“choice at the end of life” Parliamentary debate

This is on the cards for later this month. Proposed by Liam McArthur(lib dems)

I’m kind of against the idea. Makes it too easy to slip in other laws or changes to it once its on the books.

What kind of other laws or changes?

At some point in the future someone will abuse that right.

I can see that coming …

Yes thats the worry. When it becomes the norm for the ‘Doctor’ to decide

I’m for the idea and if it doesn’t pass before I’ve decided I’ve had enough (spms) then Its easy enough for me to get my hands on enough heroin to finish me off at a time and place of my choosing

This is massively overdue, I’ve watched 3 grandparents die in agony literally begging the doctors to just put them to sleep instead of wasting away over a number of weeks.

The question should move past whether we have assisted dying, and into what safeguarding and control mechanisms need to be in place to avoid abuse.

@tjagain to the forum

I’m all for it. I’ve watched both my parents die in pain and beyond the time they wanted to live. And my lovely Gran live in a fearful hell of dementia.

I would prefer a choice please.

Yep, my dad spent the last days of his life in pain dying of cancer. Similarly my wife’s. My grandfather had a stroke, was completely incapacitated bedbound, helpless and confused, he died a few weeks later.

We use euthanasia on animals as it is normally the most humane option. Odd that we don’t do it for humans. In some obscure cases it can be done (removal of essential treatment) but that seems like an odd work around.

What enigmas says is a good point. Let’s look at the practical controls and safeguards.

I’m kind of against the idea. Makes it too easy to slip in other laws or changes to it once its on the books

This is called the slippery slope fallacy…I’m sure you can work out what that means or google it but it’s best reserved for tabloid newspapers.

Voluntary assisted dying (as it’s called where I live) involves so many checks and balances the things most naysayers are concerned by (excluding the religious issues) aren’t impacted. It’s simply humane.

Assisted dying with the appropriate controls should be considered a human right.

Other countries have a good balance,  the comments above about thin end of the wedge etc are reactionary bs that shouldn’t be involved in this debate.

Discuss the circumstances when you think it is acceptable and how to prevent undue influence as that is essential.

Leave the bs alone this is far too important an issue for that

“Naysayers”

I am not for it nor against it.

As long as I am not requesting that for myself or deciding for my love ones or deciding for others, people can do as they wish.

My belief is no suicide for myself no matter what.

For me, it is better to be terminated without consent than to give consent.

I am just saying that at some point, no matter how many checks, “accident” will happen.

Assisted dying with the appropriate controls should be considered a human right.

So long as the right does not extend beyond others.  If it is in the law than it is applicable to all and sometimes there are people who are not in the capacity to make that decision.

Perhaps people who agree should carry some form of “donor card” as their right, and the law must not assume consent without the “donor card”.

Also some might assume that educating people with their right is the way forward in the case of “end of life”, but imagine those that change their decision too late as they have woken up to the fact that it is not what they want.

The law can only apply to the individual.

It would give a lot more force to living wills, but I don’t get the donor card analogy.

There should be no circumstance where an individual is assisted to die if they cannot give consent.  That is different to the existing mechanisms of treatment withdrawal that already exist

It would give a lot more force to living wills, but I don’t get the donor card analogy.

You carry a consent card or make that decision in advance in the event that you are in no capacity to decide. i.e. you want to avoid prolonging suffering in the event that you are unable to give consent.

The question should move past whether we have assisted dying, and into what safeguarding and control mechanisms need to be in place to avoid abuse.

Exactly. If we treat animals more kindly than our fellow humans, there’s something wrong.

Ben Eltons current tour features a funny but poignant gag around grandma’s last meal in an age of legal assisted dying.

Paging TJ. I’m going to email my mp voicing my support.

Overdue.

I’d like to give my consent now for if I am unable to give my consent later please. Even if that means registering it every year to build up a body of evidence. If you feel strongly against it for yourself this would protect you if others later suggested otherwise too.

There was a sad tale from Holland recently on the BBC website of a double euthanasia. Especially sad as she was starting with alzheimers so had to get it sorted before she got worse.

My mum had MND and we had to watch her lose all her power to move, then speak, then use her lungs. Dad just had an evergrowing collection of problems and pain. He was the epitome of stoic but last October he said that he just wanted to go to sleep and not wake up, sadly he didn’t get his wish until May.

Exactly. If we treat animals more kindly than our fellow humans, there’s something wrong.

How do you know the animals want to die when they suffer?

Isn’t that human interpretation for the weaker species?

Notice the injured animals in Africa continuing to try to carry on as normal even when half their body is torn apart by predator(s)?  Why don’t they just give up?

I’d like to give my consent now for if I am unable to give my consent later please.

Yes, that’s the way to decide while you are still able to make that decision (sound mind), and not while a person is terminal because no matter what, the mind is no longer able to make the rationale decision.

Wtf are you talking about?

Wtf are you talking about?

I am saying that a person should decide in advance how they wish to end their life in advance like carrying a donor card as a sign of consent in the event of incapacity.

The decision should be made while the person is not under any form of stress.

