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Euthanasia


Monkee
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This might be worthy of a thread in itself but we’ll see how it goes.

Inspired by the recent topic in the pets thread and personal goings on, what’s everone’s views on euthanasia?

It baffles that we can put an animal down - whether due to illness or overpopulation  (more common in the US) - yet a perfectly rational human being can be denied the right to make this decision about their own life. Or, depending on a situation, a relative cannot make the decision on their behalf.

Today was the funeral of my aunt. She had a severe stroke on Christmas Day and they pretty much knew right away there was nothing they could do. Over the last two weeks they had withdrawn care except for sedation. They stopped feeding her.

What completely tore me up though is that I’ve been led to believe that with a stroke the person may still be able to hear even if they are unable to move or open their eyes. I’d like to believe this as my grandfather (my best friend growing up) had a stroke and thankfully he didn’t stay long after and we were all with him when he went - telling stories and remeniscing, hoping he was listening in (getting upset just writing this).

But my aunt was left to linger. She was one of about 8 children and they were all getting very upset visiting her in hospital (understandably I know) but after about a week some siblings were saying they couldn’t face going back. I think either her son or daughter even said the same. How dare they leave her alone like that. How selfish are they that they decided to leave her and not even visit?! This made me so angry and upset.

Anyway, she finally passed last week but it really makes me think about end-of-life care or even life care such as people with MS or similar who make the perfectly reasonable decision on when and where and how they would like to die. My mother’s worst fear is dementia and always says she wants to go to Switzerland if that happened and the time was appropriate. I keep telling her she needs to make a living will but she’s still not gotten around to it...

So, after rambling, I wanted to get your views on this. Do you think we should have some sort of right to die and that medical staff should be exempt from facing prosecution?

Edited by Monkee
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I believe that providing everything checks out as being above board, medical and legal professionals agree that nothing underhanded is taking place (such as the power of attorney isn’t making unjustified decisions... or that the illness & decision isn’t based on temporary difficulties) then yes, i 100% believe that people should have the choice to die. I am thoroughly pro choice (even with what I believe are reasonable caveats as mentioned above).

Personal note:

My great Aunt Anne who is 80 is currently in hospital, my family have been called to her bedside for the 2nd time in 24 hours. Her lungs no longer function as of this morning. The decision has been made to feed her a drip which will cause unconsciousness until she dies, which could be any minute, hour, whatever from now. It’s been 11 hours since the drip was implemented.

What’s the point? she can’t recover, she can’t breath/live, why on Earth would a hospital bed, equipment, medicine and doctors time by used for this. I love her dearly, more than this post makes out, but this is idiocy.

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A similar thing happened with my stepdad. He fell and suffered some internal injuries which led to some nasty bleeding. When he got to the hospital and we found out the extent of the damage, along with knowing how advanced his cancer had gotten they gave us the choice of either keeping him alive hooked up to machines and not really able to do much of anything, or just making him comfortable and letting him go. I think in certain circumstances when it's a quality of life issue then yes, the option should be there, but it's how to establish that it's a legitimate request.

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I've seen friends and relatives go through barbaric levels of needless pain, with no hope of it leading to improvement, for absolutely no reason other than our law shows a hopeless timidity when it comes to this subject. I find it ludicrous and cruel that we have the antiquated view of end of life care. So few of us, especially in an increasingly areligious country, would want our suffering perpetuated, but yet it continues.

I'm firmly convinced that this is one of the subjects we'll look back at in in 50 years time and be appalled at our conduct, in the same manner as (just over) 50 years ago and homosexuality, or various other social reforms that were addressed during the first Wilson government. 

Do strict processes and procedures need to be in place to ensure that people aren't getting bumped off needlessly, or by relatives? Of course. But the arguments made by people claiming this will be of insurmountable difficulty are naive, or deliberately exaggerated. I also wouldn't want to necessarily put this responsibility on nurses/doctors who were uncomfortable. The fundamental problem is that many people find killing others, even for the most laudable reasons, distasteful. We let that get in the way of what, to my very core, I believe is as ethically right as you can get in a world where ethics are but a human construct. We are being cruel in order to pretend to each other that we are being kind. 

 

Edited by Gus Mears
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I'm not saying any of your points aren't valid there, Gus, but I do believe any change in the law towards legalising it will result in people being killed against their will because of convenience, money, whatever, regardless of a system or checks put in place. And once the system's been gamed in that scenario, the chances for error correction are historically low.  Obviously there needs to be a discussion, I wouldn't want to have it with the Tories in power, though. If there's a chance to privatise your death, Jeremy Hunt will be all over it.

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1 hour ago, hallicks said:

I'm not saying any of your points aren't valid there, Gus, but I do believe any change in the law towards legalising it will result in people being killed against their will because of convenience, money, whatever, regardless of a system or checks put in place. And once the system's been gamed in that scenario, the chances for error correction are historically low.  Obviously there needs to be a discussion, I wouldn't want to have it with the Tories in power, though. If there's a chance to privatise your death, Jeremy Hunt will be all over it.

