Dignity

[shetlandpeat]

as is quite right, though, I have also thought about my Dad, there was a time he was not very well. Thoughts were of other plans. Dignity should be the ongoing issue. From live through to death. Pierpoint, once those in his charge were executed, he maintained that they had served their sentence and their remains should be looked after and treated with respect, so dignity goes beyond death.

Much is about those who have to deal with this, a quiet dignified ending suits all really, what we have to keep in mind, is that we are going to die. A painfree and quiet passing is something I would want, on a selfish level and so my last views may not be of those around be suffering the additional burden of witnessing a death that could bother them even more for the rest of their lives. This is the compassion that I would want for those watching my demise.

It is quite wrong to have the attitude that this process is not worth dealing with in such ways as you will be dead, and therefore uncaring. Love and kindness can extend beyond the moment of death. Though, if you are happy to let those who love and care for you witness your death suffer the sights and sounds of a passing full of pain and unnecessary suffering because, after all, it is not about them, then of course that is your choice, they however also have a choice, but will generally want to be there.

 

The code of practice for the medical profession is one we should be proud of. There have been times I am sure when the patient feels the time is right but the doctor knows things are on the mend. This is something you need to talk to your doctor about.

 

http://www.compassionindying.org.uk/about-advance-decisions

[paulb]

"Death" and "dignity" are mutually incompatible, to go from a coherent functioning independent creature to a lump of inert decomposing meat is never going to be performed in any kind of dignified manner by the victim. As for a "comfortable" death, that in itself these days is something of an oxymoron, the obsession of Health Professionals to "preserve life" to the absolute last gasp, has created a situation that has more to do with postponing death than prolonging life. Chances are by the time most deaths finally occur in the present, the victim has had to endure so much surgical and chemical intrusion that whatever disease or condition they were suffering from has been allowed to advance so far beyond where death would otherwise have occured that they are simply a lump of meat being kept alive artificially and have been aware of nothing and have had minimal or zero functionality for quite some time, or are so tanked up on chemicals they are in the same state. Death, when it is finally allowed to happen, may well be "comfortable" but only because the victim has been denied consciousness to make it so, but it equally may not be in any way "comfortable" to them, as having been taken to such chemically induced state, its dubious whether it can be proven beyond all doubt that they really are 100% in la-la land, or are simply very aware and suffering, but wholly incapable of reacting and to it or communicating the fact due to their drugged up state

 

.thats so out dated. really it is. the care of the near dying has and will continue to improve. alot of which is driven by the hospice movement. the knowledge of how to care from someone near death has moved on a lot. there are still cases were folks are still not getting the best care but they are becoming very rare now.

[Ghostrider]

@ as:

 

I agree up to a point, the concept is sound, but they seem decidedly shakey in practice. Its difficult to find a comprehensive overview of such things, but in Scotland it appears from this at least that one version relies on "common law" rather than statute, and another isn't legally binding, but is for "guidance" only.

 

 

In Scotland and Northern Ireland the situation is somewhat different. Advance decisions are governed by common law rather than legislation. However, providing the decision was made by an adult with capacity and clearly sets out the person's intentions, it is highly likely that a court would consider it legally binding.

The term advance statement is sometimes used. This is an expression of the individual's desires and may refer to personal values, principles and religious beliefs. It is not legally binding but may act as a guide to a doctor who has to make a decision on behalf of a patient who lacks capacity.

 

http://www.patient.co.uk/doctor/advance-directives-living-wills

 

Its certainly much better than nothing at all, but IMHO needs firming up in statute before you can have any real hope that it will be followed to the letter unquestionably.

[as]

I have just recently gone through the process of making the necessary paperwork legally binding and must say I have found it to be straight forward. I have no doubt whatsoever that my wishes will be followed and respected and my GP was quite happy to discuss the matter and give their signature to the documents.

 

I would also suggest that patients finding themselves making such preparations would give consideration to granting Power of Attorney (not just over Finances but more importantly over Welfare decisions) to a trusted person.

