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Source: (consider it) Thread: Choosing a candidate for voluntary euthanasia
Penny S
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Pyx_e
quote:
In 20 years of ministry I have never known anyone suffer terribly. The morphine thing is just true.
I'm glad you have been spared that. Morphine does not always work. I thought it would. I thought my mother would be able to go gently. It didn't. She couldn't. And she was afraid.

You only need to see one black swan to know it is not true that all swans are white.

Though maybe you might not take the reports of others that they exist. But my mother's suffering was as true as that I saw a black swan off Gravesend two weeks ago.

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Lamb Chopped
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Some people (me, as I know already) morphine just doesn't work for them. Seriously. It's like getting a shot of water. It does zip zap zero. (And no, I am not a drug abuser. It's an oddity of the metabolism, and occurs in a small percentage of the population. Unfortunately, a great many medical people are not as well informed as the one who explained this to me.)

If you or a loved one is getting no relief from morphine, do whatever the hell you have to do to get them to switch to another drug. It's real. And you don't have to suffer.

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Er, this is what I've been up to (book).
Oh, that you would rend the heavens and come down!

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Pyx_e

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quote:
Originally posted by Penny S:
Pyx_e
quote:
In 20 years of ministry I have never known anyone suffer terribly. The morphine thing is just true.
I'm glad you have been spared that. Morphine does not always work. I thought it would. I thought my mother would be able to go gently. It didn't. She couldn't. And she was afraid.

You only need to see one black swan to know it is not true that all swans are white.

Though maybe you might not take the reports of others that they exist. But my mother's suffering was as true as that I saw a black swan off Gravesend two weeks ago.

I acknowledged it can be messy, I am sorry your mum struggled.

The worst was my friend who had motor neuron disease. I could not have born what he did and yet even when he could no longer speak he could make me laugh, and did. The last two weeks were fucking awful, his whole life including these two weeks were a inspirational testament to his spirit.

The last brief season must not be separated from all that went before, it is not a different person who we treat differently but the same one we always loved, who needs to know we love them still.

Pyx_e.

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It is better to be Kind than right.

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Lamb Chopped
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Oops. Adding: I don't think Pyx_e meant to say that morphine in particular works for all people. But there are other drugs, and doctors should try them as needed.

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Er, this is what I've been up to (book).
Oh, that you would rend the heavens and come down!

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QLib

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quote:
Originally posted by Pyx_e:
The last brief season must not be separated from all that went before, it is not a different person who we treat differently but the same one we always loved, who needs to know we love them still.

Bur I would want my family to show they love me still by helping me to die quickly if I get to the stage when I can't take any more.

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Tradition is the handing down of the flame, not the worship of the ashes Gustav Mahler.

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Doublethink.
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Even if you wound those you love in the process ?

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All political thinking for years past has been vitiated in the same way. People can foresee the future only when it coincides with their own wishes, and the most grossly obvious facts can be ignored when they are unwelcome. George Orwell

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QLib

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quote:
Originally posted by Doublethink:
Even if you wound those you love in the process ?

The death of a loved one is a wound, anyway, isn't it? I wanted to offer my father a quick death - but didn't - however, after I'd reached the point of wanting to make the offer, he was lucky enough to get a bed in hospice shortly after, and died peacefully. But what if he hadn't been lucky? He'd got to the stage when our GP - who was a good bloke - was saying he could do no more.

Having said that, I had the most extraordinary experience when my Dad actually died. And perhaps part of the message there was that he'd gone when the time was right. So I don't know.

And then again, this: childbirth is natural, but we control it as far as possible, control the pain, and sometimes seek to hasten the process. Why not do that with death?

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Tradition is the handing down of the flame, not the worship of the ashes Gustav Mahler.

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Niminypiminy
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Agree with much that has been said. And also: so many of the opinions in favour of assisted dying come down to "I had to watch someone suffering" -- it's not the suffering of the person that is really objectionable, it's being made to witness it.

In other words, assisted dying is a tidying-away measure, a means by which the living are protected from having to see and witness and bear other people's suffering.

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Byron
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quote:
Originally posted by Niminypiminy:
Agree with much that has been said. And also: so many of the opinions in favour of assisted dying come down to "I had to watch someone suffering" -- it's not the suffering of the person that is really objectionable, it's being made to witness it.

In other words, assisted dying is a tidying-away measure, a means by which the living are protected from having to see and witness and bear other people's suffering.

This is why I didn't post any personal experiences: they can be spun any which way.

For me, no, assisted suicide and euthanasia aren't for the benefit of the relatives, but respecting the autonomy of the person suffering.

There are issues around coercion, but they apply equally to things already legal, like withdrawing treatment, and DNR notices. The real issue is whether the state ought to override a person's will for religious reasons, even if neither the patient, nor their caregivers, share those beliefs.

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Doublethink.
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I would state that you can argue the harm done by asking others to kill is a significant harm, without recourse to religious faith.

