Assisted dying

[old man]

18 minutes ago, mel b3 said:

Lins dad has dementia , but he's convinced that he's perfectly OK.   He has no idea of the 24 hour a day chaos that goes on around him .

I think that one of my greatest fears with assisted dying,  is government involvement.  How many years will it take before g4s , or some similar overseer take over the decision making process.

If they were cheaper and 50p profit could be made out of the situation?

[mel b3]

1 hour ago, old man said:

If they were cheaper and 50p profit could be made out of the situation?

Yep . It would start with , doctors , compassion,  and the very best of intentions,  and in 25years time , it'll be some random stranger , with zero medical knowledge or compassion,  making the decision over the phone , to hit government targets , and save money on sickness benefits , and free up housing.

[Flashman]

I doubt this law will be well-drafted and will enable the painless passing of loved ones in the circumstances described in examples above. 
 

[ditchman]

what a complicated mess..................who on earth is qualified to authorize such an action...and the people doing so ...are the least qualified

[Houseplant]

Some observations:

1. The Liverpool Care Pathway was designed to improve standards of care for dying patients under the care of non-palliative specialists. It simply protocolised practices which existed before the pathway was implemented and continue to exist since it's use was stopped. It is quite misunderstood and when used properly, is one of the few examples of compassion I've seen in modern medicine. As far as I can see, criticisms arise from the pathway not being fully implemented. 

2. In contrast to the handful of patients I've come across whose death has been hastened in hospital, I've seen many more whose last hours, days and even weeks have been filled with unnecessary medical intervention. They are clearly dying, yet their remaining time is filled blood tests, x-rays, catheters and drugs which do nothing to alleviate their symptoms. Death in hospital is not recommended, it is often horrible.

3. Doctors don't feel pressure from managers to prematurely end a patient's life for the purpose of clearing bed spaces or to save money. Why? Because we just don't care about these things. Believe it or not, some of us do actually care about patient well being. Regardless, every doctor worries about complaints and litigation. Aside from professional reputation, a serious complaint can result in loss of income stream. From a personal and professional perspective, it's just not worth the risk for the sake of appeasing managers.

4. The hospice movement has strong ties with Christian thinking. It is for this reason that they are opposed to assisted dying.

5. We've had assisted dying in New Zealand for 3 years now. It hasn't proved to be as controversial as feared. The only complaints I've heard is of patients being declined the service due to an unclear prognosis or "insufficient" suffering!

[old man]

3 hours ago, mel b3 said:

Yep . It would start with , doctors , compassion,  and the very best of intentions,  and in 25years time , it'll be some random stranger , with zero medical knowledge or compassion,  making the decision over the phone , to hit government targets , and save money on sickness benefits , and free up housing.

Frightening to think of the possible long term savings that could result? Scooped into a few back pockets?

Sadly, anytime politicians are involved in anything, just have to wait for the wheels to come off?

[12gauge82]

I've seen enough bad practice in the NHS with much missed friends and family to know I don't trust all medical personnel. At the end of the day, no one will ever care like family will. 

[Aled]

Sat in a pub today with 2 medical professionals, both mentioned that primary health care and local patient knowledge was not as strong these days as it once was, therefore decisions  on care were often made on "medical/scientific" knowledge, not "patient" knowledge. Both claimed this could make this issue a lot more clear cut. 

[shaun4860]

On 29/11/2024 at 21:08, Aled said:

Well there we go it looks like it may happen, i like others have really mixed feelings, i worked in a care home for the elderly as a student, and there were people there who would of gladly taken the assisted dying option if it was available to them however.....a family friend was given 6 months to live, and...4 years later she is still with us, her pain is manageable, yet the Dr's cannot change her diagnosis, her tumour is the same size and in the same place, but...she's still with us and having a good quality of life. 

But would she have chosen assisted dying?

[Penelope]

On 30/11/2024 at 05:01, mel b3 said:

Lins dad has dementia , but he's convinced that he's perfectly OK.   He has no idea of the 24 hour a day chaos that goes on around him .

I think that one of my greatest fears with assisted dying,  is government involvement.  How many years will it take before g4s , or some similar overseer take over the decision making process.

Take a look at Canada and their MAID policy.

[oowee]

On 30/11/2024 at 09:25, ditchman said:

what a complicated mess..................who on earth is qualified to authorize such an action...and the people doing so ...are the least qualified

Who is qualified to say that a person dying in pain must live? What right does anyone have to tell another they have to live in pain and suffering?

[Aled]

On 01/12/2024 at 01:10, shaun4860 said:

But would she have chosen assisted dying?

I really don't know i'm afraid. 

[dogone]

We have had assisted death in Canada for several years . I knew two people who took advantage of it. I would not have wished the last year of their life on anyone. They had all their mental facilities and chose to go. In a similar situation I expect I would do the same. 
    I have never heard of any abuse of the system.

[old man]

On 30/11/2024 at 09:48, Houseplant said:

Some observations:

1. The Liverpool Care Pathway was designed to improve standards of care for dying patients under the care of non-palliative specialists. It simply protocolised practices which existed before the pathway was implemented and continue to exist since it's use was stopped. It is quite misunderstood and when used properly, is one of the few examples of compassion I've seen in modern medicine. As far as I can see, criticisms arise from the pathway not being fully implemented. 

