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This needs a different kind of debate


just john

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I believe the professionalism and treatment given to terminally ill patients is long overdue for a reasoned debate about what is best for them, especially pain relief, assistance and quality of life but I was saddened to see this right to die support, Times which apart from bringing the Life insurance industry into dispute( how do they judge something which is going to happen anyway?), brings unspoken but unbearable pressure on the terminally ill to do a disappearing act instead of living out their days.[:(]

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I disagree John.  There should be a point where everyone has the right to say 'I've had enough - let me go.'  However, I do share your concern that this should be the clear choice of the individual without pressure from those around them. 

There are many people that genuinely have no quality of life and who desperately want to die...and should have the right to do so with dignity. It seems that the medical profession sometimes tries to keep a patient alive just because it is possible...I have seen individuals who have been designated 'DNR' - a decision that has been taken with much anguish and thought but who are nevertheless resuscitated by medical staff who are afraid of being sued if the patient dies in their care. 

We give more thought to the death of our pets than our relatives and friends - it's not considered acceptable to let a pet suffer if the eventual outcome is death but this is acceptable for humans.

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Scooby of course I am aware of people who feel like that with a great deal of sympathy, unfortunately apart from it being an expensive sector of the health service with temptation to push it back onto families and charities; and frighteningly (thin end of the wedge to cut out long words) it is also a sector where some individuals and institutions may see the regulations offering a suggested solution. The extra dimension I would like to flag to the debate (in line with the article posted) should be more about not writing off terminal care as having no requirement for quality of life in the short term. I believe there is little thought given to how much could be given to quality of life care for the short term, and too many are simply written off as having no future irrespective of the remaining prognosis. I would rather see advances in this area than some of the cosmetic surgery for example.

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I've been reading this and thinking I shouldn't respond... maybe that I don't have anything of real value or interest, or maybe it's just too sensitive an area... but have decided to add my thoughts anyway.

My mother suffered for many years with her illness; 31 in total.  She was brave and courageous but spent the last 12 years of her life unable to really do anything herself and for the most part was confined to bed.  She had the most dreadful bedsores, she had to be fed, washed, toileted and had frequent long bouts of memory loss.  She had very limited sight and certainly in my eyes, the last few years I thought were just unbearable.  In 1999/2000 she contracted the flu (not sure if you remember but that was a dreadful year for flu with lots of deaths).  She fought the flu for 7 weeks from October to December but in the end she was just too weak.  The day before she died she said, very clearly and without any hesitation, that she wasn't ready to die.  She was 58. 

I always thought that once all quality of life was gone and there was no hope of recovery then everyone would surely want to just say, enough.  But, her words stunned me and changed my opinion forever.  I don't think it's wrong for an individual to choose and I will never make any judgment on an individuals wish to end their pain but I do agree with John's last statement that for as long as there is a desire to live we must continue to ensure that care and help will always be available.  

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I agree Rose, anyone who feels they have sufficient quality of life to fight on should be properly supported and cared for.  It is a disgrace that much of the care for the terminally ill is provided by hospices that rely on charitable donations for their running costs.  However, on the converse side, my sister cares for people with progressive mental disorders (Huntingtons), serious brain injury, those in a PVS.  She sees patients trying to starve themselves to death, refusing medication, eating themselves (literally), pulling their hair out by the handful - often taking part of the scalp etc with it.  Some of her patients desperately want to die and have communicated this wish but they are denied the escape that they crave for.

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In the final analysis, as human beings, the thing that supposedly separates us from animals is our brain - and the ability to choose.  Freedom of choice is applied, it seems to me, in all areas of life, except the freedom to choose when to die (unless, as Matthew says, we allow for suicide).  But surely with assisted suicide, the point is that the human being concerned has made a choice, but is physically incapable of carrying it through.  Thus the lack of physicial ability removes the freedom to act, though the choice has been made.

Not easy, but I think in the light of the several well documented cases recently, a decision does need to be arrived at, though I know that will not please all.  But in the end, as long as it does not affect anyone else, surely we should maintain freedom of choice if at all possible?

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This is a topic very close to my heart- I feel that not allowing a person to chose, because of their handicap - is an extreme form of discrimination. The various hospices do an absolutely wonderful job, and I so admire them - but it would not be my choice. My mother, who lived in Switzerland- made advance directive when she was in her forties, very strong and fit- it was countersigned by 2 doctors and her solicitor. I was quite shocked at the time when I received a copy in the UK from her sollicitor. In the end though, she lived the final 5 years of her life totally dependent, exactly how she didn't want to - because she lost the ability to ask. My mil at not made a directive, but had told all her children to 'snuff her out of it' (her words) if she ever went gaga (her words). She got Alzeihmers and lived the last 3 years of her life in a terrible, terrible way. Because we lived in UK, and because Alzeihmers robbed her of her will, we were unable to help her.

Of course, strict regulations need to be in place - preferably with an advance directive with 2 doctors and a sollicitor. And of course 'patients' need to be interviewed alone so that any outside pressure can be evaluated. How can we have Laws which require us and society to provide sick or handicapped people with access to as normal possible a life, re. transport, education, leisure, etc - and then deny them the most important thing.