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All political thinking for years past has been vitiated in the same way. People can foresee the future only when it coincides with their own wishes, and the most grossly obvious facts can be ignored when they are unwelcome. George Orwell

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Byron
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quote:
Originally posted by Doublethink:
I would state that you can argue the harm done by asking others to kill is a significant harm, without recourse to religious faith.

Harm to whom?

The person who's asked to be helped to die? Questionable if it spares them further suffering, but in any case, it's their choice to take the risk.

Or their caregivers? If it does cause harm (presumably psychological trauma), is it worse than other traumas caused by treating patients? Even if it is, so long as no one's forced to kill or assist in killing, they've freely accepted the consequences.

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Doublethink.
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"freely" ? There are huge emotional pressures in such a situation. That is half the problem.

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All political thinking for years past has been vitiated in the same way. People can foresee the future only when it coincides with their own wishes, and the most grossly obvious facts can be ignored when they are unwelcome. George Orwell

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Niminypiminy
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quote:
Originally posted by Byron

Even if it is, so long as no one's forced to kill or assist in killing, they've freely accepted the consequences.

But those who would be most likely to be doing the killing, that is, doctors, are not in favour of assisted dying. Palliative care specialists least of all. It's one thing to say 'something should be done' and another to say 'I will do it'. And what about those who freely do chose to do the killing? What if they like it?

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Byron
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quote:
Originally posted by Doublethink:
"freely" ? There are huge emotional pressures in such a situation. That is half the problem.

There's equally grave emotional pressures in signing a DNR notice, or deciding to withdraw treatment, or in making the call to switch off life support. In no other area of medicine is emotional pressure used as reason to deny a patient a choice over their treatment.

Right now, a patient can demand that all treatment cease. Caregivers are forced to let them die, and ease their passing if need be. Should patients be denied this right?

If not, how is assisted suicide radically different, either ethically, or psychologically?

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Byron
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quote:
Originally posted by Niminypiminy:
quote:
Originally posted by Byron

Even if it is, so long as no one's forced to kill or assist in killing, they've freely accepted the consequences.

But those who would be most likely to be doing the killing, that is, doctors, are not in favour of assisted dying. Palliative care specialists least of all. It's one thing to say 'something should be done' and another to say 'I will do it'. And what about those who freely do chose to do the killing? What if they like it?
As I said, for any medical professional, taking part in euthanasia ought to be voluntary. Doctors are divided on the issue. Since they practise medicine for the benefit of their patients, the views of opponents shouldn't be controlling.

If they "like it," they're obviously grossly unsuited to the practise of medicine! They could equally "like" a patient dying in surgery, which would not be reason to cease surgery.

These arguments don't have the highest view of caregivers, do they?

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Doublethink.
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Well, firstly, if there is enough emotional pressure you could argue they lack capacity under the MCA.

There is a big difference between doing something to someone, and not carrying out a specific treatment

In my experience, suicide has a damaging effect on those close to the deceased. An an effect that can be damaging to them years later. One of the things that raises your own risk of suicide, for example, is having known someone who took their own life.

[ 13. July 2014, 21:46: Message edited by: Doublethink ]

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All political thinking for years past has been vitiated in the same way. People can foresee the future only when it coincides with their own wishes, and the most grossly obvious facts can be ignored when they are unwelcome. George Orwell

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Byron
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quote:
Originally posted by Doublethink:
Well, firstly, if there is enough emotional pressure you could argue they lack capacity under the MCA.

There is a big difference between doing something to someone, and not carrying out a specific treatment

In my experience, suicide has a damaging effect on those close to the deceased. An an effect that can be damaging to them years later. One of the things that raises your own risk of suicide, for example, is having known someone who took their own life.

Does that include assisted suicide? There's a world of difference between a gravely ill relative choosing to end their suffering, and walking in on a loved one who's taken their own life. Many prefer to call it assisted dying to make precisely that distinction. By contrast, what's the data on relatives distressed by watching a loved one forced to suffer an agonizing death against their will?

What is the substantive difference between a doctor turning off a machine because the patient wants them to, and handing the patient the means to end their life? If anything, the first could be more traumatic, as the patient has foreclosed the possibility of recovery.

If someone lacks capacity under mental health laws, it's not specific to this issue.

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Niminypiminy
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quote:
Originally posted by Byron:

These arguments don't have the highest view of caregivers, do they?

I think Andrew Brown has it about right when he says "In general, the people most worried by the prospect of liberalising the law on assisted suicide are the professionals, whether doctors or clergy, who take a low view of human nature, having seen too much of it."

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no prophet's flag is set so...

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The CBC did an extensive series on this, and revisited again recently. How Will We Die, Euthanasia and the Politics of Death. I listened to this twice, and read it several times.