Cheers for the reply, Hallicks. Not going to get into the Conservative politics aspect of this with you (in this thread at least) if it's all the same, because it will inevitably end up miles away from the subject matter. 

I disagree with you that many people are going to be killed against their will as a result of this. Why do you believe it is an inevitability? What evidence is there of this? (genuinely interested, as I think by and large Dignatas have stayed pretty clean) I can't conceive of a system being set up that is not geared towards being safety-first, because the majority of public opinion essentially chimes with your view that people are shit-scared of getting it wrong. Far from it being a case of whispering words in Granny's ear and getting her to sign the papers, I would imagine there would be a glut of exercises to go through, and the likelihood that if you were not able to make a proactive choice on the matter (say, if you were in a coma), then current policies would remain in place. 

Partly, this is because it makes sense as an initial stage, so as not to have avoidable death, but predominantly, it is because the politics of being the government that makes such a significant change in end of life care would deem it a necessity. Looking at it from a purely cold-hearted political perspective, the potential for dreadful headlines based on needless death would be massive. If I'm thinking this, there would be dozens of press advisers, SPADS in the Department for Health, Ministers and wider thinking the same thing, but with far more reason to ensure that it doesn't become an issue.  

Second point is more a wider ethical one, but does the potential of a person getting killed against their will justify numerous people being in pointless agony for extended periods of time? If you believe that the potential of one person dying without need legitimates the current system, OK. But if we are really going to look into  the ethical ledger sheet with this, what's the knock on effect for those around the terminally ill? Does the misery of seeing a loved one in shocking pain justify the potential of a death somewhere else? Does the related impact on the health of those around justify it? 

This might sound slightly spurious, but I think it really matters to consider the far reaching ramifications of ethical decisions. I feel that it isn't as simple as 'if we allow a degree of euthanasia, more people will die'.  To put it into a relatively recent example at what I am getting at, the parent of a good friend of mine was terminally ill a few years ago with renal failure. She knew she was going to die, we knew she was going to die and she wanted to go about 2 and a half months before she eventually did. In the intervening period, her husband got progressively more ill (suffered from breathing conditions) which was understandable for a man with a bus pass dealing with the pain of seeing someone that ill every day. He died shortly after his wife, and I am absolutely convinced it was precipitated by an extra 2 and a half months of pointless suffering prior to being able to properly grieve. He intimated as much to me when I visited him in hospital shortly before his passing. 

The even longer term ramification of that event was that it caused my mate to go into a complete tailspin (understandable when both parents go within months of eachother), lose his house, job and have nervous breakdown. Would this have been prevented by euthanasia being legal? I don't know for certain and, of course, these arguments will never have the evocative nature of a Daily Mail headline reading 'WOMAN KILLED BY NEW LAW' because of that. But more than simply measuring cadavers pre and post euthanasia law is really vital.

Just on error correction. I don't think that would be too problematic in all honesty. Again, reasoning for this is chiefly political from my perspective. I think the consultation period on this will be enormous and take in a huge level of expert opinion to get the law as right as possible. This would also be a piece of legislation with a great deal of public attention on it, which would mean that if something isn't working in practical terms, it would be addressed quickly as a political necessity, probably through secondary legislation (so you would not need to pass a new law). I also could easily foresee whoever passed such a bill setting up an independent body for euthanasia which would alter things when necessary, because it would take the flack off the government of the day if something went wrong, and because it makes sense to not have work on this reduced to partisan politics every 3 seconds. 

Edited by Gus Mears
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For the most part, I agree with Gus' post; excellent points, all. Given that the vast majority of human beings are generally horrified by killing, I greatly doubt that any system put in place would not be as rigorous and exacting with regard to the patient's circumstances, frame of mind, etc. I don't know the details of Dignitas' system, but I would be very surprised if applicants weren't assessed exhaustively at both a physiological and a psychological level (not just for mentally debilitative conditions, but also for extreme depression). And I daresay the suspicion of potential foul play is one of the first things in people's minds when discussing potential plans to lay down a viable framework for euthanasia schemes.

And yes - whilst the possibility of even one wrongful death is truly horrifying to contemplate, the sheer amount of suffering that goes on simply because society is paralysed by that very fear is just too much to justify it as a rationale for continuing to prohibit it. Ultimately, it comes down to what you consider to be the greater of two evils: potential wrongful death (however few), or continued suffering en masse. I personally consider the latter to be worse; we can always legislate to alleviate the dangers of the former, but the latter has come about because we haven't yet acquired the capability of alleviating it in the first place.

Moreover, sufferers cannot be viewed purely in isolation: if they are forced to continue suffering for an extended period, longer than is humane, this has a much greater adversarial effect on those around them than should be allowable. At the very least, with the possibility of euthanasia, all those involved are given some degree of control over when it happens, how it happens, and how much time they have to prepare, in addition to the prevention of unnecessary stress and grief (of which the physical effects are all scientifically demonstrable).