I am so happy for Debbie and her husband. She would have had no choice but to take her own life much earlier than possibly required. Now she can truly enjoy the rest of her life, and may well die peacefully at home without the need for any help, which is what I wish for her. How sad that she might have to travel to a foreign country to die, rather than stay in her own home, surrounded by all those who love her. How sad that her husband will have to be alone after her death, in a foreign land, without his family and friend to help him. I was born and bred in Switzerland, and after 39 years in UK have come back to live here with English OH. We are going to our Sollicitor next week to make our advance directive.

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[quote user="odile"]

 She would have had no choice but to take her own life much earlier than possibly required.

[/quote]

For me, this is the most horrific part, as Odile spells out: the prospect of having to commit suicide while being still physically capable of taking one's own life. The pressure of  having to anticipate exactly when one is on the brink of terminal incapacity, and possibly being robbed of just a little bit more life because of existing legislation.

A dear friend assisted her husband's death (not in this country, and not in the UK). She had been his main carer for 6 years, travelling from country to country to try out several new treatments,  until it was clear it was the end of the road. The only help he could get in the hospital was a large dose of morphine - after which he was breathing with great difficulty because of phlegm in the throat from the morphine. He had managed to convey that  this was to be his last day. My friend ended up smothering him with a pillow over his face, as the struggle for breath was just so hopeless. She had to do this furtively, with their daughter keeping watch at the door of the hospital room to make sure nobody was coming. I cannot imagine how she has lived with the memory since then, although there was no doubt in her mind that she was doing exactly as he had wanted. No doubt this goes on everywhere, much more than most of us will ever know. But nobody should have to carry out such terrible acts furtively and guiltily.

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Although there is little development of the need to reinvigorate research into improving the short term care of termininally ill, this article points out the compassion of the DPP in not prosecuting people who have assisted relatives in cases of real desire to leave this mortal coil.
It also points out other reasons why the current legislation is actually protective, apart from the desires of some that could take advantage of the proposed changes it highlights sub-conscious pressures that might arise, including:- 
A GP from a country that has legalised euthanasia, Holland, told a House of Lords committee investigating the legalisation of assisted suicide: “I see growing anxiety among patients, not just the terminally ill, that they think it is not decent not to ask for euthanasia sometimes, because they feel they are such a burden to their families''

Surely not something to be encouraged.

More Erudite comment from the Times on reasons not to remove current legislation

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with the proper guidelines in place - that should not happen.

Personally, I would hate to be a burden to my daughters- beyond the time when I can laugh with them and enjoy their company. I would also find it obscene to cost HUGE sums of money to he health service - knowing (I have lived very close to the medical profession all my life) - that that time and money could be used for young people with families, children - people who still have the prospect of a good quality of life. When I visited my parents and mother-in-law in the old peoples homes- I so often wondered for some of the people there, for my mil and my mum - why, what is the point. I would HATE HATE HATE to become a vegetable, sitting like my mum, unaware of her surroundings, just hanging her head and dribbling day in day out. And my mil, washing her teeth in the loo, wiping faeces around her rooms, swearing and shouting, or in a torpor, not knowing who we were. Knowing that both these wonderful Ladies had clearly requested for that never ever to happen - and making it VERY clear that should this happen, they would like to be 'got out'. And knowing that kids out there are dying of luck of transplants, and young mums and dads leaving their children to death - who could possibly be saved were the money available.

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Terry Pratchett wrote a very interesting and eloquent piece in one of yesterday's Sunday papers on how he's approaching his end of life and followed it up with an equally moving interview on the BBC Breakfast programme this morning.

Interestingly, as a local councillor, I received a letter and draft bill from one of our Depute at the Assemblee Nationale, through the Commission des Affaires Sociales, Proposition de loi No 1814 'Reconnaisance de l'exception d'euthanasie et de l'aide active a mourir' which is now opened up for public debate.

To me, with several chronic and one very painful medical conditions, it is a very straight forward argument.  When - if - my type of leukaemia reaches the 4th stage, it is extremely painful, mindnumbingly so, it's bad enough as it is but some days the pain IS almost unbearable.  To have that level of pain constantly would literally be maddening.  I have a living will and so does J and whilst it is unenforcable in France, it does make clear to our families what we want in respect of medical treatment if my condition is life threatening or undearable and the same for J if she becomes incapacitated by reason of a serious stroke etc.  I've already made my decision and have the resources to take my own life, if for no other reason, there is no way I would want to inflict having to care for a complete invalid on somebody that I care about as much as I care about J.  I saw this with both my parents and it was both horrendous and finally destroyed an already fragile family dynamic and it isn't something I would put anybody else through.

Our Depute is holding a series of public meetings to discuss this issue between 17th and 21 August and I for one will be at least one of the meetings to give him my support.  I'm also going to email him to ask if there's anything I can do to support him with the Anglophone community in 24.

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[quote user="Tony F Dordogne"]as a local councillor, I received a letter and draft bill from one of our Depute at the Assemblee Nationale, through the Commission des Affaires Sociales, Proposition de loi No 1814 'Reconnaissance de l'exception d'euthanasie et de l'aide active a mourir' which is now opened up for public debate.[/quote]

The proposition in French HERE     (in google English: HERE)

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