Assisted dying - where do we really stand?

[archie]

I have wanted to open this up for debate for a while, but have been hesitant for a number of reasons. I know it's been discussed before, but I'm conscious that there are really strongly held views on the issue. That's not a reason to avoid the discussion, but unlike other topics here, there will be a lot of deeply personal feelings and experiences that maybe don't lend themselves to Holy Ground knock about. But over the new year period I read this article that really seemed to capture where my thinking is: https://www.theguardian.com/commentisfree/2023/jan/01/assisted-dying-seems-humane-but-can-we-protect-the-vulnerable-from-the-malign

When I was younger, I thought it was unbelievably cruel to force people to stay alive when they found it unbearable and couldn't end their lives themselves and the consequences for people who helped them were severe. I can still see that argument, but as I got older, I increasingly have doubts about the issue. I don't know whether that's because you become more aware of your mortality as I get older or simply it's easier to have unquestionable certainties when you are young.

A number of things have moved my thinking on this. And just to be clear, it's not a religious issue for me.

As I get older I'm much more sensitised to issues that involve ending life. It's such a precious thing that I can't easily agree to options that involve ending life. It might be embarrassingly idealistic, but I can't feel comfortable in a society where assisted dying is part of a suite of care options. I'm not naive. I watched by own mother die and her last few days were excruciating. This was partly because the hospital was concerned not to send her over the edge and so took time get the meds right. Her last day was very peaceful and it's that I hold on to. But it didn't make me think she should have been given drugs to end her life, not least because it's not what she would have wanted.

But what if it is what someone wants? Why not agree to their wishes? Again, it's not as straightforward as it appears. There is talk of living wills where someone says they would rather die than go through the end stages of dementia. But how do we know what they thought 10 years ago represents what they might think now? We can't ask them. Also, the pressures on older people (often self-imposed) to avoid being a burden as very strong. I knew a consultant who worked with older people. They told me that the biggest question they were asked was 'can you not just give me a blue pill'. This wasn't always due to pain. In one case they thought the estate would help grandkids buy a house.

And that's where I hit my biggest concern. When I was younger I would have dismissed the slippery slope argument out of hand. But looking at the application of assisted dying laws elsewhere, it does seem to have moved on from what I think most people would envisage it for. I assumed the focus was on people who found end of life excruciatingly painful or humiliating. But in holland we have cases where the justification for an assisted suicide is a person's mental illness. To me that's the very case where it shouldn't be allowed. I was also troubled by the case of Daniel James who was taken to Dignitas at 24 after a tragic rugby injury made him a quadriplegic. Is there nothing we could have offered them? And is Canada really discussing extending assisted suicide to 'mature children'?

So what's the resolution? I'm still supportive of the idea that people should be able to end their life in dignity. But I'm perplexed as to how we do that in a way that respects their rights, but doesn't compromise the rights of other, often vulnerable, people. And a society that doesn't value or support life is not one I feel comfortable with at all.

But, as ever, I welcome thoughts and views.

[Glory Lurker]

This has the potential to be one of the best threads we've had on here. Thanks, archie, for putting it up.

[archie]

This has the potential to be one of the best threads we've had on here. Thanks, archie, for putting it up.Thanks! I'm really interested in what people have to say.

[Glory Lurker]

Thanks! I'm really interested in what people have to say.

Me too. I am roughly where you are although a bit more in favour of it being introduced. There is a fair bit of instinct in that opinion so I need to test that. Your post and the article have already caused me a wee bit of turmoil!

[Santa Cruz]

What a really well constructed and sensitive post the OP has written. I share most of the OP's views. I find it personally distressing reading stories of people feeling they have no choice but to travel overseas to end their life at Dignitas, but in some cases I understand their decision. It's the loopholes that exist in all legislation that could be exploited that is the biggest concern. I don't know how you safeguard against that, that would be the stumbling block for me. If I was asked to vote on this, I honestly think I'd abstain.

