Richard and Judy suicide pact

Not sure that it is necessarily a bad idea for doctors to identify people who may wish to discuss this, and have that talk to find out their wishes, which the person may never have the courage to broach otherwise. But yes, I can truly understand your concerns there.

Surely if someone asks a doctor 'are you going to do a Shipman on me'- a doctor should be prepared to reassure them that this would never happen- unless they specifically wish for that sort of help.

As said, I really believe that it is much better for outside trained volunteers (called 'accompagnant/es here) rather than one's GP.

Indeed- but it is great to know that, if ever you feel you just can't go on, that the pain, etc, is too much, the option is yours. In fact, it has been shown by research from Exit, that actually knowing that the option is there- means that many people don't ask for it in the end- it is like having an 'insurance', gives you peace of mind and in fact, often strength to keep on the fight. It is of great re-assurance for many just to know the possibility is there.

I have to admit that I have not gone into all the details of my mother's joining Exit, perhaps I should as it sounds as if there is more to it than I had realised. I think she is very sensible, and I have been meaning to look into it for myself. It was something that she always felt very strongly about, it used to make my father very angry as he really feared the thought of death and refused to even make a will, saying that she was morbid when she suggested even that step.

My stepfather however completely agrees with her, so she finds that a huge relief.

Even so, when push comes to shove, I wonder if they will go through with it.

She's 92, granjura.
The last time she saw her middle son, my husband, was on her 90th birthday. He never got out of bed again, and died 3 weeks later.

What has not been mentioned in all this is that GPs are asked to identify the 1% of patients they expect to die within the next year and have a conversation with them about how and where they want to die.

With a living will, or advance directive, the GP and another doctor at least have to agree that the directive should be followed through, and no help be given unless the patient asks for it.

I would not like to be a GP in these circumstances.
My mother in law's GP said that she wasn't ready to go in a home every time he saw her.

[email protected]

www.dignityindying.org.uk

Thanks, yes it was so sad to see my mum suffer like this, mentally more than physically even- she was compus mentis to the end. So sad too that part of our reason for wanting to move back here was to help her- but she died 3 weeks before our move, because we were taken for a massive and expensive ride by the awful guy who made an offer on our house in the UK.
My aim was to persuade dad to let her go, and for her to move here with us if ever she asked again.

Jane, if you read the guidelines for Exit, all the concerns you raise are dealt with. Exit has its own trained volunteers- some are doctors and nurses, some are not- and the GP, although consulted for advice, etc- especially is the member has placed a living will and their Exit membership with them, will never be asked to be involved in the final act- for all the reasons you state, and quite rightly. However, I am sure you are aware that, pre Shipman, GPs looking after end of live patients at home very often helped hasten the process, at the request of the patient or the family unable to bear being witness to the suffering- and out of sheer common sense and humanity. Most will now never ever consider doing this, for fear of being accused or sued. The legacy of Shipman is actually really tragic in this respect.

What a serious, thoughtful and interesting thread - I have learned a lot from all your comments and experiences. Thank you.

I too would hate to be kept alive at all costs. I have, however, seen the palliative care, that Riverwalk talks about, in action and it was a quiet, calm and gentle death. And my mother died holding my hand, in my house, having had that sort of superb care. She just drifted away peacefully.

So sad Granjura

The Royal College of General Practitioners (and the BMA) remains opposed to assisted dying, although 2/3 of GPs supported a change.
www.pulsetoday.co.uk/clinical/therapy-areas/elderly-care/rcgp-members-vote-to-maintain-opposition-to-assisted-dying/20005929.article#.U3SFkvldV8E

The opposition of the RCGP was based on the following:

the detrimental effect it would have on the doctor-patient relationship;
the risk to the most vulnerable groups in society;
the possibility that patients may be in some way coerced into the decision to die;
the shift of focus away from investing in palliative care;
and would instigate a ‘slippery slope, whereby it would only be a matter of time before assisted dying was extended to those who could not consent due to reasons of incapacity and the severely disabled’.