Worthy of understanding:

quote:
Dr. Balfour Mount, the father of palliative care [who is also a cancer patient himself], said on our program last week doctors get very little training in end of life issues....
I think it is totally irresponsible to talk of mercy-killing, euthanasia, assisted suicide etc unless you also reference end of life care and proper medical access to it. No one ever discusses palliative sedation which does not involve actively killing the patient.

I also expect there is a economic argument, that emptying the hospital bed and disposing of the dead body is cheaper than the alternatives. I would also ask about the access to proper palliative pain management, in addition to palliative care at all.

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Leorning Cniht
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quote:
Originally posted by Byron:
The real issue is whether the state ought to override a person's will for religious reasons, even if neither the patient, nor their caregivers, share those beliefs.

You assume that the reasons to oppose voluntary euthanasia are all religious ones. That's not the case.

Whilst there certainly are religious reasons that people can give to oppose this, many of the arguments given (about slippery slopes etc., for example) are completely secular.

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orfeo

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quote:
Originally posted by Curiosity killed ...:
quote:
Originally posted by orfeo:
You realise the thread title is pretty much a contradiction in terms...

Anyway, carry on.

Yep - no-one else was going to start a thread and I was still running a temperature, so shoot me.
I'm going to be charitable and assume that wasn't you demonstrating how to volunteer. Besides, I don't have a gun and even if I did my aim from THAT distance isn't sufficient.

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Technology has brought us all closer together. Turns out a lot of the people you meet as a result are complete idiots.

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orfeo

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quote:
Originally posted by Byron:
All the practical concerns skirt the central issue: the sanctity of life.

You didn't get to decide when to start your life, which raises significant philosophical problems with the notion that 'sanctity of life' means you get to decide when to end it.

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Technology has brought us all closer together. Turns out a lot of the people you meet as a result are complete idiots.

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ExclamationMark
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quote:
Originally posted by Byron:
quote:
Originally posted by Niminypiminy:
As I said, for any medical professional, taking part in euthanasia ought to be voluntary.


That's is how involvement with abortion was treated under the 1967 Act. It's rather different now .... who's to say that if Assisted Suicide or Voluntary Euthanasia was legalised, that the same wouldn't happen?

The safeguards may be there now but will change later.

[edited: busted UBB code]

[ 14. July 2014, 07:06: Message edited by: Sioni Sais ]

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QLib

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quote:
Originally posted by Niminypiminy:
...so many of the opinions in favour of assisted dying come down to "I had to watch someone suffering" -- it's not the suffering of the person that is really objectionable, it's being made to witness it.

In other words, assisted dying is a tidying-away measure, a means by which the living are protected from having to see and witness and bear other people's suffering.

Ahhh... Fundamental Attribution Errors - where would Hell be without them?

Incidentally "I had to watch someone suffer" is an experience, not an opinion. The opinion may be developed after reflection on experience, certainly, whereas your opinions are ... what, exactly? Utterly objective? Or second-hand and derivative?

If people were as utterly selfish as you suggest, then watching someone else suffer would not be a problem. You wouldn't need to tidy them away, because you could just walk.

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Boogie

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quote:
Originally posted by orfeo:
You didn't get to decide when to start your life, which raises significant philosophical problems with the notion that 'sanctity of life' means you get to decide when to end it.

And what does sanctity of life mean anyway?

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orfeo

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^That too, Boogie. Because once upon a time it meant that suicide was a sin. I'm not at all sure what meaning Byron is giving it.

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Technology has brought us all closer together. Turns out a lot of the people you meet as a result are complete idiots.

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Matt Black

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quote:
Originally posted by mousethief:
quote:
Originally posted by Lyda*Rose:
I worry about people who are terminal asking for death because they want to make it easier on their families. And even worse, unscrupulous family members who nudge a person toward choosing their death for the nudger's own well-being, and dare we say it, material ends in terms of legacy. This is similar to my opinion about capital punishment: what if it is gotten wrong? What if the dying miss out on important moments because of an attitude that if one is dying one might as well just get it over with?

This is precisely my problem with voluntary euthanasia -- the possibility or likelihood that a dying person be talked into getting out of the way by unscrupulous relatives.
There are also cases (and I know, I know, the plural of 'anecdote' is not 'data') of seriously/ terminally ill/ disabled people wanting to die when also suffering from severe depression who, when the depression is treated more or less successfully have said that they are very grateful that assisted suicide wasn't legal.

In addition, I think this kind of proposed legislation is very dangerous in the context in the UK at least of the recent horror stories of severe abuse of the elderly in care homes; there is therefore already a culture of abuse of the vulnerable and this kind of law should at the very least not be considered unless and until that culture has been eliminated.

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"Protestant and Reformed, according to the Tradition of the ancient Catholic Church" - + John Cosin (1594-1672)

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seekingsister
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Beyond the moral and ethical issues (of which there are many), why would a pharmaceutical company invest in research for better palliative care or pain management, when governments are passing assisted suicide laws?