[JeMeSouviens]

I think (if I read the post carefully enough) I"m in a similar-ish boat to the OP: not opposed/can see good in the principle of assisted dying but am deeply concerned about how it would work in practice, especially if/when it became a more widespread, normal occurrence.

In particular the thought of unscrupulous family members putting pressure on to get things over with gives me the heeby jeebies.

[Paul1642]

A very well thought out post Archie and has the potential to be very interesting.

My personal view is that I am for it in limited capacity. When someone is at the excruciating pain stage of an illness or becoming incapable of even the most simple movements and tasks it is cruel to force them to live if they would rather not.

It’s really hard to imagine your being in the situation of being in constant pain with no hope of recovery because you will only be in it once in your life, however my current thought is that I would definitely like to call it a day in my own terms when the pain of living started to outweigh any happiness or joy.

You get 60/70/80/90 years of good life, why drag out the final and worst few months.

The occasional news story’s that surface about family members assisting a relative with suicide are absolutely heartbreaking and no one should ever feel like that is the only option.

The safeguarding would need to be immense but it’s the right way to go.

[HibsGW]

I think (if I read the post carefully enough) I"m in a similar-ish boat to the OP: not opposed/can see good in the principle of assisted dying but am deeply concerned about how it would work in practice, especially if/when it became a more widespread, normal occurrence.

In particular the thought of unscrupulous family members putting pressure on to get things over with gives me the heeby jeebies.

I think a very short summary of it is that theoretically, I agree that assisted dying makes sense if some people would want that option but I don’t see how it could ever be applied in a way that would 100% prevent outside factors (other family members etc) influencing decisions. With that in mind, I think I couldn’t support it.

[wookie70]

I have always been in favour and it happens now in some ways by treatment being withheld.

My Dad had a horrible death. He was a proud, active and intelligent man. His last years were miserable for everyone. At one point we were asked about treatment when he was in intensive care, made worse after being assaulted by another patient whilst he was bedbound. Our instructions were clear in that we wanted no treatment unless it was to prevent pain. He then got sepsis and he was very frail along with prostate cancer and a number of other issues including dementia. We had full legal right to make decisions on his behalf. As it was the Doctors at the hospital called me while at work to discuss the sepsis but I didn't have a signal. They treated my father, against the families instructions, and he had a miraculous recovery from the sepsis but moved to the bottom rung of the health ladder. He survived another 9 months in a care home just about knowing who we were and growing weaker and more distant by the day unable to do even the most basic tasks. He pretty much died in front of me day by day. It was a horrible way to die and one which no-one in our family subscribes too. We are all fairly pragmatic and have no faith. To us it was fairly obvious a life was being extended past it being worth living. That meant not only my dad suffering but all those that loved him. I've had that discussion with my wife and she knows she can pull any plugs any time when I can't go to the toilet myself or converse with others. If I can't communicate and have no dignity I don't want to be here.

I think we need to have a sensible discussion as a society. I think individuals have dominium over their being and I also think there needs to be some way that they can decide to pass that to others or that can be legally passed to others by the state. It is deeply personal though and some value life over living and that is entirely valid too.

My feeling is that the laws around this have been very influenced by the Church and as a society we are moving in a different direction. I would absolutely want those whose faith means they have an opposing view to mine having the availability of care and treatment until nature takes it course but for many others I want the option or I want my loved ones to have the option on when my lights go out, if that is a decision that needs taking. I trust them to know what is right for me. If I never had any loved ones I'm fairly sure I could write a set of instructions that a trusted health care professional could use as a decision tree if teh law allowed and that could be overseen by a legal person.

Really interested to read replies and other's thoughts. It is a difficult subject and hopefully nothing I have written is disrespectful.

[archie]

I have always been in favour and it happens now in some ways by treatment being withheld.

