefully as it scares me. It's bad enough when people ignore you or treat you as brainless and look over you just because you're disabled.

But people will have the choice - that's the whole point. If it conflicts with someone's moral or religious views, that's fine - but why should those views hold sway over those who don't hold the same views?

Totally agree with you there MissInterpreted.
The UK is a mostly secular society now.