And even if they did, why would the NHS or an insurance company prefer to pay for the more expensive treatment (palliative care) when a cheaper alternative (assisted suicide) is now available?

What is being presented as a "choice" may not be much of one in practice.

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Karl: Liberal Backslider
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# 76

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quote:
Originally posted by seekingsister:
Beyond the moral and ethical issues (of which there are many), why would a pharmaceutical company invest in research for better palliative care or pain management, when governments are passing assisted suicide laws?

Because some people want them and therefore there'll be a market for them?

quote:
And even if they did, why would the NHS or an insurance company prefer to pay for the more expensive treatment (palliative care) when a cheaper alternative (assisted suicide) is now available?

Because they're not the sociopaths you seem to think they are?

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Might as well ask the bloody cat.

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Pyx_e

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# 57

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Matt Black wrote
quote:
I think this kind of proposed legislation is very dangerous in the context in the UK at least of the recent horror stories of severe abuse of the elderly in care homes; there is therefore already a culture of abuse of the vulnerable and this kind of law should at the very least not be considered unless and until that culture has been eliminated.
Amen brother. Only to add that the whole care system abuse thing is in my opinion only exaggerated and mirrored in family care situations. We keep saying "oh those horrible strangers not looking after us" while the vast majority of cruelty, abuse and emotional manipulation goes one behind the closed doors in our streets. To suggest that opening the doors to AS will do anything but cull the weak is IMHO daft.

This is not Sparta!

Pyx_e

p.s. if Lord Carey had spent a little less time sitting on his grey polyester covered arse in the House of Lord's and a little more time in his local hospice I suspect he would not be spouting this dangerous bollocks. And if we were to need any further example of how power corrupts I need look no further than him. And he ought to be careful his kids aren't putting labels on the telly and the best Wedgewood!

edit is/if ffs

[ 14. July 2014, 10:10: Message edited by: Pyx_e ]

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It is better to be Kind than right.

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seekingsister
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quote:
Originally posted by Karl: Liberal Backslider:
Because some people want them and therefore there'll be a market for them?

"Some people" isn't enough to spend hundreds of millions of dollars on R&D. The drugs needed for assisted suicide already exist. Anyone who can do math can guess what a profit-oriented company might choose.

quote:
Originally posted by Karl: Liberal Backslider:
Because they're not the sociopaths you seem to think they are?

I'm not accusing anyone of being a sociopath. There are drugs available in the global market that are more effective than those available on the NHS, but the NHS does not provide them due to cost. I personally am in such a situation. They are making a rational choice, but it affects my life and health for the worse.

To think the same organization would not compare the cost of a new pain management/palliative care therapy vs. that of euthanasia is idealistic at best.

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Adeodatus
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quote:
Originally posted by Spawn:
quote:
Originally posted by Adeodatus:
What we're really talking about is "my" right to demand that "you" kill me - and I don't believe I have such a right.

Pretty much agree with everything Adeodatus says and in fact I have severe reservations about assisted dying, but Adeodatus' reaction is to euthanasia not to a terminally ill person requesting medication to hasten their own end.
Well, yes, I suppose so - but if this Bill becomes law, the courts will soon fill up with cases arguing over when that line is crossed.

Oddly enough, it's precisely because of this that the Bill fails to help the people whose cases, to me, seem most clear cut. The request to die has to be consciously made, and then the fatal drug has to be self-administered: that would seem to rule out those who are extensively paralysed or unable to communicate.

There is currently a "conscience clause" in the Falconer Bill, but there isn't one in the parallel Bill currently before the Scottish Parliament: physicians and pharmacists in Scotland would have no opt-out. It's probably worth noting, too, that "conscience clauses" have come increasingly under attack in recent years, so the English one may not survive its passage through Parliament.

Niminypiminy, it's true that the professionals who would be involved tend to be opposed to assisted dying, but I fundamentally disagree with Andrew Brown that it's because we have a "low view of human nature". I think it's because we see death daily, and know just how much can be done to give high quality care to the dying and those close to them.

(It's odd: in all the polls I've seen asking the question on assisted dying, I've never seen one that asked the opinions of the terminally ill. It's a truism in healthcare that the sick, who judge on their experience, have very different opinions from the well, who rely on their imagination.)

--------------------
"What is broken, repair with gold."

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Anselmina
Ship's barmaid
# 3032

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quote:
Originally posted by Byron:
Putting my own cards on the table, I support both, as I believe that people ought to control their own lives, so much as possible. I'd have no problem with physicians having a conscience opt-out.

