Assisted Death

[Margaret Pilkington]

John, that is because Morphine is regulated by the Dangerous Drugs Act(1920) and is what is known as a controlled drug........and yes Dianne, Morphine does depress the respiratory centre in the brain....all opiates do this, but the effect is much more pronounced in the absence of pain.....so if you give someone who is painfree, a good dose of morphine, it is a good way to see them off this mortal coil......thier breathing will just get shallower and shallower until it stops altogether.

[Margaret Pilkington]

I think the DDa was brought up to date in the seventies, and I don't know if the Shipman case made the authotities look at the use of controlled drugs again....can't remember.
Would have to check that out.

[Acrylic-bob]

I must admit to being a little ambivalent on this subject.
Would I wish to be helped to die?
I don't know, honestly, I don't. It would depend on my prognosis and how much pain, inconvenience and loss of dignity was involved. I must admit I am a bit of a coward when it comes to pain.

The thing that naffs me off about this whole subject is that we are actually having the discussion in the first place. I am an adult taxpayer and yet the organisation that I help to fund appears institutionally incapable of treating me as an adult.

I am advised on a regular basis what I should and should not eat and how often. I am restricted in what drugs I may legally purchase. I must apply for a license to do anything more complex than passing water. I getting just about sick to the back teeth of the army of concerned professionals nannying me to death.

And not content with adding insult to injury but twisting the knife too, the decision as to whether or not I can legally end my life when I have had enough of it is in the hands of people like Graham Jones and his best mate, Ed Millband and is something over which I will never be allowed any say whatsoever.

There is something seriously and sadly wrong with our society.

[MargaretR]

If you think that your governments care about individuals - think again.
There is a policy in operation to reduce world population.

If you happen to be a 'useless eater' beware.
Laws to make suicide easier will happen, but will be restricted to non productive members of society. There will be the added bonus of benefit and NHS savings.

The law is more preferable (to governments) than the expensive alternative of providing effective pain relief and palliative care, which are rarely provided.

So you think you are being given a choice? - it is Hobsons choice!

[Margaret Pilkington]

Margaret, I have witnessed effective pain relief, and palliative care being given......and with compassion and dignity too.(anyone who has used or witnessed the services of the hospice would attest to this.....I have even seen similar care being given on my own ward....helped by the skills of the pain control and palliative care nurses who came out from the hospice)
But not everyone wants to go down that route.......especially because it relies on the loss of independence......and for some people this is untenable

[Eric]

Originally Posted by Margaret Pilkington

John, that is because Morphine is regulated by the Dangerous Drugs Act(1920) and is what is known as a controlled drug........and yes Dianne, Morphine does depress the respiratory centre in the brain....all opiates do this, but the effect is much more pronounced in the absence of pain.....so if you give someone who is painfree, a good dose of morphine, it is a good way to see them off this mortal coil......thier breathing will just get shallower and shallower until it stops altogether.

Of course, no one has to "give" anyone morph ... the stuff is readily available on the street at around $15 for a grey ... doctors have over-prescribed it over here, and there seems to be more than enough floating around. Morph and other pain killers ... you know the ones I mean ... have become the drugs of choice for lotsa folks, particularly the working girls who don't want track marks on their bodies. But you probably know this, having worked in the health care system.

[Margaret Pilkington]

Eric, I never worked with drug addicts(though we did sometimes get patients who were drug dependent, on our ward - they got Methadone while they were with us)....and yes drugs are available on the streets....but whether those who wish to end their lives would know how to go about getting some...or whether they would be well enough to do this is a moot point.
Any relative who assisted, by procuring some of the illegal stuff, would be dealt with by the courts.

[Eric]

Originally Posted by Margaret Pilkington

Eric, I never worked with drug addicts(though we did sometimes get patients who were drug dependent, on our ward - they got Methadone while they were with us)....and yes drugs are available on the streets....but whether those who wish to end their lives would know how to go about getting some...or whether they would be well enough to do this is a moot point.
Any relative who assisted, by procuring some of the illegal stuff, would be dealt with by the courts.

Is it really all that hard to come by Maybe .... never thought of it really. I think I have spent too much time tending bar and driving a hack (all in the pursuit of a liberal arts education ... never really enjoyed the life). But it really isn't all that hard to come by. Oh, and we do have methadone clinics ... free of course, with taxi chits for those on welfare and disability.

[Acrylic-bob]

Margaret P, it is rare that I disagree with you, but on this occaision I feel I have to.

