Human 'euthanasia'

Re: Human 'euthanasia'

Gillian Mostyn — Thu, 14 Feb 2013 15:58:16 GMT

just set it up Anthony - when you start a new thread just do it as a poll!

Re: Human 'euthanasia'

Anthony Todd — Wed, 13 Feb 2013 22:08:25 GMT

Arlo, perhaps we could have a poll?

Vets in favour of the broad concept of euthanasia or not.

What better group to poll??

Re: Human 'euthanasia'

Anthony Todd — Wed, 13 Feb 2013 22:04:50 GMT

[quote user="Elizabeth Billimore"]The LCP is not the baddy and euthanasia is not the goody.[/quote]

I strongly disagree!

The LCP is the baddy and euthanasia is the goody.

I cannot see how starving and dehydrating any animal, whether human or not, is anything but cruelty .

And don't assume that the patient [and "patient" it is], is happy waiting to die a horrible death.

The medical profession is too mealy mouthed, legally terrified and timid to face the obvious need for a better solution.

Of course they currently nicely justify it by using the escape argument that, as we did nothing we can't be held responsible.

Should be called the British Stop Everything and Wait Ordeal!!

With the LCP under current intense scrutiny we vets have a golden chance to influence opinion that euthanasia, under the guidelines I have very tentatively outlined, offers a better and much more humane pathway than the only alternative offered at the moment.

There are bound to be instances where patients could have been saved but currently there are patients who recover on prolonged life support so there is a parallel.

There are bound to be instances where the avaricious family want the patient gone for financial or other reasons but the medical criteria can surely be formulated to prevent this.

These are not reasons to dismiss euthanasia; people die travelling. Should we remain indoors?

As this profession is the only one with vast euthanasia experience, and where often the patient is as dear as a family member, we have a responsibility to discuss and advance the issue of euthanasia.

I find the negative opinions expressed here rather frustrating and very disappointing.

Re: Human 'euthanasia'

Bibs — Tue, 12 Feb 2013 13:53:21 GMT

This is just another argument over choice of words.

There are a lot of differences between the way other animals and humans are treated.

One main difference is based on the fact that animals do not appear to have insight into what is happening to them and no choice.

We do have blanket euthanasia for animals when they are presented to us and they are dying imminently. I'm talking about when animals/people are presented to us. Not what happens out of our sight when no appropriate professional is involved.

What you are advocating is that if a doctor is involved in a dying person's care then the only option should be euthanasia. I am saying even if you agree with it, that is not for everyone in every case, and the LCP would be the alternative. As it stands it's the only option apart from continuing with invasive treatment.

Re: Human 'euthanasia'

Michael Woodhouse — Tue, 12 Feb 2013 13:11:15 GMT

[quote user="Elizabeth Billimore"]Why is this about animals?[/quote]

Because we are animals too.

[quote user="Elizabeth Billimore"]a question designed to try and make me look like a bad vet[/quote]

Elizabeth - I am in no way calling you a bad vet. What I cannot comprehend is why we should be treated differently, and how it is ok to do something to one animal, but not another.

[quote user="Elizabeth Billimore"]How is anyone going to agree to blanket euthanasia in all dying people?[/quote]

We don't have blanket euthanasia in animals, some die quietly at home in their sleep. I have never given it much thought the proportion of pets that die themselves vs with our intervention.

If the LCP allows a move towards acceptance of euthanasia then that's great, but that is the only good I can see from it. When I'm 85 years old I hope I don't have to spend a week in a hospice bed barely conscious before death, like my Grandfather.

Re: Human 'euthanasia'

Bibs — Tue, 12 Feb 2013 12:53:43 GMT

[quote user="Michael Woodhouse"]

[quote user="Elizabeth Billimore"]The LCP has it's place and it's a shame people don't want to discuss the details of it and what it means because it's interesting and important.[/quote]

Honestly I'm not sure it does.

Very simple yes or no question - would you ever advocate similar for an animal under your care?

I would never knowingly leave an animal to die that was unable to eat and drink. Ever. The answer to my own question is an emphatic no.

[/quote]

Why is this about animals?

The answer is no because we PTS animals, there is no need to consider end of life pathways and the various reasons are well known in our culture. This is a over simplified comparison, and a question designed to try and make me look like a bad vet if I agree with humans having the option to palliative end of life care.