On the face of it - in a black and white world - that would appaer to be a practical solution. But what would happen in that case would be what happens - to an extent - in the clergy world of, say, remarriage of divorced people. Those who opt out, because of conscience become those nasty moral judgemental medics who aren't willing to engage with the messiness of pain and death; just as clergy who choose not to re-marry divorcees get labelled as those not wanting to get involved in the sticky end of failed relationships. In other words, their freedom of choice simply becomes a focus of abuse, and a big stick with which to beat them for exercising their 'free' choice. Legislative history strongly suggests that such situations are rarely allowed to rest until the 'right' of one party MUST trump the 'right' of the other party.

Again, I do think the effect of pressure on the role of the loved ones, next of kin - whatever - is being somewhat underestimated here. Moral pressures within families to act against one's own conscience arise all the time, whether it's as banal as going with a choice of decor you abhor because you share the house with a parent, or taking up a job you don't care for because that's the family expectation. If it's hard resisting a loved-one's pressuring to conform to ordinary lifestyle decisions, imagine the impossibility of a situation such as signing up to a loved one's assisted euthanasia, on the premise of it as a 'free choice'?

It is one thing to discreetly - and on a day-by-day decision-making basis - work alongside medical professionals and with the wishes of the dying person, to respond to what is happening. It's quite another to find that the cold hand of the law is being leveraged against one's own inclination to plan and execute a path of deliberate death. I'm sure there would be a lot of intent with legislators and medical professionals to put in safeguards, permissions - perhaps even pastoral provision. But, personally, I would have little confidence in the comprehensive efficacy of such law-making for all parties - especially for the vulnerable, the dissenting, or the ambivalent.

--------------------
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Liopleurodon

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quote:
Originally posted by seekingsister:
I'm not accusing anyone of being a sociopath. There are drugs available in the global market that are more effective than those available on the NHS, but the NHS does not provide them due to cost. I personally am in such a situation. They are making a rational choice, but it affects my life and health for the worse.

To think the same organization would not compare the cost of a new pain management/palliative care therapy vs. that of euthanasia is idealistic at best.

It's cheaper to let people die of cancer than it is to give them chemo. It's certainly cheaper to let a heart attack finish someone off than it is to do heart surgery. And yet the NHS does do chemo and heart surgery. Yes it has to do a cost benefit analysis to decide which treatments it will fund. But the fact remains that it's a massive leap to assume that the NHS will start bumping people off rather than giving them pain relief and nursing in their last days.

I'm hearing on this thread that:
a) Doctors don't want to kill people, even when those people are terminally ill and suffering and are actively stating that they want to die
and that
b) Doctors will kill everyone who's a bit vulnerable, even if they don't want to die, if we give them a foot in the door - however carefully we try to regulate.

While I can see that it's possible that all doctors fall into one group or the other, it doesn't seem very likely.

Yeah, I'm pro legalised voluntary euthanasia. Because I think that people have the right to check out when their suffering becomes unbearable. Not because I don't want to see them suffer, but because they don't want to suffer.

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seekingsister
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quote:
Originally posted by Liopleurodon:
It's cheaper to let people die of cancer than it is to give them chemo. It's certainly cheaper to let a heart attack finish someone off than it is to do heart surgery. And yet the NHS does do chemo and heart surgery. Yes it has to do a cost benefit analysis to decide which treatments it will fund. But the fact remains that it's a massive leap to assume that the NHS will start bumping people off rather than giving them pain relief and nursing in their last days.

I'm not saying they are going to murder people - chill with the hyperbole. I'm saying they will be suggesting it to people, and that the suggestion could be tainted by a financial bottom line.

I had an operation on the NHS and beforehand I got a second opinion from a US doctor on a visit home. The US doctor said the surgery was a necessity for my long-term health, even though I had made clear I would be having any operation in the UK (so no additional income for that particular doctor). The NHS specialist had previously told me it was optional. Had I gone with the NHS view I would be in big trouble as the results from the tissue removed came up as a borderline malignancy. A few more years and it would have been full-blown cancer.

I would not trust that same hospital to tell me the truth about whether my loved one should have palliative care vs. an early exit.

[ 14. July 2014, 12:17: Message edited by: seekingsister ]

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Erroneous Monk
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At the same time that Tony Nicklinson was campaigning for the right to require someone to end his life, Tony Scott committed suicide. For every expression of public support I read for Tony N's right to die, I read a public expression of sadness for the waste of Tony S's life.

Is the life of a physically disabled person worth so much less in modern terms that that of a not-yet-physically-disabled person?

[Frown]

--------------------
And I shot a man in Tesco, just to watch him die.

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The Great Gumby

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quote:
Originally posted by Pyx_e:
I know this is the age we live in but the venality of some adult/children of elder folk astonishes me. I have heard them complain that being in a nursing home is "wasting" their inheritance. I have often heard conversations which would take only the lightest straw to reach, "it's best we let them go now, they have no quality of life."

Only the lightest straw? I don't doubt it. Because something along these lines is often pretty much how it is.