The example of using animals is to illustrate that even nature has the strong will to survive (no desire to die), and some people might be unable to make the right choice when they are under stress or incapacitated.  In the event of incapacity, no matter how many checks are put in place there will always be “accidents”.  Therefore, to avoid mistaken consent, perhaps a fail check measure in the form of “donor card” concept can be put in place.

I’m kind of against the idea. Makes it too easy to slip in other laws or changes to it once its on the books.

I do feel like this is where lots of people’s minds immediately go, directly to the worst case scenarios and the hundreds of would be Harold Shipman’s apparently waiting in the wings.

Personally I see the debate as more about individual’s rights to quality of life, and by extension ‘quality of death’ and rather than shut it down with fears about abuse by malevolent medical professionals, the debate should be about how to safeguard a right for vulnerable people in the most difficult situations, yes preventing abuse, but also to allow people to die with dignity rather than having their lifes prolonged past the point that they would choose.

I do feel like this is where lots of people’s minds immediately go, directly to the worst case scenarios and the hundreds of would be Harold Shipman’s apparently waiting in the wings.

I think that will happen eventually if not careful.

Wtf are you talking about?

Nobody knows, nobody ever knows.

Nobody knows, nobody ever knows.

If you cannot even attempt to understand what I said then what chance do the people have when they are incapacitated and unable to decide or to give or not to give consent.

Imagine your doctor etc are in charge and with no attempt to understand you, by simply brushing aside your attempt to explain by carrying on as they determine right for you in the event of end of life choice?

The idea of having the choice of end of life might be good, but what happen if there is a coercion?

Another question you need to think about is whether a person can remain normal with sound mind when they are in pain or suffering.

Also if a person is under stress or time pressure how good are they at making the right decision?

I do feel like this is where lots of people’s minds immediately go, directly to the worst case scenarios and the hundreds of would be Harold Shipman’s apparently waiting in the wings.

I’m of the opinion the conversation should move from the fact that this is a remote possibility and therefore we shouldn’t have assisted dying, but rather onto onto how we can best manage it via case studies of existing countries and building together a case for best practice that mitigates this to the highest possible level. All the usual stuff of prior consent, multiple doctors signing off, definitions and tests for whether someone is in a position to give consent etc.

There will unfortunately be an inevitable case where something goes awry. But this should be managed via all the safeguards, and a constant improvement process to learn from that case, and improve the system. As with everything else, the approach should be to make the risk ALARP, rather than to remove it entirely when that leads the increased suffering of thousands every year.

I find comparisons with the justice system. There’s been plenty of cases where we’ve locked up innocent people for decades and they’ve lost a third of their life to a mistake. But we continue to send people to jail because the justice system is designed to be a robust process to mitigate the risk as much as possible, not remove the risk of a false conviction.

I’m kind of against the idea

I’m kind of against you or anyone else preventing me from deciding how my life should finish.

When it becomes the norm for the ‘Doctor’ to decide

And yet it has been in place in many more civilised countries for several years without the sky falling in.

The idea of having the choice of end of life might be good, but what happen if there is a coercion?

As others have pointed out, it can be set up in such a way that this is unlikely.

I’m willing to take the very small chance of coercion as you call it in order that people don’t die in unnecessary suffering.

OK Cards on the table this discussion feels very prescient for me;

My Mum had the early signs of dementia in about 2022, and on the Bank holiday Monday following the Coronation last year, she suffered a massive stroke that has ultimately paralysed her right side, and basically robbed her of the ability to speak. This is very much the way her Mum (my Grandmother) went and her older sister (My Aunt) was already in a similar situation. We honestly don’t know ‘how much‘ of my Mum is there anymore. The gestures and facial expressions are familiar, the jabbered noises have the sort of cadence and intonation of her speech (and she could bloody talk), but then she goes quiet and often wakes up seemingly confused, she really does not like the level of quite intrusive care she requires now, where people she doesn’t know have to get up close and intimate with her.

Given 20/20 hindsight, had the option to say what she wanted ahead of time existed before I think she might have asked not to be given the treatment that saved her life, but effectively put her in this situation. It was her greatest fear having seen her own mother go through it. Of course there was no legal mechanism for her to express such a wish, and now any future laws with appropriate safeguards would probably rule that her capacity could not be sufficiently determined, for her to make such a request now. This debate has come too late for my Mum, but perhaps not me and my siblings. She was otherwise very healthy at the time of having the stroke and could easily live another decade, all the time with declining physical and cognitive capacity, trapped by an inability to communicate, basically a living Hell for the person my Mum is (was).

At the same time, My Mother in Law is sat downstairs right now as I type this, having lived (with us) through about 7 years of respiratory decline and associated Heart issues from COPD, and a few weeks ago finally had a chuffing great tumour that was impinging on her oesophagus diagnosed. She completed a course of Palliative Radiotherapy on Monday, intended to shrink is and give some limited relief. We are very much in the “Quality of Death” phase with her, she is lucid, able to communicate, and taking the opportunities now to spend time with her Daughter and Grandchildren, she needs oxygen 24/7, can’t walk more than a handful of steps, (but still refuses to let anyone else do the bloody washing). She’s hard as nails, but I can foresee a time, not too far from now, where the loss of capability and physical discomfort might be more than she could tolerate, and she might want things to be over at that point.