2. In contrast to the handful of patients I've come across whose death has been hastened in hospital, I've seen many more whose last hours, days and even weeks have been filled with unnecessary medical intervention. They are clearly dying, yet their remaining time is filled blood tests, x-rays, catheters and drugs which do nothing to alleviate their symptoms. Death in hospital is not recommended, it is often horrible.

3. Doctors don't feel pressure from managers to prematurely end a patient's life for the purpose of clearing bed spaces or to save money. Why? Because we just don't care about these things. Believe it or not, some of us do actually care about patient well being. Regardless, every doctor worries about complaints and litigation. Aside from professional reputation, a serious complaint can result in loss of income stream. From a personal and professional perspective, it's just not worth the risk for the sake of appeasing managers.

4. The hospice movement has strong ties with Christian thinking. It is for this reason that they are opposed to assisted dying.

5. We've had assisted dying in New Zealand for 3 years now. It hasn't proved to be as controversial as feared. The only complaints I've heard is of patients being declined the service due to an unclear prognosis or "insufficient" suffering!

Not havind a pop at you personally Hp.

I would have to take  issue with some of the protocols. 

How does the withdrawal of hydration and nutrition be a humane action? 10 days possibly to pass on?

In my book a piece of 4 x 2 applied with force over the ear would be more humane?

[12gauge82]

I'm all for it in principle. The problem is I could see an older person who has no one to advocate for them. An under funded hospital over worked and stressed staff, a few conversations, a stiff upper lip and not wanting to be a burden and someone who should be alive is dead. 

[Houseplant]

7 hours ago, old man said:

Not havind a pop at you personally Hp.

I would have to take  issue with some of the protocols. 

How does the withdrawal of hydration and nutrition be a humane action? 10 days possibly to pass on?

In my book a piece of 4 x 2 applied with force over the ear would be more humane?

 

I'm glad you asked. If a patient is drowning in their own secretions, then fluids make it worse. If someone is dying from a bowel obstruction, then food will make the symptoms worse. Both are a horrible ways to go. I've seen it many times. You don't forget seeing someone vomiting their own faeces. Even if these aren't the main problems, fluids and nutrition will obviously prolong life such as it is and depending upon your point of view and the patient's wishes, this may not be the desired outcome. That said, if the patient says they are thirsty, give them a bloody glass of water!

10 days to pass on is a long time for someone who is actively dying. Sounds like the prognosis was incorrect, but every case is different. The Liverpool Care Pathway was designed to be reversible. 

Every medical ethicist will tell you there is a difference between withdrawing treatment and actively performing an action with the aim of killing a patient. It may sometimes seem illogical and inhumane, but it is a line that many are not willing to cross. 

Edited December 4 by Houseplant

[old man]

6 hours ago, Houseplant said:

 

I'm glad you asked. If a patient is drowning in their own secretions, then fluids make it worse. If someone is dying from a bowel obstruction, then food will make the symptoms worse. Both are a horrible ways to go. I've seen it many times. You don't forget seeing someone vomiting their own faeces. Even if these aren't the main problems, fluids and nutrition will obviously prolong life such as it is and depending upon your point of view and the patient's wishes, this may not be the desired outcome. That said, if the patient says they are thirsty, give them a bloody glass of water!

10 days to pass on is a long time for someone who is actively dying. Sounds like the prognosis was incorrect, but every case is different. The Liverpool Care Pathway was designed to be reversible. 

Every medical ethicist will tell you there is a difference between withdrawing treatment and actively performing an action with the aim of killing a patient. It may sometimes seem illogical and inhumane, but it is a line that many are not willing to cross. 

Thank you for your reply.

We not at the sharp end don't see the full picture, we are only able to see snap shots?

Our experience was 10 days, not humane at all and obviously the wrong prognosis instigated from within and regretfully resulting in a family rift.

 

 

[Houseplant]

13 minutes ago, old man said:

Our experience was 10 days, not humane at all and obviously the wrong prognosis instigated from within and regretfully resulting in a family rift.

 

Sorry to hear that, sounds awful. None of us get it right all the time, but the right thing to do is realise that you haven't got it right or that the situation has changed and respond accordingly. 

[old man]

5 hours ago, Houseplant said:

 

Sorry to hear that, sounds awful. None of us get it right all the time, but the right thing to do is realise that you haven't got it right or that the situation has changed and respond accordingly. 

Again,  thank you. It was 9 years ago. It left a sibling rift.

[Edtwozeronine]

On 02/12/2024 at 09:07, Penelope said:

Take a look at Canada and their MAID policy.

Saw the documentary about it by an American YouTuber, can't recall if I already mentioned it here or one of the other forums. It had a clickbaity title like "the country where they kill disabled people" or something like that. 

[Aled]

A situation we as a family are facing now, my aunt is 94 years old is in a home, and is not terminally ill, she is old full stop. She flits in and out of reality, my Mam called to see her last week, she told my Mam, that she prays every night for God and Fred (her deceased husband) to come and get her. If she could take a route out of life, she would. Take what you want from my comments. 

[Houseplant]

7 hours ago, Aled said:

A situation we as a family are facing now, my aunt is 94 years old is in a home, and is not terminally ill, she is old full stop. She flits in and out of reality, my Mam called to see her last week, she told my Mam, that she prays every night for God and Fred (her deceased husband) to come and get her. If she could take a route out of life, she would. Take what you want from my comments. 

My wife did some rest home work and she said there were quite a few women in that state (it's always women, the husbands are already dead). They were begging her to euthanise them which of course she couldn't. Very sad.

https://www.bbc.com/news/articles/c0j1z14p57po