If f they make euthanasia in people legal there needs to be another option. How is anyone going to agree to blanket euthanasia in all dying people? We don't even have any kind of human euthanasia legal. The LCP needs to exist in any case because people want the option to die in their own time too, and it's intended to help people die more comfortably. However it's only as good as the people implementing it, and that's what the press have picked up on.

The LCP is not the baddy and euthanasia is not the goody.

Re: Human 'euthanasia'

Helen Wallace — Tue, 12 Feb 2013 11:15:04 GMT

This is the real reason I could never be a doctor. I do believe quality of life is more important than longevity and we shouldn't be prolonging life at all costs. Once upon a time it was accepted practice to titrate morphine levels up to risky doses in terminally ill patients if pain could not be adequately controlled by other means. What was this if not euthanasia by the back door? Then along came Shipman...

A lot of the public seem to think that death is a peaceful, dignified process. Those of us with experience know that this is rarely the case. I do think euthanasia should be available for terminally ill patients but that is not the current legal state.

The LCP seems to me to be a first step in recognising that sometimes intervention to prolong life is not in the best interests of a suffering patient. That it may be kinder to make them as comfortable as possible and wait for the inevitable. Yes it has to be managed properly but I don't think it deserves the bad press its getting.

And yes- when owners have not been ready to make the decision to euthanase, I have discussed it with them and given patients whatever level of medication is needed to make them comfortable with the warnings that it might hasten their demise. Clients have always been ok with this approach so far and almost always return in the morning for euthanasia, having had a chance to say their goodbyes.

Re: Human 'euthanasia'

Utlendigur — Tue, 12 Feb 2013 10:36:50 GMT

[quote user="Michael Woodhouse"]

[quote user="Elizabeth Billimore"]The LCP has it's place and it's a shame people don't want to discuss the details of it and what it means because it's interesting and important.[/quote]

Honestly I'm not sure it does.

Very simple yes or no question - would you ever advocate similar for an animal under your care?

I would never knowingly leave an animal to die that was unable to eat and drink. Ever. The answer to my own question is an emphatic no.

[/quote]

But that's easy to say because we have the option of euthanasia Until the medical profession and public has that option it seems to me that the LCP is at least trying to formalise the need to consider patient welfare as the main priority, ie changing the emphasis from trying to "treat disease" to making people as comfortable as possible, and ensuring that things like analgesia, reduction of anxiety, withdrawl of non-helpful interventions, are considered/anticipated . As has been stated numerous times before on this thread it is not a licence to starve or dehydrate someone to death

Just out of interest though, what do you do when an animal is brought in that is nearing needing euthanasia but whose owners can't accept it, or want to take it home for a night to say goodbye to the family? Do you wrestle it out of their arms and put it to sleep - or do you do your best to make it comfortable?

Re: Human 'euthanasia'

Michael Woodhouse — Tue, 12 Feb 2013 00:21:53 GMT

[quote user="Elizabeth Billimore"]The LCP has it's place and it's a shame people don't want to discuss the details of it and what it means because it's interesting and important.[/quote]

Honestly I'm not sure it does.

Very simple yes or no question - would you ever advocate similar for an animal under your care?

I would never knowingly leave an animal to die that was unable to eat and drink. Ever. The answer to my own question is an emphatic no.

Re: Human 'euthanasia'

Bibs — Mon, 11 Feb 2013 19:46:29 GMT

Even if euthanasia was legal in certain cases, it would not replace the LCP in everyone else. The LCP has it's place and it's a shame people don't want to discuss the details of it and what it means because it's interesting and important. It's not necessarily what the press have you believe. It doesn't even totally preclude artificial hydration.

The abortion talk doesn't make any difference to the LCP debate. It's just arguing over emotive language (and a bit of stirring as I see it).

Re: Human 'euthanasia'

Anthony Todd — Mon, 11 Feb 2013 16:36:58 GMT

[quote user="Gillian Mostyn"] I just think that very few cases are likely to be clear cut.[/quote]

Well they all are at the moment because no case is allowed even to be considered let alone decided.