One of the comments below the article refers to an elderly woman patient with a lung infection saying to her doctor 'You won't do a Shipman on me, will you?'

That's so sad, granjura

So sorry to hear you have to go through this all over again now with your MIL- so hard, I know. You've not mentioned her age (although age in itself is not really that relevant, my dad was as fit as a fiddle well until his mid 90s)- and her quality of life, and how much she enjoys seeing family, great grandchildren, etc.

My mum was an Exit member and her wishes were clear to all of us from the day Exit became an official Society here. Totally blind, in a wheel-chair with her legs refusing to work- she had to endure this for more than 10 years, hating almost every minute of it. She tried many times to stop eating- first at home and then in the OAP home- but first dad forced her- than the same (out of kindness- but often I wondered??) in the OAP home (where the care was excellent I have to say). In the end, they would only feed her things she loved, chocolate- but they 'tricked her' because the chocolate puddings they fed her were choker full of multivitamins and other stuff to keep her going. Dad just could not let go of her- and as a good Catholic, begged her NOT to ask for help from Exit- which she requested many a time. In the end- she was forced to continue to the bitter end anyhow- because the Charter at the home said that Exit was not allowed to intervene on the premises!!!! I loved her so much, she was an amazing woman- and I grieve that she was forced to live that extra 10 miserable years.

www.pulsetoday.co.uk/your-practice/one-in-four-gps-remain-reluctant-to-discuss-death-with-patients/20006697.article

Riverwalk, that's more or less what happened with my husband two years ago. He had signed a living will, so did not have a DNR. The doctor had to agree with him that there was no hope of recovery.

However, last week his mother was in hospital having had a bleed on the brain. From last Wednesday to this Monday, she had had nothing to eat or drink, and we were told to expect that she would die. On Monday she woke up and had some icecream to eat. She is now being fed liquidised food, as she cannot swallow or talk properly. She now recognises her family, which she did not last week. We have been told to take it one day at a time, to see how she improves.

Do not know what else to say. This completely messes up my mind, happening to my own family. It's easy to talk about these things objectively; not so easy now.

Thank goodness sensible debate has prevailed today.

Ana, thanks, so one more reason for people in the public eye to highlight this, and how unfair it is. I am so glad it will be discussed in the House of Lords- the safety guidelines proposed are very much like the ones for Exit- with the same huge disadvantage, that it is not suitable for people with advanced Alzheimers or dementia, or severy physical impairment, even if totally compus mentis - which is what is currently being worked on by Exit. But at least it would be a great start and step in the right direction.

I totally agree with Granjura on the point of being kept alive at all costs. I too would hate to think that scarce resources that have to stretch to so much need should be spent on me if I had reached the stage of, lets face it, neither use nor ornament! Once you get to the stage of not knowing where you are or who is visiting you and all the distress that goes with that, surely the kindest thing to do is to make sure that someone is comfortable and let nature take it's course. I worked in 'Care' for years, and there were times when it would have been kinder to let the person quietly slip away in their sleep. As someone once said to me, you'd be prosecuted for allowing your dog to go through this poor persons particular illness. (I was asked by the patient to bring a shot gun next time I came, how dreadful is that?!!) but no, they had to struggle on to the bitter end, for no other reason than?!! I personally don't want my life to be fought for at all costs when I'm clearly at the end of my life. I too would be asking for that shotgun!!!

I agree absolutely, granjura, I was just saying that Dignitas is really the only option for us at the moment, and not all who wish to end their lives would either want or be able to take that option.

I'd encourage all with doubts on this issue, to listen/watch again to the Terry Pratchett Dimbleby lecture oa a couple years ago, beautifully delivered by Tony Robinson. So moving. If ever the time came, although I've never read any of his books- I'd like to offer him my home- and not some awful flat on a Zurich industrial estate.

Why should people have to travel abroad- when they are so ill- and then die in a flat on an industrial estate- so tragic. Sadly the Law in the UK does not allow for any other alternative if this is the way chosen. I have huge respect for palitative care and for hospices, like our wonderful one, Loros, in Leicestershire. But it has to be a CHOICE, not enforced on all.