At the end of last year, my elderly grandmother was diagnosed with a particularly nasty form of cancer. We knew that her time was short. We were all prepared. She managed the pain with morphine, increasing the doses every time it stopped doing the job and reaching a pretty staggering dose by the end, but even then it wasn't really doing the job. I last saw her on the afternoon she died, at home as she'd wanted, although she was barely recognisable and may not even have recognised me. Because of the nature of her disease, she'd been able to make plans about how she wanted to die. She was DNR, and not to be taken to hospital - just a quiet slip away under the morphine blanket.

That afternoon, as a family we had a lot of conversations which could be interpreted in this way as taking just the lightest straw to get to whatever you want to put into other people's mouths, because we knew she was going fast and in serious pain, and we could see that every breath was a battle against her entire body. It was agony when she died, and the loss still hurts months later, but it was also a relief. And don't you fucking dare to tell me that this makes us anything but a loving family. She Rests In Peace now, and yes, having seen her at the end, in severe pain even through the morphine, that matters to me hugely. We didn't want to lose her, but we're so glad that her suffering's over.

There are some important practical and ethical concerns about assisted dying, but there's also a huge amount of sanctimonious bullshit flying around. Pumping her full of morphine (by the end, this was done by Macmillan nurses as she was unable to swallow tablets or even communicate clearly) shortened her life compared to other possible treatments, but it was what she wanted and it was the right thing to do. Anything else would have been wanton cruelty, and any attempt to define this as not somehow assisting her to die is pure sophistry. But this is rightly legal and accepted even by people who have an attack of the vapours at the mere suggestion of other means to the same end.

And my grandmother was lucky in one sense - she had the right sort of disease, one in which there's time to formulate an end of life plan and there's a societal acceptance of simply easing the pain at a cost to lifespan. What if she'd felt far greater mental torture from being suddenly paralysed after a stroke? She'd just have to live with it, for years on end, even if she'd rather be dead, because we are a Civilised Society and we know better than her.

We never thought of helping her to die in the way most people here are meaning it, but the final sedative she was given did the job as effectively as anything, as we all knew it would. And we wouldn't consider any alternative means when we knew how fast she was going, but if she'd been in that level of pain for days, weeks, months - how long is she expected to suffer for our legislative convenience?

It's a massively complicated issue, with many associated dangers and pitfalls. It would be nice if the conversation could be free from slippery slopes, Godwins, excluded middles and demonisation of anyone who ever held or expressed (conversations which would take only the lightest straw to reach) a view you disagree with, especially if they aren't present to defend themselves.

--------------------
The first principle is that you must not fool yourself, and you are the easiest person to fool. - Richard Feynman

A letter to my son about death

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Byron
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# 15532

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quote:
Originally posted by orfeo:
You didn't get to decide when to start your life, which raises significant philosophical problems with the notion that 'sanctity of life' means you get to decide when to end it.

quote:
Originally posted by Boogie:
And what does sanctity of life mean anyway?

quote:
Originally posted by orfeo:
^That too, Boogie. Because once upon a time it meant that suicide was a sin. I'm not at all sure what meaning Byron is giving it.

The usual one. Much opposition to assisted suicide and euthanasia is motivated by a belief in the sanctity of life, but it's often not expressed in those terms.
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JoannaP
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# 4493

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quote:
Originally posted by Liopleurodon:
Yeah, I'm pro legalised voluntary euthanasia. Because I think that people have the right to check out when their suffering becomes unbearable. Not because I don't want to see them suffer, but because they don't want to suffer.

I agree that people have the right to check out when their suffering becomes unbearable but I do not see that that necessarily entails the right to demand that somebody else kill them.

--------------------
"Freedom for the pike is death for the minnow." R. H. Tawney (quoted by Isaiah Berlin)

"Those who would give up essential Liberty, to purchase a little temporary Safety, deserve neither Liberty nor Safety." Benjamin Franklin

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Byron
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# 15532

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quote:
Originally posted by Niminypiminy:
I think Andrew Brown has it about right when he says "In general, the people most worried by the prospect of liberalising the law on assisted suicide are the professionals, whether doctors or clergy, who take a low view of human nature, having seen too much of it."

Andrew Brown is an entertaining journo, but he's never met the fallacy he wouldn't spend the night with, so in finest irony, I'm not that worried by what he has to say.

Yes, healthcare professionals are human and therefore flawed. This applies to everything they do. What makes assisted suicide a special case?
quote:
Originally posted by Anselmina:
quote:
Originally posted by Byron:
Putting my own cards on the table, I support both, as I believe that people ought to control their own lives, so much as possible. I'd have no problem with physicians having a conscience opt-out.

