Dignity

[paulb]

http://www.telegraph.co.uk/news/uknews/law-and-order/8738415/44-assisted-suicide-cases-since-CPS-guidelines-published.html

so in 4 years no one has been prosecuted.  

[Ghostrider]

In England and Wales.

 

They may not have been prosecuted, yet..... but only because of current CPS guidelines, and they've had to go through a Police "murder" investigation as a "prime suspect".

 

CPS guideline can, and do change, and old "closed" cases can be reopened.

 

It poses questions, namely if the CPS have taken a decision not to prosecute unless there is evidence of "foul play" in such cases, why on earth are Police resources, which we all pay for, still be wasted on it, and why the resistance to legislation which has already in effect been enacted in all but name. Also, how can you justify putting a friend/relative who has the death on their head of someone they were close to to give them release, the same ordeal as a random "knife sticker in the ribs" suspect.

[paulb]

just in case it was murder. not everyone is a caring compassionate spouse or loved one. there are many more murders and some are for greed and some will be because a carer gets angry. sick folks are not always nice either. even if some one is in the last days of life no one has the right to end it against there will. so if you do assist someone its right that the old bill should cast there beady eye over them. the law seems to be working no innocent folks locked up, if you dont have police over view you end up with killers like shipman doing is thing, 

[Ghostrider]

^ Of course there needs to be safeguards, but whether the Police are the right people to act as overseers is a whole other debate, and rather missing the point here.

 

As long as assisted suicide is a crime on the statute books and its purely discretionary on the part of the CPS whether or not they choose to pursue a conviction, its a huge cop out and leaves anyone choosing to assist in another's suicide in a legal vacuum. The Police, in such circumstances really have no choice but treat any such case and the suspect(s) involved exactly as they would any other murder case and murder suspects, its only when the result of their investigations are passed up to the CPS that the differential is being made.

 

There needs to be an unambiguous statement made on the part of statute as to what exactly constitutes murder and what exactly constitutes legally accepted "assisted suicide", and a framework established to allow the latter to operate as painlessly for all concerned as possible, while still ensuring genuine murderers are justifiably called to account.

 

Treating people who have, with the full authority of the victim, for reasons of mercy assisted that victim in committing suicide, the same as your common and garden random disemboweler and then having to live with the threat of a murder trial hanging over them for the rest of there life, at the whim of the pen of some clerk somewhere, or of some un-elected "policy maker" is not any acceptable permanent solution to address the issue.

Edited July 29, 2014 by Ghostrider

[brian.smith]

Its strange that Ghostie as Murder in Scotland requires wicked recklessness and murderous intent I doubt anybody who assisted someone to commit suicide in Scotland as the law stands could possibly be convicted of Murder Culpable Homicide however is a different question

[paulb]

even if assisted suicide became legal the police would still need to investigate. in the rest of the uk a report would be needed for the coroner. look at how the police now investigate sudden infant deaths. they have to interview the family but they dont go in heavily unless there is a concern.

[Ghostrider]

Its strange that Ghostie as Murder in Scotland requires wicked recklessness and murderous intent I doubt anybody who assisted someone to commit suicide in Scotland as the law stands could possibly be convicted of Murder Culpable Homicide however is a different question

 

All down to a matter of opinion I guess. If someone assists another in the suicide of that person, by say administering to them a substance in a dose they know to be almost certainly fatal, the "intent to kill" benchmark required for a murder conviction IMHO is most certainly present.

 

Culpable Homicide on the other hand I have always been under the impression applies to when it is proven that the actions of a person directly caused the death of another, but that that person did not intend to kill, or were not aware that their actions were causing the death of another. I'm having a pretty difficult time seeing how culpable homicide would be appropriate in an assisted suicide case, as when helping another achieve death, however its done, its going to be one hell of a job for the person helping them to die, to prove beyond reasonable doubt that they did not intend their actions to directly contribute to the death, or that they did not know their actions were directly contributing to that death.

Edited July 29, 2014 by Ghostrider

[Ghostrider]

even if assisted suicide became legal the police would still need to investigate. in the rest of the uk a report would be needed for the coroner. look at how the police now investigate sudden infant deaths. they have to interview the family but they dont go in heavily unless there is a concern.

 

That may be how it unfolds right now, but it need not always be like that.