Like you, I have witnessed the administration of pain relief and palliative care to a person very close to me who was dying of cancer which left her unable to eat. Effectively, she starved to death. I also witnessed the apalling laxity, rudeness and general lack of care exhibited by the staff of Christies Hospital, Blackburn Royal, the local Hospice and the GP's service. If it had not been for the Macmillan nurse an elderly woman would have died in a deal more agony and fear than she eventually did. The experience was anything but cosy and reassuring and supportive. It scarred all of us who witnessed it. Moreso because we all knew it was largely unecessary but were powerless to do anything about it, no matter how loudly we remonstrated.

I had a pretty low opinion of the NHS and its staff before this shocking death. My opinion of it and them now could not be any lower. I DREAD the day that I should have to rely on the NHS for anything. Let alone End of Life care.

[mobertol]

Originally Posted by Acrylic-bob

I must admit to being a little ambivalent on this subject.
Would I wish to be helped to die?
I don't know, honestly, I don't. The thing that naffs me off about this whole subject is that we are actually having the discussion in the first place. I am an adult taxpayer and yet the organisation that I help to fund appears institutionally incapable of treating me as an adult.

I am advised on a regular basis what I should and should not eat and how often. I am restricted in what drugs I may legally purchase. I must apply for a license to do anything more complex than passing water. I getting just about sick to the back teeth of the army of concerned professionals nannying me to death.

And not content with adding insult to injury but twisting the knife too, the decision as to whether or not I can legally end my life when I have had enough of it is in the hands of people like Graham Jones and his best mate, Ed Millband and is something over which I will never be allowed any say whatsoever.

There is something seriously and sadly wrong with our society.

It is by adding your voice to discussions such as these that society as a whole, and the individuals that make it up come to some concensus on what is right or wrong - laws are made and boundaries laid down, for the good of, if not all, then at least of the majority.

As you high-light the main problem currently is the translation of the collective voice through the political system, which would then allow change. The rules are there to be tested and challenged, as society itself and the individuals that make it up are constantly changing.

You are obviously one of societies rule testers and question much of what is imposed on individuals. Constant discussion and the sounding of the communal voice is the way to effect change in a democracy- so lets keep talking about even the most controversial of arguments which are part of all our lives.

Let's not forget that each individual also has to take responsibility for his actions within society, and take the consequences of those actions. The major social changes of the last century would never have come about if not for those who questioned the norm and voiced concerns and exchanged knowledge and experience.

Currently there are some people who risk imprisonment by going with their loved ones to clinics in Switzerland where they can end their lives in a dignified way. Some are challenging the judicial system directly and there has recently been an overview which suggests that medics in the UK should be able to offer such a possibility to all terminally ill patients with less than one year to live. I am personally in favour of their efforts at change in this direction. Sorry this a long-read if you've made it this far
The following is extracted from philosophy paper I translated a few years ago, which in part prompted the above

"As we all know, in our age, the most challenging bioethical questions are about what a person is, what are his rights, his unity and his proper boundaries. The notion of “person” is a static one: it implies invariance, uniformity, stability, regularity and predictability, all notions extraneous to life.

Man is a community (of ideas, of signs, of interpretations), as the community is the most consistent individuality: there is a continuity, among selves, among ideas, and among inner experiences of any human being.

The community is not simply the collection of its individuals, as an organism is not simply a whole composed, as a machine, by the assemblage of its parts. It has an identity, a consistency, a coordinated body and a ‘social soul’, that has aims, hopes and common memories, that feels and suffers. The community is thus more real and concrete than any single individual"

[mobertol]

Originally Posted by Acrylic-bob

I had a pretty low opinion of the NHS and its staff before this shocking death. My opinion of it and them now could not be any lower. I DREAD the day that I should have to rely on the NHS for anything. Let alone End of Life care.

I have also experienced exactly the same thing here in Italy, witnessing the slow agonising death of my mother-in-law after she suffered a series of mini-strokes and was kept alive, to the distress of her family for over a month by intubation etc.

I truly hope something will change for the better in the not too distant future.

[Acrylic-bob]

Originally Posted by mobertol

As you high-light the main problem currently is the translation of the collective voice through the political system, which would then allow change.

Constant discussion and the sounding of the communal voice is the way to effect change in a democracy- so lets keep talking about even the most controversial of arguments which are part of all our lives.