[paulb]

very wise as. without the paperwork being in place the nursing/medical staff are bound to attempt cpr. the wife is 2/3 through a palliative care course. apart from the drug/medical aspect most of the course is about the patients wishes and communicating them. seriously things are improving and the treatmeant of the dying is becoming its own specialist field. 

[Ghostrider]

 

"Death" and "dignity" are mutually incompatible, to go from a coherent functioning independent creature to a lump of inert decomposing meat is never going to be performed in any kind of dignified manner by the victim. As for a "comfortable" death, that in itself these days is something of an oxymoron, the obsession of Health Professionals to "preserve life" to the absolute last gasp, has created a situation that has more to do with postponing death than prolonging life. Chances are by the time most deaths finally occur in the present, the victim has had to endure so much surgical and chemical intrusion that whatever disease or condition they were suffering from has been allowed to advance so far beyond where death would otherwise have occured that they are simply a lump of meat being kept alive artificially and have been aware of nothing and have had minimal or zero functionality for quite some time, or are so tanked up on chemicals they are in the same state. Death, when it is finally allowed to happen, may well be "comfortable" but only because the victim has been denied consciousness to make it so, but it equally may not be in any way "comfortable" to them, as having been taken to such chemically induced state, its dubious whether it can be proven beyond all doubt that they really are 100% in la-la land, or are simply very aware and suffering, but wholly incapable of reacting and to it or communicating the fact due to their drugged up state

 

.thats so out dated. really it is. the care of the near dying has and will continue to improve. alot of which is driven by the hospice movement. the knowledge of how to care from someone near death has moved on a lot. there are still cases were folks are still not getting the best care but they are becoming very rare now.

 

 

I'm not going to get in to a protracted debate on the subject, as at the end of the day such things rely more on opinions than facts. While some cases of "end of life care" I have been made aware of in recent years may well have been beyond criticism, a scarey number stand out as something completely different. Its not possible to post on a public board in any detail about some of them in case a relative or friend can recognise the details and from those the victim, but I can cite one. One year ago a person was already in the untreatable stages of cancer, they were already on morphine injections to control pain which knocked them out for hours on end, when conscious they consistently and repeatedly expressed the opinion that "they were sick and tired of waiting and suffering, and wished death would get on with it". Around six months ago they'd had to have their morphine dose upped to the point they were never lucid enough to hold even the shortest of conversations even in their best moments. Not long after that they had to be started on assisted feeding, they were still just hanging in to life a few weeks ago, having never been lucid enough to communicate or function for several months due to their morphine dosage and only kept alive by being fed by tube or however it is they do it. If you believe someone being treated that way is "good", "dignified" or even has a point, I'm not going to argue with your opinion, but in my opinion its just about as cruel, barbaric, undignified and torturous as it can likely get.

 

Add to that that statute makes it very difficult to allow a person to have their last wishes respected. I was in a condition some years ago that I was dying, and knew it, and as long as I remained conscious I repeatedly and adamantly told family who were aware of my condition that they must not in any circumstances call for medical assistance to me. I had been declining and in extreme untreatable pain for some years, and I saw no point in continuing the torture, masochism isn't one of my kinks. As long as I remained conscious they tried as far as possible to respect my wishes, but when I did eventually slip in to unconsciousness it left them in a dilemma, of on one hand wanting to respect my wishes, but on the other being very aware that to do so they were running a real risk of being arrested, which obviously proved a no contest deal, and they felt powerless not to call medical assistance, despite the threats of vengeance I'd left behind should anyone dare try and pull me back from the brink.

 

I could have put up with that, had the Medics involved respected my wishes that were relayed to them, and simply monitored my eventual exit, that would have been fine but of course they didn't, they just had to "try", "because they could". They brought me back, "because they could", but they only managed to drag me kicking and screaming back to the state of continious untreatable pain I had endured for years before eventually deteriorating enough to enter the release of unconsciousness, and there I have been stuck ever since, in agony. Don't think for one minute I became the grumpy old bar steward without being driven to it by being eaten from within by pain 24/7/365 and the resentment and anger at those who felt compelled to bring me back to a living hell "just because they could" when I had an exit so close to my fingertips.