 

That's what the topic of this thread is all about - a change in the law to accomodate in a more appropriate and acceptable manner that which is already happening, and the powers that be are turning a blind eye to....for the moment at least.

 

Which would you rather have, folk doing what is technically illegal but what they feel they must regardless, and "getting away with it" only because a few civil servants don't think its worth bothering to pursue, for the moment anyway. Or a clear, clean ruling of what is and isn't acceptable, so that everybody knows exactly where they stand, what has consequences, and what they are.

[paulb]

i would prefer it stayed as it was and the care of the dying was better funded and provided. 

[Ghostrider]

i would prefer it stayed as it was and the care of the dying was better funded and provided. 

 

I'd see that as an oxymoron. Surely providing care of the dying also includes giving, or at least allowing them to have, as near the kind of death they choose for themselves as is practically possible. I see preventing fully legalised assisted suicide to those who want to choose it and end up in a position to qualify for it, as denying care of the dying that could very easily exist.

[shetlandpeat]

We are still campaigning for the choice we should have, however, there are still obstacles. From talking to folk, and many folk at that, it is the talking about ones own demise that is the block with this. I think we are the only creatures who are aware of our demise. It makes us special, it can concentrate a purpose in life and we can prepare ourselves for that end. While not one for "life after death" and other thoughts, I do believe we live on in what we have done and how we have been with others. Regardless of any past disagreements, I know of no one I would not extend my hand out to as an offer of help if they were in real trouble. This is also applicable in the way I want my own demise looked at. I would not want to watch those who love me and all my friends to remember me as shrivelled shell of my former self, filled with pain and torment in my last moments. I would like to have been able to spend quality time with them and be able to do my own thing. Much of the campaign against this is really about the fear factor, this magical death we all will endure. If they do not want to talk about it, fine, but don't use it to stop me from enacting my last wishes, to be honest and blunt Who The Cough are You to do that to me?

 

Please take a look

 

I am now part of a forum at the hospital looking at this, for me, it is worth the time I put into this.

Edited August 2, 2014 by shetlandpeat

[paulb]

no thanks. if thats how you think most folks die like you describe you need to go and work for a while in a hospice. until you have some real experience you should not be pushing for changes. or is this more trolling. 

[Suffererof1crankymofo]

no thanks. if thats how you think most folks die like you describe you need to go and work for a while in a hospice. until you have some real experience you should not be pushing for changes. or is this more trolling. 

 

Are you suggesting that unless you've seen other people die that you have no right to plan your own exit?  

[shetlandpeat]

I have not said that that is how I think most folk die. Where did I say that Paul? Show me. What I wrote was a personal statement, about myself and my thoughts and wishes on how I would like not to be remembered. Please also keep in mind Paul, you are not the only one here with experience. I am sure Paul it is not a wonderful experience to watch someone with a brain tumour go through the last few days of life, that would be, something I would not want to go through myself, or know others are being forced to watch because they cannot do anything else within the confines of my wishes. As mentioned before, many medical practicioners to engage in end of lfe drug administration, you do know that!

In the year 2000, only 4.3% of all deaths occured in a hospice, many many mor occured in hospital, many more occured at home.

The BMJ mentions that once death is diagnosed, then all should be done to eleviate the suffering, there is no cure for death as yet. It also mentions that relatives and friends should feel that the dying will have a good death. However, the following points were made if there were a mixed message from the multiprofesional team..

 

 

Overcoming barriers to caring for dying patients

Barriers to “diagnosing dying”

1. Hope that the patient may get better

2. No definitive diagnosis

3. Pursuance of unrealistic or futile interventions

4. Disagreement about the patient's condition

5. Failure to recognise key symptoms and signs

6. Lack of knowledge about how to prescribe

7. Poor ability to communicate with the family and patient

8. Concerns about withdrawing or withholding treatment

9. Fear of foreshortening life

10. Concerns about resuscitation

11. Cultural and spiritual barriers

12. Medicolegal issues

Effects on patient and family if diagnosis of dying is not made

1. Patient and family are unaware that death is imminent

2. Patient loses trust in doctor as his or her condition deteriorates without acknowledgment that this is happening

3. Patient and relatives get conflicting messages from the multiprofessional team

4. Patient dies with uncontrolled symptoms, leading to a distressing and undignified death

5. Patient and family feel dissatisfied

6. At death, cardiopulmonary resuscitation may be inappropriately initiated

7. Cultural and spiritual needs not met

All the above can lead to complex bereavement problems and formal complaints about care