Giving people the right to express their desires and describe the circumstances (and exclusions) for their own dignified death is something a Civilised society should grapple with and facilitate where it can. We sit at a point in time where several centuries of medical science have extended life expectancies hugely, but we still seem very squeamish about discussing quality of life for people as they approach the end.

It’s easy to jump directly to imagining the potential for abuses, but what about the benefits for (many) people who will otherwise be forced to suffer through a prolonged, uncomfortable end to their lives without the dignity they would have chosen?

We won’t all get to just wake up one morning, Dead without any prior suffering. I for one have been forced by circumstance to think about what sort of end to my life I would accept, and what I wouldn’t (and I’m not yet 50).

Edit: sorry for the Ramble – TLDR I have relatives at the end of their lives potentially about to face a prolonged death.

I’m for the idea and if it doesn’t pass before I’ve decided I’ve had enough (spms) then Its easy enough for me to get my hands on enough heroin to finish me off at a time and place of my choosing

One of the perks of living in Scotland, I guess.

I’d like to give my consent now for if I am unable to give my consent later please. Even if that means registering it every year to build up a body of evidence. If you feel strongly against it for yourself this would protect you if others later suggested otherwise too.

@mugboo – do you have an advance health directive (maybe called a living will where you are?) That’s a good start.

Seriously, for the people that think that choice at the end of life is ‘loose’ and your GP can just knock you off when you’ve had enough, read the eligibility criteria we have here. It’s only a few years old in Queensland but it’s very very tightly regulated, and it was developed off the back of many other jurisdictions that already went down this path:

Eligibility criteria for voluntary assisted dying | Health and wellbeing | Queensland Government (www.qld.gov.au)

1. Have an eligible disease, illness or medical condition
2. Have decision-making capacity
3. Be acting voluntarily and without coercion
4. Be at least 18 years of age
5. Meet residency and citizenship requirements

Imagine your doctor etc are in charge and with no attempt to understand you, by simply brushing aside your attempt to explain by carrying on as they determine right for you in the event of end of life choice?

Imagine reading about how the systems work in places where there is choice rather than inventing spurious scenarios on a whim!

Edit: sorry for the Ramble – TLDR I have relatives at the end of their lives potentially about to face a prolonged death.

There is no need to apologise.  You just stay strong.

I will join the discussion next Tuesday. Not sure I have much to contribute but there are certainly some questions.

Hopefully, TJ will join to contribute his views before that.

If the Parliament is going have a debate about this, we might as well have our “mini debate” here too.

5. Meet residency and citizenship requirements

Don’t want them immigrants comin’ over, looking to kill themselves. Especially after the Tony Hancock incident.

When i listen to you Reeksy, it makes me wonder if the banjo is a popular instrument where you are 😛

Bit rich coming from the UK! Haven’t been race-related riots here for ooooh, 15 years at least.

But yes, there are places known for their slack-jawed yokels and duelling banjos of course. The weather brings them out.

But there’s obvious reasons, legislative as well as simply wanting to avoid becoming a place people come specifically to die. For a start it’s a public health system that’s paying.

Assisted dying with the appropriate controls should be considered a human right.

It really is that simple. The detail is in the controls.

Reeksy – yes, I’m in the UK so that is my only option for the moment but I am hopeful for a change.

The really sad thing is that at the very end of my mums life, they gave her an extra dose of morphine on top of the drip of morphine she was on and she slipped away soon after. It would have been kinder to do this earlier.

We aren’t asking anyone to reinvent the wheels here, other more progressive societies have done the hard work for us.

I’m of the opinion the conversation should move from the fact that this is a remote possibility and therefore we shouldn’t have assisted dying, but rather onto onto how we can best manage it via case studies of existing countries and building together a case for best practice that mitigates this to the highest possible level.

I struggle to understand anyone not thinking this is the way forwards.

I’m pretty sure doctors have been discreetly helping people have a quicker and less unpleasant death since the dawn of time. “Doing no harm” can be interpreted in a number of ways. The justice system already allows decisions on best end of life choices to be taken away from families where it serves no purpose.

My parents PoA makes it clear they don’t want unnecessary life extending treatment, and mine will too when we get them done next year once both kids are over 18 to act as attorneys.

Will just leave this here for your perusal:

https://web.archive.org/web/20241003004039/https://www.telegraph.co.uk/news/2024/09/28/nhs-sedate-downs-syndrome-patient-for-covid-jab-mother/

I’m kind of against the idea. Makes it too easy to slip in other laws or changes to it once its on the books.

I’m kind of for the idea. Would have made it far less traumatic to have taken my sister in law to dignitas via the airport without the need to be interviewed by the police under caution afterwards.

Both my fil & next door neighbours mother effectively died of starvation/dehydration in hospital over a few days, both lives ended horribly for all those involved, a few days less suffering with a lethal injection would have been far more humane.