My Dad had a horrible death. He was a proud, active and intelligent man. His last years were miserable for everyone. At one point we were asked about treatment when he was in intensive care, made worse after being assaulted by another patient whilst he was bedbound. Our instructions were clear in that we wanted no treatment unless it was to prevent pain. He then got sepsis and he was very frail along with prostate cancer and a number of other issues including dementia. We had full legal right to make decisions on his behalf. As it was the Doctors at the hospital called me while at work to discuss the sepsis but I didn't have a signal. They treated my father, against the families instructions, and he had a miraculous recovery from the sepsis but moved to the bottom rung of the health ladder. He survived another 9 months in a care home just about knowing who we were and growing weaker and more distant by the day unable to do even the most basic tasks. He pretty much died in front of me day by day. It was a horrible way to die and one which no-one in our family subscribes too. We are all fairly pragmatic and have no faith. To us it was fairly obvious a life was being extended past it being worth living. That meant not only my dad suffering but all those that loved him. I've had that discussion with my wife and she knows she can pull any plugs any time when I can't go to the toilet myself or converse with others. If I can't communicate and have no dignity I don't want to be here.

I think we need to have a sensible discussion as a society. I think individuals have dominium over their being and I also think there needs to be some way that they can decide to pass that to others or that can be legally passed to others by the state. It is deeply personal though and some value life over living and that is entirely valid too.

My feeling is that the laws around this have been very influenced by the Church and as a society we are moving in a different direction. I would absolutely want those whose faith means they have an opposing view to mine having the availability of care and treatment until nature takes it course but for many others I want the option or I want my loved ones to have the option on when my lights go out, if that is a decision that needs taking. I trust them to know what is right for me. If I never had any loved ones I'm fairly sure I could write a set of instructions that a trusted health care professional could use as a decision tree if teh law allowed and that could be overseen by a legal person.

Really interested to read replies and other's thoughts. It is a difficult subject and hopefully nothing I have written is disrespectful.Thanks for your really thoughtful post.

[oconnors_strip]

I fully support assisted dying but only for certain people, eg certain medical conditions or circumstances. I have watched family and friends slowly die and it’s absolutely heartbreaking for myself and even worse for the person who is suffering.

When my grandma was in intensive care for 6 weeks, I could see the hurt and pain in her eyes, it felt like she was telling us she wanted to close her eyes and never open them again. Thankfully the consultants eventually said she would never recover and my grandad made the decision to stop any medical care.

There of course would have to be rules and regulations, and lots of discussions with people who would be “eligible” for this and medical experts. I don’t mean to sound disrespectful here, but if you didnt meet all the levels required then you wouldn’t be allowed to do this, no appeals or taking to court.

My dad is 74 and doesnt have the best of health, and has talked about his future, if he was to take unwell and be put on life support, he has said don’t. He doesn’t want to prolong misery for him and our family. I think this is something families should talk about, it would save a lot of problems and heartbreak.

[ErinGoBraghHFC]

I’m in my twenties so maybe that’s why my view on it is so strong - I’m fully supportive of it. I’ve watched two of my grandparents in excruciating pain in their finals days (from lung cancer and multiple myeloma) and I just can’t see past it. It’s inhumane to have a person suffer like that unnecessarily imo


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[archie]

I’m in my twenties so maybe that’s why my view on it is so strong - I’m fully supportive of it. I’ve watched two of my grandparents in excruciating pain in their finals days (from lung cancer and multiple myeloma) and I just can’t see past it. It’s inhumane to have a person suffer like that unnecessarily imo


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Thanks for posting. I hope this isn't intrusive, but did your late grandparents express a view?

[NORTHERNHIBBY]

My late father passed away after a stroke. It was a stroke after a series of little strokes so the damage was incremental. Almost cruelly, the 100 percent oxygen and the feeding by tube whilst he was deeply sedated fighting an infection, took years off him in weight loss and pink skin colour replacing grey. He almost looked like he was asleep. The best recovery that the doctors would commit to, was alive and breathing and brief periods of lucidity. Everything would have to be done for him, and there would be no mobility or speech. That's dead while being alive and he would have hated that, and also would not have wanted to put us through the drawn out heartache of dying in stages. We gave the go ahead to remove treatment and he slipped away in his own time. That's a form of assisted dying and it was the right thing to do.