Anyone can join Exit International, granjura, for information and support.

There is always Dignitas, of course - many British people have chosen to end their lives with them, there are very strict criteria and checks.

janerowena, do your parents like in Switzerland, as Exit is only available to people who are resident here.

If a person is a member and asks for assitance to die- a trained person will visit, and speak to them ON THEIR OWN- to ensure what their problems are, and that absolutely no outside pressure is put on them, and that they have absolutely NO doubt whatesoever about the desired outcome. If there are any doubts, etc, then they will support but refuse to go ahead. Liaison is then made with their doctor, specialist, etc- and if possible family (at the discretion of member) and on the day of the deed- again, the trained 'helper' will again talk to the person on their own and again, assess that no pressure is born to bear from family, etc, etc, and that there is no doubt or hesitation whatsoever. The person is then give the potion to drink- be it in their garden, favourite armchair, bed- wherever- on their own or with their best friend/s, family- as they choose- with their favourite music on- whatever. Where is the slippery slope there?

Previous to Shipman, doctors often hasten the terminal process- because it was requested by patient, or because the suffering witnesses by doctor, staff and family was just unbearable- and that all agreed the quicker the better. Not really possible now since Shipman- sadly imho.

Loss of dignity and the way we care for people ... well, yes, I see what you mean. No staff, excellent or otherwise, could have stopped my mil from doing some of the awful things she did in late stage Alzheimers- I won't go into detail, but had she known she was doing those things, she would have been mortified and totally disgusted and upset. Watching her in the last few months of her Alzheimer days was the saddest thing ever. People will probably jump on me for saying this- but keeping people alive for far too long than is good for them costs millions- which really could be better used to help those who still have a chance, a will to live, some joy to experience, kids and grand-kids to see grow. If I ever got to that stage- or in extreme pain with a debilitating illness- I would not want to live beyond a certain point- and I certainly would really and truly HATE to know all that money (and resources, doctors, nurses, expensive drugs, etc, etc, etc) being taken out of a tight NHS budget to keep me living longer in my undignified misery- when it could all be used so much better elsewhere.

This is a very difficult subject to discuss as we all have different sincerely held opinions. I have read the Telegraph article and I like others think that hostility to Richard and Judy's sincerely held plans for their demise is actually driven by peoples dislike for them. Perhaps Richard was a bit cavalier, but again I think it was a defensive attitude, knowing the furore that their opinions/plans were going to cause. At the very end of the day how they end their lives is their business, and if that is the path they choose to go down that is entirely up to them, as it is with all of us. It is a pity though that these plans have to be considered somehow criminal, wicked and finger waggingly beyond the pale, and yet somebody dying with appalling suffering and, for all the good work and sympathy from relatives and appropriate medical staff, loneliness, is considered to be right and proper! The thing I most remember about my S father's life (after my mother died suddenly) and subsequent death from cancer, was his EXTREME loneliness, no matter how much we/friends visited, stayed for the w/end, took out on trips, he had to spend a lot of time by himself and it was just heartbreaking. Nothing we did COULD comfort or console him, although he did make valiant efforts, bless him, we weren't HER and there was no way we could be. OH and I remember this and, yes, when the time comes, we too hope to go together. No-one ever prepares you for 'two turning into one', so I can certainly see where Richard and Judy are coming from - good luck to them I say - Quality of life NOT quantity!

How refreshing that a 'man of god' can see past the limiting influences of ancient scripts like the Talmud (and the bible and the Koran).

A good essay on the use of our own moral compasses on the issue of assisted dying, by Rabbi bruce Warshal.

So it was POGS! I think I'm losing it!!! Perhaps just old age! However it did apply to me as well as my parents didn't plan to go together, and I implied that they did. How much better though, if they had got to that stage, to be able to throw in the towel legally than fiddling about with ancient sleeping pills and the distress that would have caused, probably in more ways than one.