Here we go (sooner rather than later) again.

Well personally if I’m ‘at the end’ (whenever that is) I don’t want to be officiously kept going by more and more drugs. I made the hard decision to have a beloved pet euphanased recently and I’d like that option myself when the time comes.

Re his second point: nurses do need a pay rise and we do need more hospital beds and modern equipment. I’d hope that a NI rise would be sufficient to improve pay, conditions and give us a better service, so don’t agree on that point.

Must say I agree that in some cases people are kept alive even though they have no quality of life. I certainly don't want to be kept going just to spend my days sat in an armchair staring at the same four walls. And if I have a serious long term illness that prevents a normal life I don't want to be pumped full of who knows what just to give me another year.

Yes pay should be increased but I think there is so much money wasted by the present system, I'm sure a lot could be done to save money, maybe that could also go to fund wages for nurses.
There does always seems to be building, refurbishing or decorating going on when you go to a hospital these days.

I'd vote for that. When I'm in my dotage, if it came between the cost of drugs for me or a much younger person...no contest in my opinion

Controversial, and will no doubt be misquoted in the press, but I can't help thinking he does have a point. The comment about hundreds and thousands of pounds is unlikely to be correct though; we keep reading of younger people being refused funding for an expensive cancer treatment due to cost. This is a very difficult moral question, and should not just be about cost, each case is different, this needs to be discussed with the family concerned about the likely outcome of the treatment. Personally, I would rather have a year of relative comfort than 18 months of pain and indignity and uncomfortable drugs and procedures, but I have never been in this position so should not really comment I suppose. He is a brave man to say this and will likely be pilloried for it.

It sounds simple doesn't it; if you have had a long life are now ill and a drug can give you a few months further life (at what quality?) most of us would say (have said) 'So what, if the drug is not given.

But decisions like that are easy. My fit and healthy 92 year old DF, still active in the running of several community groups, developed a heart problem. The surgeons advised a keyhole surgery operation. It had a very high success rate, was designed for older people like DF. The surgeon said he would be back to normal and, in his overall state of health, could live another 5 years, possibly more and continue making a contribution to his local community. But the operation was expensive (£25,000). How soon before the cost of operations like that are excluded, then expensive drugs when they are needed beyond a certain age. It is a slippery slope.

""Personally, I would rather have a year of relative comfort than 18 months of pain and indignity and uncomfortable drugs and procedures, ""

I would agree with this. Having seen my dear sis in law being discovered to have a stage 4 cancer and the dreadful suffering that the treatment brought. She had very few good times in order to have some extended time.

As long as I had enough time to spend a little special quality time with those who live far away, and to say my goodbyes while relatively 'well'. Then hopefully go quickly and quietly.

That is me speaking as someone who has some health issues but not cancer. If such a time came for me it might be that I'd be of a different mind and looking for treatment to give me a few extra months. Of course, sometimes it's more than months.

But at present, my feelings are, let me go with dignity.

A very debatable question and one most people may find utterly distasteful.

My dear friend had parents living happily together in Sheltered housing.....both in their early 90`s.
They had lived a happy productive life and were surrounded and supported by loving family members.

The husband fell and died almost immediately last November.

The wife totally refused to accept his death and from a happy little lady she became completely changed virtually
overnight and her one wish was to die to be with her husband.
Since then she has been Hospitalised on numerous occasions,has been put into several differing Care Homes,has been a patient in a Mental Hospital .......the amount of Medics and medicines she has been given are quite ridiculous.
She has become violent,she lies,she repeats she does no longer want to live and the last few weeks has had to have her daughter at her side even in a Care Home......simply to ensure her safety as she tries breaking out of any wheelchair,climbs out of bed despite handrails,............although now being extremely frail and unable to walk even with an aid.
She refiuses to get out of bed each day, refuses to eat or drink...........despite continued Urine infections.
The cost of keeping her alive must be enormous.

She is a lady whom has lived a great life and now in her 90`s her one overriding request is to die.

Do you think these lengths to keep her alive should be taken,although costing the earth............when her one wish is to die to be alongside her husband?

It is when faced with dilemnas such as this, one seriously wonders exactly what steps should and could be justified?
The country and its attitude to such extreme cases are changing,but are we ready to accept these changes???

IMO it’s a pity that MPs aren’t taking this opportunity of talk about NHS funding to open a proper national debate about euthanasia.
So many care homes full of people who have said they would rather die than enter a care home; so many care homes and agencies only able to offer an indifferent service because they can’t recruit staff; so many people with terminal illnesses terrified of a slow and painful death.
There are difficulties; safeguards would obvs be needed. The medical profession may think it isn’t its role to start this debate, but if so shouldn’t that view be challenged, or whose role is it?