[Skol]

Some very well thought out and presented posts on this thread.

I am not sure where I stand on this exactly, but reading the posts made me think. I see a difference between assisted dying and not prolonging life when’s the quality of life is going to be limited.

I think on balance I don’t support assisted dying as a choice. However families choosing not to accept treatment just to prolong life I think I do agree with.

Right now I have a family member who has a pretty limited quality of life due to a variety of issues. However although they are unwell there is nothing sinister going on and they could continue with ongoing deterioration for many years to come. This is already challenging for the family and will become more and more challenging as time move on.

It really is a difficult situation to deal with.

[EH6 Hibby]

I think on the whole I agree with people being allowed to end their life if they have a terminal illness that has no chance of getting better. I struggle with it for the reason already brought up by a few people, the decision not being fully the patients own choice. I was in hospital a few years back and there was an old lady in the bed opposite me that had cancer. She was from West Lothian and we were in the western general hospital. Her family did nothing but complain about the fact that they had to travel to Edinburgh, they had loud discussions with her telling her to tell the doctors that she didn’t want treatment, and when the doctor was discussing her options, they kept talking over her to reject all the options, when they were not there she was asking about each of the options and it really seemed like she wanted to try. I often wonder what happened to her after I was discharged because it really seemed like she was being made to feel like a massive inconvenience to her family and I worry that they talked her out of treatment.

I’m not sure how that sort of situation would be prevented if assisted dying was an option.

[ErinGoBraghHFC]

Thanks for posting. I hope this isn't intrusive, but did your late grandparents express a view?

They may well have done to my parents but that’s not something that’s have been discussed around myself or my cousins at the time, they tried to shield us from it to an extent but it was fairly clear to see the pain they were in


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[HibsGW]

I think on the whole I agree with people being allowed to end their life if they have a terminal illness that has no chance of getting better. I struggle with it for the reason already brought up by a few people, the decision not being fully the patients own choice. I was in hospital a few years back and there was an old lady in the bed opposite me that had cancer. She was from West Lothian and we were in the western general hospital. Her family did nothing but complain about the fact that they had to travel to Edinburgh, they had loud discussions with her telling her to tell the doctors that she didn’t want treatment, and when the doctor was discussing her options, they kept talking over her to reject all the options, when they were not there she was asking about each of the options and it really seemed like she wanted to try. I often wonder what happened to her after I was discharged because it really seemed like she was being made to feel like a massive inconvenience to her family and I worry that they talked her out of treatment.

I’m not sure how that sort of situation would be prevented if assisted dying was an option.

This is the worry I would have, you could end up with some horrible situations occurring and even if it was a small minority I couldn’t accept it with that in mind.

[pollution]

I think on the whole I agree with people being allowed to end their life if they have a terminal illness that has no chance of getting better. I struggle with it for the reason already brought up by a few people, the decision not being fully the patients own choice. I was in hospital a few years back and there was an old lady in the bed opposite me that had cancer. She was from West Lothian and we were in the western general hospital. Her family did nothing but complain about the fact that they had to travel to Edinburgh, they had loud discussions with her telling her to tell the doctors that she didn’t want treatment, and when the doctor was discussing her options, they kept talking over her to reject all the options, when they were not there she was asking about each of the options and it really seemed like she wanted to try. I often wonder what happened to her after I was discharged because it really seemed like she was being made to feel like a massive inconvenience to her family and I worry that they talked her out of treatment.

I’m not sure how that sort of situation would be prevented if assisted dying was an option.


I can imagine that type of conversation happening. Especially if there is a big inheritance to be had. Unscrupulous family could easily put emotional pressure

on the relative to choose to not be a financial burden and to go quietly and quickly. Stories abound in Canada, from what I have read.