Re: Human 'euthanasia'

Bob Russell — Mon, 11 Feb 2013 15:04:54 GMT

[quote user="Gillian Mostyn"]

Anthony:

You have obviously had a lot of painful personal experience of suffering before death, and I can absolutely see why you think rules governing euthanasia need to be both tackled and made law. Your suggestions are eminently sensible. Unfortunately I just think that very few cases are likely to be clear cut.

[/quote]

Many cases are pretty clear cut. the patient wants it, the relatives want it and I am sure the hospital wants it (either because they hate to see suffering or because they need the bed) .

Clear rules can be set out and there is always the 'fall-back' position of if in doubt don't!

Re: Human 'euthanasia'

Arlo Guthrie — Mon, 11 Feb 2013 14:21:29 GMT

[quote user="Bob Russell"]I have to say I have no fear of being dead. I like being alive so have no great ambition for the alternative. The bit in the middle does frighten the heck out of me especially if involves chronic suffering.[/quote]

Exactly how I feel.

I like Mark Twain's quote: "I do not fear death. I had been dead for billions and billions of years before I was born, and had not suffered the slightest inconvenience from it."

Re: Human 'euthanasia'

Gillian Mostyn — Mon, 11 Feb 2013 14:16:49 GMT

Anthony:

Re: Human 'euthanasia'

Anthony Todd — Mon, 11 Feb 2013 14:04:27 GMT

[quote user="Anthony Todd"]Ok, well let's see if we can come up with a protocol. It really won't be that difficult.[/quote]

Thought I'd be splattered with red stars by now, or even some comments!

Re: Human 'euthanasia'

Bob Russell — Mon, 11 Feb 2013 12:39:08 GMT

I have to say I have no fear of being dead. I like being alive so have no great ambition for the alternative. The bit in the middle does frighten the heck out of me especially if involves chronic suffering.

My uncle died with/from a form of motor neuron disease and his suffering was beyond any level of acceptability. I dare say he would have accepted death even by dehydration over the alternative but there must be a better way.

I would like to go when it suits me and only when it suits me. I would hate to be put in the situation where I was forced to travel to Switzerland while I was fit enough to but before I had decided the time was right.

I would feel more comfortable having some degree of control and having the confidence that medical staff were going to care for me sympathetically. For whatever reasons this seems to be a bit of a lottery. Scary stuff!

Re: Human 'euthanasia'

Jo Cobbett — Mon, 11 Feb 2013 11:45:58 GMT

[quote user="Evelyn Barbour-Hill"]

[quote user="Jo Jones"] It is ending the life of a being who does not have any comprehension of death or of what will be happening to them. If it is done humanely then there is little/no suffering involved. [/quote]

It's killing a human being. You have to think very long and hard before allowing it.

[/quote]

I agree. Personally I know could never have an abortion, although I do think they should be legal (in certain circumstances).

Re: Human 'euthanasia'

Anthony Todd — Fri, 08 Feb 2013 18:27:27 GMT

[quote user="Evelyn Barbour-Hill"]It's killing a human being. You have to think very long and hard before allowing it.[/quote]

Ok, well let's see if we can come up with a protocol. It really won't be that difficult.

[ If you'd seen by brother-in-law die of basal ganglionic nuclear degeneration at the age of 67 after 7, not 6, years of progressive motor paralysis, starting with one foot and ascending totally to his eyelids.

Oh, and with minimal alleviation of suffering which I can detail if anyone wants!]

Errors. omissions and suggestions welcome.

1. Diagnosis made and confirmed by X [ number] experts to be defined, depending on area of expertise required.

2. Chances of survival with this nominated condition nil, or near nil.

3. Degree of "suffering" to be endured with said condition.

3. Agreement of relatives if patient unable.

4. Authorised by Court of protection [say]

5. Right of appeal by medico or relative to be before a judge.

Isn't this roughly what they do before they "turn of the machines"?

I hope this happens to me at the beginning, and not after 7 years.

Re: Human 'euthanasia'

Evelyn Barbour-Hill — Fri, 08 Feb 2013 17:40:47 GMT

It's killing a human being. You have to think very long and hard before allowing it.

Please note, jump-to-conclusioners, I haven't said I am dead set against euthanasia.

[quote user="mariette asselbergs"]This has not happened in Holland where euthanasia is legal and widely accepted for many years now.[/quote]

But maybe the Dutch health service is not run in the same way as the NHS. I don't know.