All these factors, as far as I'm concerned, would legitimise a euthanasia system that had thorough checks and balances all throughout, and had mechanisms every step of the way to allow for changes of mind, but also to enable full transparency to prevent attempts at foul play.

The only problematic factor that I can see logistically would be resolving this issue with insurance companies. Does anyone know what the current arrangements under the Swiss system are?

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@Gus Mears I won't quote to save screen space. Just to be clear, I didn't say "many people" would be killed, if I implied "many" that's my mistake, sorry. As you rightfully say, there would and should be many checks and a procedure in place to stop people exploiting it for personal gain. As for why it would be an inevitability, well, look, it's not very scientific, but there are some very shit humans out there that would go to extraordinary lengths to get free money, even at the expense of an innocent person's life. You just give them that chance, I guarantee there will be fuckers that will try to take it.

As for the wider moral implications, it's a tricky one. "Does the misery of seeing a loved one in shocking pain justify the potential of a death somewhere else?" Well, who gets to decide that? Is it worse for more to needlessly suffer than for others to needlessly die against their wishes? Where do you draw that line? I watched Alzheimers slowly turn my dad into a shell before eventually succumbing it. But I also know that he was a Catholic and it would have been his choice to go that way. What if he didn't have family and there was no-one to honour his wishes, and a decision was taken, "well, he's in pain, can barely move or talk, has to wear a nappy, let's get it over with", or if he had money and the aforementioned fuckers were trying to get at it? I'm not saying the system wouldn't account for these scenarios, but maybe I'm just too cynical to think there wouldn't be innocent lives lost. Would I feel differently if it was my mum or other half going through something similar as your friend's parents? I don't know.

Re: error correction, I just meant if someone was killed against their will for whatever reason, it's quite difficult to come back from that.

Also I must stress I'm not really on one side or the other. I appreciate there are very good arguments on both sides. I'm not sure I'd want to choose which one to be on.

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Apologies on the 'many' aspect of that, Hallicks. think I deliberately misread it in my head due to, basically, having the same view as Carbomb in that I probably would, if forced, chose a few unnecessary deaths over a continuation of the present system. I don't know how 'many' would be in my head, and it's hardly a decision that any of us would want to make, but I would on balance.

I think you are, in all honesty, right that there would be a wrongful death somewhere and at some time. But I do have genuine confidence that a robust system could be designed, modified when needed, and maintained through non-primary legislative means. I absolutely think you would need to start on the (small c) conservative end of the spectrum around the ease to which you could take such a decision. A good degree of self-awareness of the situation etc. and not being heavily compromised in terms of cognitive function (some of the things you mentioned). I feel bad in theory about that, because it allows a lot of awful situation to fall by the wayside, but I can't see how it would commence any differently without the aforementioned issues. 

Get you now with regard to error correction, mistakenly thought it was related to the policy itself. 

I am certainly clouded by experience on this one. Of the five close people I have lost over the past five or so years, two had extended periods of hospital-bound illness where they would have taken the decision to end their life if offered. 

Bloody hell, Carbomb and I largely agree on a politics/ethical/historical point! 

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1 hour ago, Gus Mears said:

Bloody hell, Carbomb and I largely agree on a politics/ethical/historical point! 

Euthanasia's one of those subjects where the controversy of it isn't divided at all along the political axis, I think. There are issues that end up being intersected by both politics and morality, but euthanasia seems to be almost strictly a moral question, which can divide traditional left- and right-wingers in ways you wouldn't expect.

Basically, we're more likely to agree on things discussed by bishops rather than MPs.

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I think Death is/will be the last taboo.

I recall a few years ago, there was due to be coverage of a Commons debate, but then Diane Abbott said something racist and all coverage swung to that, because that's what matters, obviously.

I wholeheartedly support the right to die, and living wills should be used much more than they are. I think a patient with a terminal condition should be able to choose to forgo months of pain and deterioration in favour of a comfortable, even happy passing, with all the expected physical and psychological assessment, and social support in terms of getting one's affairs in order.

This would of course be spun as "hospitals becoming death factories!" and other Soylent Green-level nightmare visions. Speaking personally, I would rather my family remember me as close to I am now, conscious and happy, than as the tube-ridden husk I would become if forced to stay on life support. I'd rather the Brixton cocktail than dissolving into dust.

Incidentally, we suspect my grandfather may have been "helped along" by his carers in his last day before succumbing to cancer. After weeks of deteriorating health and wavering consciousness, he suddenly had a day when it was as if he was back with us, tired, but still cheery and jokey and the man we all knew. Coincidentally, this was a day when most of his family had made plans, independently, to see him. Before we left, my mum (his daughter) joked to him "Don't you go anywhere." He died less than an hour after we went, having said his goodbyes as himself.

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