It all sounds wonderful, in theory. But in practice, The executive hears what it wants to hear and only what it wants to hear, despite frequent protestations to the contrary accompanied by copious quantities of crocodile tears. How many time times did we hear that labour were "Learning the lessons" after each and every cock up only to see them then carry on with business as usual? How many times will we have to hear 'Call me Dave' tell us he 'Gets it' before we all come to the conclusion that he is lying through his teeth?

We have a prime example in a thread currently being bumped up the board regarding our MP's decision to vote with his party and the government, against the wishes of his electorate in the issue of the EU referendum. Will he explain his decision? Will he come and discuss the matter with any of his former friends on this forum? Will he respond to anything that we now have to say to him on this or any other matter? What do you think!

A few years ago The French and the Dutch gave their opinion of the Lisbon Treaty in referendums. Did the Brussels executive take any notice? The Irish had to have two go's at getting the only answer acceptable to the executive.

You clearly have much more faith in the nature of representative democracy than I do. And I am sort of pleased that you are able to be less cynical than I am. For me, it seems nothing short of revolution will effect meaningful change. Perhaps I have lived too long.

[Margaret Pilkington]

Originally Posted by Acrylic-bob

Margaret P, it is rare that I disagree with you, but on this occaision I feel I have to.

Like you, I have witnessed the administration of pain relief and palliative care to a person very close to me who was dying of cancer which left her unable to eat. Effectively, she starved to death. I also witnessed the apalling laxity, rudeness and general lack of care exhibited by the staff of Christies Hospital, Blackburn Royal, the local Hospice and the GP's service. If it had not been for the Macmillan nurse an elderly woman would have died in a deal more agony and fear than she eventually did. The experience was anything but cosy and reassuring and supportive. It scarred all of us who witnessed it. Moreso because we all knew it was largely unecessary but were powerless to do anything about it, no matter how loudly we remonstrated.

I had a pretty low opinion of the NHS and its staff before this shocking death. My opinion of it and them now could not be any lower. I DREAD the day that I should have to rely on the NHS for anything. Let alone End of Life care.

I am really sorry to hear of your experience A-B and can understand why you felt you needed to disagree with me.
I have had a bad experience with the Christie Hospital....and when I was working it was always held up to us in the DGH as the epitome of care and service....but my experience didn't perceive it like that.

But then again, I did have many patients who were given excellent service from our local hospice and the palliative care team from there(they visited daily or more often if the need arose).....and it is that on which I base my comments.
I have been out of the NHS now for almost 10 years.......and I know things have become increasingly tough...resources limited etc.

End of life care is a very difficult and emotive subject......and dealing with the dying (and their relatives - who need just as much care as those who are at the end of their life) is a labour of love. It really needs dedicated services with nurses who really do care about those in their care.

I know when I trained, we were always taught to not get involved, but from my own experience, I cannot see how you can look after someone at the end stage of their life without some emotional involvement....because failing to become involved, means that you don't fully grasp the importance of getting it right.

That is my perspective on it anyway.

[mobertol]

Originally Posted by Acrylic-bob

You clearly have much more faith in the nature of representative democracy than I do. And I am sort of pleased that you are able to be less cynical than I am. For me, it seems nothing short of revolution will effect meaningful change. Perhaps I have lived too long.

Possibly you are right - you are the realist, more worldly than myself, undoubtedly.

Revolution is a word that is being bandied about rather a lot recently. If the traditional methods don't work then that is the inevitable conclusion, though I've honestly always believed that our democracy was too grown-up, no, "evolved" for that.

I am quite an idealist though so maybe I'll be proved wrong and you will turn out to be right.

Don't be too world-weary though A-b, you're not quite at the age of resignation yet...

[Margaret Pilkington]

Originally Posted by mobertol

I have also experienced exactly the same thing here in Italy, witnessing the slow agonising death of my mother-in-law after she suffered a series of mini-strokes and was kept alive, to the distress of her family for over a month by intubation etc.

I truly hope something will change for the better in the not too distant future.

A 'living will' would or should have prevented that.....she would have not have been intubated and would have been allowed to succumb.
I don't know if you have the equivalent of living wills in Italy.

Sometimes the doctors will speak with relatives of seriously ill patients who are not expected to survive and will mark the notes DNR(do not resuscitate) but my own experience of this, is that the consultants that I worked with were very reluctant to mark this in the case notes...regardless of how hopeless the case was....and in the absence of such a record, it meant that if the patient arrested we had to attempt resuscitation. This is not good when you have a patient in the terminal stages of cancer.......all you are doing is prolonging their suffering and pain.