That is an extreme case Panache but does illustrate the point. We should not strive, officiously to keep alive. Just because it can be done does not mean it should be done.
I agree with Coolgran let me go with dignity. I would not want to be kept alive at any cost, quality is more important than quantity now I am older.

But what happens when quality of life is good, and can be again but only after an expensive operation?

M0nica as the Bard says, ay, there’s the rub.

Many people will say they wouldn’t like to have heroic measures taken in their end of life care.

But what about their cancer diagnosis at 67, or their broken hip at 69? “So sorry, too spendy, take two paracetamol”

Many folk are vocally in favour of “don’t treat X group on the NHS!!”

....until X group turns out to be themselves.

I think he makes a very good point.If expensive drugs that can only keep a person going for a few extra months are given ( in many, many cases) at a great cost to the NHS , then it isn’t worth doing.Remember this isn’t for just one person but thousands.
If expensive drugs will allow a few years where the patient could be improved and have a reasonably good quality of life, then it is worth doing.

Yes, of course, fully agree with that. The other side of the coin is the definition of quality of life. Physical circs that may be perfectly tolerable with reasonable financial means and family nearby can be unendurable for a person with very little money and family at a distance, or no family. This appears to be too fraught with difficulty for professionals to discuss.

Some of the new drugs can give people a very good quality of life which they would not otherwise have had.

Has anyone on here received any of these drugs?
They may think differently if they have.

Two points here.
The first is David Davies’ definition of ‘elderly’. Whilst I certainly do not want to go gently into that dark night at 70, I might be more amenable to the idea at 90.

The second is that NICE already have a rationing system - drugs and treatments are approved depending on the cost per QALY(quality adjusted life year). And apparently the threshold for end of life drugs has just been raised.
Whichever government is in power, NHS funds are limited and hard decisions have to be made about spending priorities. I think more open debate is a good thing.

^ I'm speechless......^
*Well, I'm not Granny23
I have written to him.

Good points JaneA

Having read your responses and gathered my thoughts, I see that many of us would prefer a quick, pain free end at a time of our choosing, rather than being kept alive at all costs. I therefore think that any discussion or change in protocols must also address the issue of voluntary euthanasia.

My second thought is that discussions should be informed by the views of ordinary people i.e. NHS 'Customers'. I strongly object to decisions about the NHS being made by those who have Private Medical Insurance or can easily fund their own and their family's care.

I’m not sure that simply being a service user, ie patient, qualifies someone to make decisions about spending priorities within the NHS, G23.
And disqualifying someone because they have private medical insurance seems illogical. Why not disqualify non-taxpayers as well, while you’re at it?
NICE have an extremely difficult job to do.
My understanding is that they do have input into their decision-making processes from clinicians in the relevant disciplines. They would seem to me to be the people who should be involved in policy decisions.
As far as individual patients go, doctors do try as far as possible to involve them and their families in treatment planning options and individual preferences taken into account wherever possible.

We have recent made our powers of attorney for both health and finances.
When I asked my niece, a medic, if we really needed to do the health one, as we have already made our wishes clear to our children, she said yes.
If you haven’t got one then the medics will listen politely and compassionately to their (your) wishes and then do what they think won’t end up with them being sued.

Good point Pamela

It depends on the cut off date for ‘elderly’. In principle I agree with noy giving them to anyone over 80 but there will always be exceptional circumstances.
Eg. if a person has overseas relatives it would be nice to keep them alive so that they can come and see them one last time.
On the other hand, there are much younger people. perhaps with Alzheimers, or in a semi conscious state etc, who should be suported to remain alive but maybe not given drugs to artificially prolong life.
What if a person and/or their family were willing to pay for the cost of the drugs themselves? Should that be allowed if the person is being supported to live by the NHS or by council funds in a care home?

Rationing already exists. Some cancer drugs for example, are not available on the NHS as the cost is said to outweigh the benefits. I think it’s one thing to agree you won’t want a few months more if you are ill and very aged, but much as there are concerns about euthanasia being a slippery slope, I think that would also apply here - how old is enough, is it all treatment etc. I don’t disagree with a rise in NI in principle, but huge amounts of money are wasted, and a bigger budget woukd not necessarily fix things.

There were cases in the papers recently; a trust had found that by combining purchasing with another, they got cheaper prices. (No-one in the private sector would have found that surprising). So many admin/managerial staff - a lot of them are monitoring and checking. The old adage of too many chiefs, not enough indians comes to mind.

There needs to be a proper, open (and not politically driven) debate about the NHS and funding for the future.

Most of us don't know when we will die - even if we are ill. It maybe that some treatments for some 'elderly people' (as others have said - what does that mean?) may give them many years of good life ahead of them. So I would not want a simple rule to be applied on the basis of age alone.