Educational objectives for overcoming barriers to diagnosing dying

1. Communicate sensitively on issues related to death and dying

2. Work as a member of a multiprofessional team

3. Prescribe appropriately for dying patients to:

• discontinue inappropriate drugs
• convert oral to subcutaneous drugs
• prescribe as required drugs appropriately, including for pain and agitation
• prescribe subcutaneous drugs for delivery by a syringe driver

4. Use a syringe driver competently

5. Recognise key signs and symptoms of the dying patient

6. Describe an ethical framework that deals with issues related to the dying patient, including resuscitation, withholding and withdrawing treatment, foreshortening life, and futility

7. Appreciate cultural and religious traditions related to the dying phase

8. Be aware of medicolegal issues

9. Refer appropriately to a specialist palliative care team

 

Some of the issues raised in discussions amongs medical folk were...

 

 

• Too many patients die an undignified death with uncontrolled symptoms
• Transfer of best practice from a hospice setting to other care settings, including for non-cancer patients, is a major challenge
• Diagnosing dying is an important clinical skill
• One of the key aims of specialist palliative care is to empower generic healthcare workers to care for dying patients
• Core education objectives related to the care of dying patients should be incorporated in the training of all relevant healthcare professionals
• Resources should be made available to enable patients to die with dignity in a setting of their choice
• National indicators for care of the dying patient should be identified and monitored

However, due to the budgets reducing within the NHS, more so in England, the realisation of a dignified and peaceful death becomes more difficult.

 

However, hospices came about, or were first mentioned during the Crusade days, not only did they care for the sick and dying, they accomodated the traveller, alas, all there were on a journey. The Knights Hospitaller of St John of Jerusalem opened the first.

 

Hospices were scorned by the medical community for hundreds of years (took the money away I guess).

 

Part of the conclusion mentions this...

 

 

The hospice movement, supported by charitable funding, has challenged the prevailing death-denying attitude of our healthcare system and championed a positive attitude to caring for vulnerable and dying patients that resonates with society.

 

If sociey then opts for the choice in the end of life, as in the time and the nature of departure, then hospices may then be the lead with this. As you keep telling us, they are the experts, and should reflect the attitudes of society. After all, we are that traveller, why can we not choose to leave when we want?

 

In the conclusion from an article in the BMJ titled "Death With Dignity" is

 

 

In the conception of death with dignity outlined, the term “death” has been taken to apply to the process of dying, and the term “dignity” has been taken to apply roughly to someone who lives well (in the Aristotelian sense of living in accordance with reason). It follows from this that dignity is a function of someone’s personal qualities and that a death with dignity is a personal achievement; it is not something that can be conferred by others, such as health care professionals. By contrast, indignities are affronts to personal dignity. They are things that prevent or impede someone from living with dignity, mainly because they prevent him from taking an active, reasoned part in his own life. Health care professionals have a twin role here; the first is not to impose such indignities, the second is to minimise them, wherever possible

Does this conception imply anything for the euthanasia debate (where the phrase is so often used)? It would seem to offer prima facie support for voluntary euthanasia. For example, someone might choose to end his life now whilst he is still capable of living and dying with dignity rather than suffer an illness that removes that possibility. But this support for euthanasia is fairly weak. It is clear that no matter how good someone’s character is, bad luck can remove his dignity. If this happens, it is far from obvious that suicide or euthanasia will rescue it. Furthermore, opting for euthanasia without good reason could presumably itself constitute an affront to human dignity.

This was written soon after the figures I mentioned, 2001.

 

The support for euthanasia is now far from weak. There are no reasons someone could not have that choice. As I have shown in the previous posts, many who have that option do not take it, though it improves their state of mind having it.

 

 

Why is it wrong for some one of sound mind to decide upon their own exit?

Edited August 2, 2014 by shetlandpeat

[as]

Oh Heaven forbid we take responsibility for our own life and death......

 

MY life

MY body

MY death

MY choice

 

NOT the NHS's or any other folk's.

 

I think I'll get a T-Shirt printed.....