On the face of it - in a black and white world - that would appaer to be a practical solution. But what would happen in that case would be what happens - to an extent - in the clergy world of, say, remarriage of divorced people. Those who opt out, because of conscience become those nasty moral judgemental medics who aren't willing to engage with the messiness of pain and death; just as clergy who choose not to re-marry divorcees get labelled as those not wanting to get involved in the sticky end of failed relationships. In other words, their freedom of choice simply becomes a focus of abuse, and a big stick with which to beat them for exercising their 'free' choice. Legislative history strongly suggests that such situations are rarely allowed to rest until the 'right' of one party MUST trump the 'right' of the other party.
Should abortion be recriminalized then? If not, pressure on a person who wants to exercise their conscience isn't grounds to ban something.
quote:
Again, I do think the effect of pressure on the role of the loved ones, next of kin - whatever - is being somewhat underestimated here. Moral pressures within families to act against one's own conscience arise all the time, whether it's as banal as going with a choice of decor you abhor because you share the house with a parent, or taking up a job you don't care for because that's the family expectation. If it's hard resisting a loved-one's pressuring to conform to ordinary lifestyle decisions, imagine the impossibility of a situation such as signing up to a loved one's assisted euthanasia, on the premise of it as a 'free choice'?

It is one thing to discreetly - and on a day-by-day decision-making basis - work alongside medical professionals and with the wishes of the dying person, to respond to what is happening. It's quite another to find that the cold hand of the law is being leveraged against one's own inclination to plan and execute a path of deliberate death. I'm sure there would be a lot of intent with legislators and medical professionals to put in safeguards, permissions - perhaps even pastoral provision. But, personally, I would have little confidence in the comprehensive efficacy of such law-making for all parties - especially for the vulnerable, the dissenting, or the ambivalent.

With coercion, what separates assisted suicide from the withdrawal of treatment, or a DNR notice? These issues exist across the field of medicine, but they seem to get raised selectively, as inverted special pleading against euthanasia.

If murderous relatives are a dime a dozen, shouldn't we ban any home deaths, just to be sure they're not offing their loved ones with a pillow or a vial of morphine?

Of course there should be safeguards against coercion, but in no other area of medicine is its risk used as reason to deny treatment.

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Doublethink.
Ship's Foolwise Unperson
# 1984

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quote:
Originally posted by seekingsister:
quote:
Originally posted by Karl: Liberal Backslider:
Because some people want them and therefore there'll be a market for them?

"Some people" isn't enough to spend hundreds of millions of dollars on R&D. The drugs needed for assisted suicide already exist. Anyone who can do math can guess what a profit-oriented company might choose.

quote:
Originally posted by Karl: Liberal Backslider:
Because they're not the sociopaths you seem to think they are?

I'm not accusing anyone of being a sociopath. There are drugs available in the global market that are more effective than those available on the NHS, but the NHS does not provide them due to cost. I personally am in such a situation. They are making a rational choice, but it affects my life and health for the worse.

To think the same organization would not compare the cost of a new pain management/palliative care therapy vs. that of euthanasia is idealistic at best.

They already do, they work out how much they will pay for a Quality Adjusted Life Year - it is partly derived from large surveys of people asking how they would feel about living with such and such a limitation.

I note the article opines:

quote:
However, the weight assigned to a particular condition can vary greatly, depending on the population being surveyed. Those who do not suffer from the affliction in question will, on average, overestimate the detrimental effect on quality of life, compared to those who are afflicted.


--------------------
All political thinking for years past has been vitiated in the same way. People can foresee the future only when it coincides with their own wishes, and the most grossly obvious facts can be ignored when they are unwelcome. George Orwell

Posts: 19219 | From: Erehwon | Registered: Aug 2005  |  IP: Logged
seekingsister
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# 17707

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quote:
Originally posted by Byron:
The usual one. Much opposition to assisted suicide and euthanasia is motivated by a belief in the sanctity of life, but it's often not expressed in those terms.

Or it's motivated by the fear of potential for abuse and slippery slope. One glances to Belgium and the Netherlands and sees how interest groups have lobbied for the inclusion of the non-terminal, the depressed, and children. Where one of the leading doctors who campaigned for the law, now deeply regrets its introduction.

The Daily Beast

One glances at Oregon where someone was told by the state-run health insurance plan to go for suicide instead of chemo.

quote:
Richardson also interviews uninsured prostate cancer patient Randy Stroup, who was denied further health care by Oregon's insurance program after an initial operation was unsuccessful. In a notorious case that gained nationwide attention, the state offered him the Death With Dignity option instead of further surgery. Although the agency ultimately reversed its ruling and approved chemotherapy, Stroup succumbed, bringing further attention to the inadequacies of healthcare coverage for the uninsured.
Reuters

The pro-euthanasia argument seems to come down to two points:

- I don't want to suffer if I get sick or disabled
- I don't want to watch a loved one suffer if they get sick or disabled (or I've watched it and it was horrible so I don't want to watch it again)

It's all about personal choice and experience. No concern for those who will be victimized by this law - and there will be victims, they've already had them in the other places where this is legal.