 

It took a bit of time to forgive family for disregarding my express wishes, but it happened, as I could see they were between a rock and a hard place compelled by legislation to have no choice. However, despite trying to tell myself that they were just doing their job, and what they thought best, even if it was very misguided, I will never be able to forgive the medics who arrogantly crashed ahead regardless. Any day is a good day to die, as no day will ever be the right day to die, so when the ducks line up you may as well run with it, hanging around at all costs isn't always the smartest plan, and you know it, you just can't get perhaps well meaning but interfering sods to leave you alone to get on with it.

Edited April 6, 2014 by Ghostrider

[Ghostrider]

I have just recently gone through the process of making the necessary paperwork legally binding and must say I have found it to be straight forward. I have no doubt whatsoever that my wishes will be followed and respected and my GP was quite happy to discuss the matter and give their signature to the documents.

 

I would also suggest that patients finding themselves making such preparations would give consideration to granting Power of Attorney (not just over Finances but more importantly over Welfare decisions) to a trusted person.

 

Well, I hope everything works out as you believe they will. If these things are legally binding and all medical personnel are fully aware of that fact, it should be a very good thing for all concerned. However based on the mass of vague and sometimes contradictory information that seems to be out there on the subject, and the fact that such things exist at all seem to be given little publicity, I would tend to reserve judgement on just how well things might go in practice until it becomes general knowledge and openly accepted practice. I will look in to it further though, and I hope others do too.

[shetlandpeat]

Good Afternoon,

Thank you to everyone who has been in touch with messages of support ahead of the Assisted Dying Bill debate tomorrow. Below is a final update on how you can get involved on the day and some advice to anyone coming to our demonstration.

Watch the debate 
BBC Parliament will be broadcasting the debate all day.  Broadcast on:

• Freeview Channel 81
• Sky Channel 504
• Virgin Media Channel 605

For those who won’t have access to a TV but will be online, you can also watch it on:

• BBC Democracy Live
• Parliament TV 

The debate starts at 10 am and is likely to go on until the early evening.

[paulb]

im against it. mainly because there will be a creep downwards. its happened where its legislated. once that barrier has been lifted its not far for it to become involuntary. then onto eugenics ect..  

[shetlandpeat]

The research into where it has been accepted does not show this.

[as]

exactly, SP!

 

PaulB, I'd really like to see the source of your claim!

[paulb]

http://ije.oxfordjournals.org/content/early/2014/02/17/ije.dyu010.full

 

 the above shows that lone women are most likely to opt for death this way. there is no interdependent overview of Switz deaths.

 

http://www.lifenews.com/2013/01/30/oregon-assisted-suicide-deaths-hit-record-high-in-2012/

 

the above is pro life however they are right that there is no safe guard

 

http://www.bbc.co.uk/news/health-19989167

the fist comment is interesting

 

 http://dredf.org/PIIS1.pdf

 

it will happen its a small step from a dying person to a disabled and then on to others choosing for others, if you dont believe so im impressed by you optimism however i think its a very bad step, fine if someone wants to die let them but dont get doctors involved in it, dont make it legal to help suicide its a dangerous step,

[shetlandpeat]

Wow, talk about doom and gloom.

 

However, what is the difference between a doctor prescribing a lethal dose for the private use of the patient and one that throws themselves in font of a train?

 

If you have been given six months to live, there is nothing to stop you from commiting suicide. If you are however disabled and cannot achieve the mechanics of ending your own life at your will, why then should you have that choice removed? Sounds very selfish.

 

I remember having a copy of a report from the US, where they have progressed to allow an individuals choise recognised, the majority of those who opted for suicide were middle class academics or profesionals.