[quote user="Utlendigur"]I get the impression that people with strong views (pro or anti) on euthanasia often develop those views early in life and don't tend to change.[/quote]

You sure? I must be an exception then.

Re: Human 'euthanasia'

Evelyn Barbour-Hill — Fri, 08 Feb 2013 17:32:36 GMT

[quote user="Gillian Mostyn"]

[quote user="Evelyn Barbour-Hill"]

[quote user="Gillian Mostyn"]

A different debate Michael, but no it isn't. A foetus is not a person.

[/quote]

Who says?

[/quote]

The law.

[/quote]

Gillian, you can do better than that. Or was that a piece of irony too subtle for me?

Re: Human 'euthanasia'

Bibs — Fri, 08 Feb 2013 17:24:15 GMT

I think it probably will eventually become legal in this country and especially if it's been shown to work in other countries. In the mean time I think they are trying to move towards a approach that is more geared towards comfort (and ideally discussion). It's a step in the right direction in my eyes.

I'm wondering whether half the problem in this country are the views and influence of the church/religion. I think they would be against it similar to how they react to abortion. Someone correct me if I'm wrong. I'm not into religion at all so not sure what the latest thinking is.

Interesting point about Holland.

Re: Human 'euthanasia'

mariette asselbergs — Fri, 08 Feb 2013 16:24:52 GMT

"I doubt if it would be long before safeguarded euthanasia would become euthanasia upon demand (by selfish relatives, by hospital managers..... )"

This has not happened in Holland where euthanasia is legal and widely accepted for many years now. In my family cancer is common. My grandmother died after days of screaming on the hospital ward. My mother suffered equally for weeks even though she was provided with painkillers. By the time the doctors would allow morphine she died before they could give it. What was worse was to know how she had been scared all her life to have to undergo what she had seen as a teenager in her own mother, and then to see how she had to endure it over the time of a year, the fear and the pain both. When it was my sister's time it was totally different. She had discussed it with her GP during her life, when she got the final; diagnosis she immediately discussed it again and was guaranteed that the decision and timing would be hers. And she took the decision, probably only days before she would have died anyway, but mentally it was totally different since she knew that she was in control and respected. As a vet, before euthanasia became legal, I always viewed the medical profession as clumsy or even sadistic people with warped sense of superior morality to oblige people under their care to suffer out the destruction in their terminally ill bodies. Now, having known quite a number of family and friends who have been able to end their lives in dignity I am convinced this is the only civilised way. And none of the fears of abuse have materialised with the saveguards provided.

Mariette

Re: Human 'euthanasia'

Utlendigur — Fri, 08 Feb 2013 15:13:40 GMT

[quote user="KMurphy"]More offering a choice to people [/quote]

I get the impression that people with strong views (pro or anti) on euthanasia often develop those views early in life and don't tend to change. I've often wondered whether it wouldn't be possible to have something akin to the organ donor register, where people could if they wished sign up in early adulthood to state that they wished to have the choice of euthanasia if the situation arose - ensuring their views are known, unequivocably, well in advance, avoiding any suggestion that they were coerced in old age, or just depressed or not of sound mind. My personal views on euthanasia (ie that is is a choice I would want to be available) haven't changed since I was in my teens and if anything have got stronger because of the deaths of my parents.

Re: Human 'euthanasia'

Jo Cobbett — Fri, 08 Feb 2013 11:04:49 GMT

We were watching the panorama programme on abortion the other day, and it occurred to me that abortion can be aligned with euthanasia of our patients (I'm not saying it's the same thing, but parallels can be drawn). It is ending the life of a being who does not have any comprehension of death or of what will be happening to them. If it is done humanely then there is little/no suffering involved.

Please don't think I'm saying the two are the same, or that legislation etc should be the same, but it got me thinking...

Re: Human 'euthanasia'

KMurphy — Fri, 08 Feb 2013 09:30:06 GMT

Edit: Get too depressed when I read what I wrote!

I'm sure most people heard about the Tony Nicklinson case. So sad. I'm not suggesting eradicating everyone over a certain age or everyone with a disability. More offering a choice to people in circumstances where there is no hope of a cure or improvement.