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HCH
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# 14313

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Perhaps this is a tangent: I have heard of criminals sentenced to life in prison who stated that they would prefer the death penalty. (Timothy McVeigh was one such.)
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no prophet's flag is set so...

Proceed to see sea
# 15560

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It is said upthread that the idea of being in control one's own life is important. Really? Of one's conception too I suppose, navigating on'e sperm half to the egg half of yourself. And one's birth, by deciding when to go through the tunnel to the light.

--------------------
Out of this nettle, danger, we pluck this flower, safety.
\_(ツ)_/

Posts: 11498 | From: Treaty 6 territory in the nonexistant Province of Buffalo, Canada ↄ⃝' | Registered: Mar 2010  |  IP: Logged
quetzalcoatl
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Knowing when to breathe is also important.

--------------------
I can't talk to you today; I talked to two people yesterday.

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Byron
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quote:
Originally posted by seekingsister:
[...] Or it's motivated by the fear of potential for abuse and slippery slope. [...]

I'm not arguing that abuse isn't a valid concern. (The "slippery slope" is a fallacy.) Why single-out euthanasia?

Your example from Netherlands is a specific issue, the ability of mentally ill patients to give consent. This issue extends beyond euthanasia, and would apply equally to a withdrawal of treatment. It's not an argument against euthanasia per se, but against a specific model of euthanasia. Don't allow people with depression and no other medical issue to be euthanized, and that problem goes.

The Oregon case is an egregious abuse, that says far more about insurance than it does assisted suicide. The callous accountants could equally have told him to withdraw from treatment and allow nature to take its course.

In both cases, specific issues are inflated to argue against an entire sphere of medicine. Unless this happens across the board, it suggests that abuses are being used as a pretext for something else, even if you're unaware of it. (It may not be sufficiently hellish to say I've done exactly the same thing myself, but I have, and often. We're all subject to unconscious motives and confirmation biases.)
quote:
The pro-euthanasia argument seems to come down to two points:

- I don't want to suffer if I get sick or disabled
- I don't want to watch a loved one suffer if they get sick or disabled (or I've watched it and it was horrible so I don't want to watch it again)

It's all about personal choice and experience. No concern for those who will be victimized by this law - and there will be victims, they've already had them in the other places where this is legal.

Of course I'm concerned about abuses. I just try to ensure my concerns are proportionate.
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no prophet's flag is set so...

Proceed to see sea
# 15560

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quote:
Originally posted by quetzalcoatl:
Knowing when to breathe is also important.

The point I think it that we have an illusion of control, even when we assert we are and feel we are, we aren't. Life is somewhat easier, and what I've observed of death and people dying is that it's better to understand you're not in control of either.

--------------------
Out of this nettle, danger, we pluck this flower, safety.
\_(ツ)_/

Posts: 11498 | From: Treaty 6 territory in the nonexistant Province of Buffalo, Canada ↄ⃝' | Registered: Mar 2010  |  IP: Logged
quetzalcoatl
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# 16740

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quote:
Originally posted by no prophet:
quote:
Originally posted by quetzalcoatl:
Knowing when to breathe is also important.

The point I think it that we have an illusion of control, even when we assert we are and feel we are, we aren't. Life is somewhat easier, and what I've observed of death and people dying is that it's better to understand you're not in control of either.
Yes, I was being sarcastic. One thing I have learned through working as a therapist, is that when people resist some difficult process, such as mourning, they usually feel awful; if they surrender to it, they often feel awful, but they get through it, and it is over.

--------------------
I can't talk to you today; I talked to two people yesterday.

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Gwai
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# 11076

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quote:
Originally posted by seekingsister:
The pro-euthanasia argument seems to come down to two points:

- I don't want to suffer if I get sick or disabled
- I don't want to watch a loved one suffer if they get sick or disabled (or I've watched it and it was horrible so I don't want to watch it again)

It's all about personal choice and experience. No concern for those who will be victimized by this law - and there will be victims, they've already had them in the other places where this is legal.

Can you promise that there won't be victims if assisted suicide becomes/stays illegal? For instance, that no one will die horribly in pain feeling that they've had the right to die as they wish stolen from them? That argument only works if you can show that there will be clearly more victims one way than the other.

--------------------
A master of men was the Goodly Fere,
A mate of the wind and sea.
If they think they ha’ slain our Goodly Fere
They are fools eternally.


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Gwai
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# 11076

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quote:
Originally posted by no prophet:
It is said upthread that the idea of being in control one's own life is important. Really? Of one's conception too I suppose, navigating on'e sperm half to the egg half of yourself. And one's birth, by deciding when to go through the tunnel to the light.

You aren't the only one who can take an argument to silly extremes. If control is not important, does that mean you'd be okay if the government told everyone who to marry, when to have kids, if they needed to divorce, and where to work?

--------------------
A master of men was the Goodly Fere,
A mate of the wind and sea.
If they think they ha’ slain our Goodly Fere
They are fools eternally.


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