 

 

In the 17 years assisted dying has been legal in Oregon there have been no calls to extend the law beyond terminally ill, mentally competent adults.

The 2013 Oregon report showed:

• 71 people had an assisted death. This accounts for around 0.2% of total deaths in Oregon, a number that has remained stable over the last 5-6 years.
• 122 people requested life-ending medication in 2013. 51 did not take the medication – many of them took comfort in knowing the option was there.
• Around 90% of people who had an assisted death were also enrolled in hospice care (average deaths under hospice care in the USA are 45%¹)
• The majority of people who had an assisted death had terminal cancer and were aged between 55-84.

 

 

Under Oregon’s Death with Dignity Act the terminally ill patient must be able to self-administer and ingest the life-ending medication themselves and they can only be prescribed the medication after meeting a number of legal safeguards. These include:

• The patient must be 18 years or older
• The patient must be mentally competent
• The patient must be diagnosed with a terminal illness that will lead to their death within 6 months

How people are protected in Oregon

 

Safeguards in Oregon’s law ensure potentially vulnerable people are protected and the option is only available to dying patients. The safeguards and the request process are designed to protect patients.

The terminally ill patient:

• Must request life-ending medication twice, with 15 days separating each request (a ‘cooling off’ period).
• Must make a written request to their doctor– witnessed by two individuals who are not primary care givers or family members
• Can cancel the verbal and written requests at any time
• Must be able to self-administer and ingest the life-ending medication themselves.

In addition:

• The diagnosis of a terminal illness with less than six months to live must be certified by a consulting doctor, who must also certify the patient is mentally competent to make and communicate healthcare decisions
• If either doctor determines the patient’s judgement is impaired the patient would either be deemed ineligible for assistance or they could be referred for psychological evaluation
• The attending doctor must inform the patient of alternatives, including palliative care, hospice and pain management options

 

http://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Documents/year16.pdf

 

http://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Pages/index.aspx

 

I have yet to see an argument against this, that will convince me that I would be abused into commiting suicide. As there will be protection against abuse of such nature, I hope that I will, when I have had enough, be able to end it in the company of my family and friends in surroundings of my choice and pleasing. I have seen, heard of and known too many folk that have gone to other lengths to end their own suffering, sadly, mostly alone, in horrid surroundings and affecting others state of mind.

 

My friend sadly jumped infront of a train, he had cancer that was killing him and he was in excruciating pain, watching the video from the station that was used to identify him, you could see the pain and effort he put into this lonesome act. He died alone.

Edited July 18, 2014 by shetlandpeat

[as]

Paul, I fail to see the relevance of your first link.

 

your second one is Pro Life, so what else does one expect?  Peat's link (you got to it first) explains the Oregon law and what it really says much better.

 

with regards to the first comment in your 3rd link: We are talking about a very personal choice here, not what the spouse thinks the deceased should have done. If a person wishes to go before their situations deteriorates, why not? It was his choice, not hers. It was his life and his and no one elses decision to make.

 

I passionately and wholeheartedly believe in personal choice in this matter.

 

your last link I could not open, therefore can't comment.

 

I can understand that Pro Lifers and health care professionals etc. are worried that this could lead to elder/ disabled abuse. That's why safeguards must be put in place and I cannot see why that should be such a difficulty.

 

http://www.euthanasia.cc/ssvbill.html

[shetlandpeat]

The first comment!?!

 

 

Saw one couple going this route the husband was at the time still very able and lucid. He died and his forlorn wife said he could have waited a few more years as he was still reasonably healthy. The thought crossed my mind was how arrogant he was because he wanted to go out 'on top'. Little or no consideration for his family and like most cowards didn't have the guts to do it himself, very sad.

 

This comment is crass. If you think this is worthy of evidence against, it could be that the situation was right for the person, if they ever existed. You need to be lucid and on top to be mentally able to go down this route. How is he a coward, he killed himself? He would have had to administer the chemicals himself. It could be viewed that this highlights the selfishness of the wife. Though, it would have been a testing time for both.