[McD]

I think on the whole I agree with people being allowed to end their life if they have a terminal illness that has no chance of getting better. I struggle with it for the reason already brought up by a few people, the decision not being fully the patients own choice. I was in hospital a few years back and there was an old lady in the bed opposite me that had cancer. She was from West Lothian and we were in the western general hospital. Her family did nothing but complain about the fact that they had to travel to Edinburgh, they had loud discussions with her telling her to tell the doctors that she didn’t want treatment, and when the doctor was discussing her options, they kept talking over her to reject all the options, when they were not there she was asking about each of the options and it really seemed like she wanted to try. I often wonder what happened to her after I was discharged because it really seemed like she was being made to feel like a massive inconvenience to her family and I worry that they talked her out of treatment.

I’m not sure how that sort of situation would be prevented if assisted dying was an option.


cant actually express how upsetting and the fury at reading that, sickening


It is true though, how family members can choose to act in these kinds of moments. A friend of mine has lost both his parents, a number of years apart, and on both occasions had to deal with family members acting like vultures, demanding access to the recently deceased’s home to take what they wanted (and have a rake for what else they could find), appearing with lists of jewellery that they were expecting to be handed over, screaming down the phone at support staff in the home, even turning up on the morning of the funeral to make it clear that, just before we go to the church, you know your mum told me I was to be given xxx thousands of pounds when she died?

[wookie70]

I can imagine that type of conversation happening. Especially if there is a big inheritance to be had. Unscrupulous family could easily put emotional pressure

on the relative to choose to not be a financial burden and to go quietly and quickly. Stories abound in Canada, from what I have read.

I think those worries are all well founded but in similar situations the alleged unscrupulous family member could be the only one representing the wishes of the ill family member. Greed and need are pretty powerful motivators though so it will never be straightforward. Like many laws though you can't just legislate on the extreme examples and I would hope those arguing in public or seeking to end someone's life for their own gain would be an extreme. The vast majority of people I know who went through loved ones dying in horrible circumstances went above and beyond what is decent and any decision on assisted dying would be mostly about the patient but with thought given on how that patient would view their loved ones suffering too.

I see this as something that should happens when in good health and not when already in a stressful situation. Yes, view mays change but it would certainly provide an intention much like a donor card did. There will never be a perfect solution to this but the current situation, particularly with a population living into old age and more likely to suffer Dementia etc, it needs looking at.

[Hibby70]

Unfortunately this topic is something that we are starting to consider. My father is determined that he doesn't want to endure months of pain for an illness that is ultimately terminal.

He wants us to help him set this up with dignitas. I have a number of fears but some are more around the legalities for those that help plan and assist him.

I believe that it's a maximum 14 year sentence for assisting someone with suicide and a potential that you lose rights to inherit. On the flip side I wouldn't want him to have to organise it himself and definitely wouldn't want him alone on his final journey.

[nonshinyfinish]

Unfortunately this topic is something that we are starting to consider. My father is determined that he doesn't want to endure months of pain for an illness that is ultimately terminal.

He wants us to help him set this up with dignitas. I have a number of fears but some are more around the legalities for those that help plan and assist him.

I believe that it's a maximum 14 year sentence for assisting someone with suicide and a potential that you lose rights to inherit. On the flip side I wouldn't want him to have to organise it himself and definitely wouldn't want him alone on his final journey.

Does this apply to a Dignitas-type situation where you're helping someone to go somewhere where assisted dying is legal?

[wookie70]

Unfortunately this topic is something that we are starting to consider. My father is determined that he doesn't want to endure months of pain for an illness that is ultimately terminal.

He wants us to help him set this up with dignitas. I have a number of fears but some are more around the legalities for those that help plan and assist him.

I believe that it's a maximum 14 year sentence for assisting someone with suicide and a potential that you lose rights to inherit. On the flip side I wouldn't want him to have to organise it himself and definitely wouldn't want him alone on his final journey.


No idea on the law but hope it all turns out as well as it can in the horrible circumstances.

[Hibby70]

Does this apply to a Dignitas-type situation where you're helping someone to go somewhere where assisted dying is legal?

It's still applies, whether the courts have ever prosecuted someone for it is another thing. Still not a nice thing to be hanging over you mind you.