Medically Assisted Dying

RE: Medically Assisted Dying

Ruth Eyre-Pugh — Fri, 20 Jan 2017 10:32:11 GMT

[quote user="An On MRCVS"]The Dutch approach to end of life care is incomparably better than in the UK - carefully planned and co-ordinated care plans implemented by trained staff as opposed to the chaotic interventionist NHS treatment which is geared up to deal with accidents and emergencies and not with elderly/dying people. [/quote]

Can I suggest that any vets who feel strongly about this join 'healthcare professionals for assisted dying' :

http://www.hpad.org.uk/welcome-hpad/

Hopefully if we apply en masse they will consider us as worthy health care professionals.

RE: Medically Assisted Dying

mariette asselbergs — Mon, 26 Dec 2016 18:35:08 GMT

Of course agree with you there!

Mariette

RE: Medically Assisted Dying

Dinu Catilina — Sun, 25 Dec 2016 22:10:04 GMT

Of course it was. But there were no two identical communist countries, well there was no country with trues real communism.

RE: Medically Assisted Dying

mariette asselbergs — Sun, 25 Dec 2016 17:02:36 GMT

Nothing to do with communism. I lived in a communist country, Mozambique, where abortion was legal in the interest of women even though the country was/is underpopulated.

Mariette

RE: Medically Assisted Dying

Dinu Catilina — Thu, 22 Dec 2016 20:35:15 GMT

Not religion related. But educated poor people don't want children that they can't take care of. The state tried to push the numbers back up for economical reasons.

RE: Medically Assisted Dying

Martin Atkinson — Thu, 22 Dec 2016 13:35:09 GMT

[quote user="Dinu Catilina"]Wynne, abortion was illegal in Romania during communism [/quote]That really does surprise me Dinu. I considered one of the few benefits of communism was that they tried to suppress religious dogma and as it is Catholic dogma which is the main driving force behind banning abortion I would have thought that it would have been made easier.

RE: Medically Assisted Dying

Dinu Catilina — Tue, 20 Dec 2016 22:22:58 GMT

[quote user="Hannah Wynne Richards"]My sole objection arises from the fear that they will do the same as they did with the Abortion Act. If you read the original 1967 Act (readily available on-line). you'll find it didn't legalise abortion on demand, but that is what we've ended up with, I'm scared that mentally confused old people who have become a nuisance to their families will be treated like unwanted children.[/quote]

Wynne, abortion was illegal in Romania during communism and women still did it. Even with a strong almost omnipresent state police illegal abortion clinics were run in basements and garages. Not to mention the ones that died at home after self inflected haemorrhages. It must surely be better if it's done in a safe environment for the mother, even if it is on demand?

I for one hope to realise when the Alzheimer kicks in but I am really afraid I will not. I just don't want to be in that situation.

RE: Medically Assisted Dying

Michael Woodhouse — Mon, 19 Dec 2016 23:33:45 GMT

[quote user="Hannah Wynne Richards"]you'll find it didn't legalise abortion on demand, but that is what we've ended up with, I'm scared that mentally confused old people who have become a nuisance to their families will be treated like unwanted children.[/quote]

So? I can't think of much worse than bringing a child into the world that is unwanted. Is it really fair keeping your batty great aunt alive so she can go wandering in the dark, have the police hunting for her and causing stress and anxiety to her family?

I don't think you need to worry just yet, Wynne.

I have no intention of dying from natural causes, unless it is a rapid accident.

RE: Medically Assisted Dying

An On MRCVS — Mon, 19 Dec 2016 16:51:44 GMT

[quote user="Malcolm Buchanan"]Personally I like the Dutch approach,[/quote]

The Dutch approach to end of life care is incomparably better than in the UK - carefully planned and co-ordinated care plans implemented by trained staff as opposed to the chaotic interventionist NHS treatment which is geared up to deal with accidents and emergencies and not with elderly/dying people.

I've had 2 elderly relatives die in each country - everyone's experiences were far far better in the Netherlands where things were dealt with in a peaceful and caring way, dignified and under control of the patient and their regular carers, whereas the UK relatives experiences were a series of forced and pointless hospitalisations, hospital acquired infections, invasive treatment that did more harm than good, poor treatment in hospital, no communication between home care staff and hospital staff, and fear and stress for all concerned. This is without any mention of euthanasia in any of the cases.

RE: Medically Assisted Dying

Hannah Wynne Richards — Mon, 19 Dec 2016 08:37:11 GMT

Can our doctors with their abysmal record of signing anything be trusted? My sole objection arises from the fear that they will do the same as they did with the Abortion Act. If you read the original 1967 Act (readily available on-line). you'll find it didn't legalise abortion on demand, but that is what we've ended up with, I'm scared that mentally confused old people who have become a nuisance to their families will be treated like unwanted children.

I would support this if doctors were honest, but all the evidence ( abortion and social security fraud) shows that dishonesty is endemic in that profession.

Wynne

RE: Medically Assisted Dying

Malcolm Buchanan — Sun, 18 Dec 2016 17:00:38 GMT

As most people have someone close who has died badly, the question is would you consider MAD or do you want to die under present conditions?

If yes to MAD, read Ruth's book and look at the MD-MD website mentioned in her initial post.

Investigate the process in the five countries where it is legal. There are rigorous conditions in place - no bumping off bed blockers or getting the inheritance early.

Contact your MP, make your views known and ascertain theirs. It is for Parliament to legislate the conditions and procedure. They will if there is enough pressure despite the emotional and irrational debate in Sept 2015.

Personally I like the Dutch approach, especially as they are now considering a complete life option.

RE: Medically Assisted Dying

Ruth Eyre-Pugh — Sat, 17 Dec 2016 13:37:30 GMT

The last radio episode of 'We need to talk about death' can be accessed here:

http://www.bbc.co.uk/programmes/b084xr5f#play It is about Death itself.

RE: Medically Assisted Dying

Ruth Eyre-Pugh — Mon, 12 Dec 2016 12:46:55 GMT

You may be interested to read this article, published today, quoting a granddad who made the journey to Dignitas.

http://www.kentlive.news/a-folkestone-grandad-of-two-has-died-in-an-assisted-suicide/story-29973008-detail/story.html

RE: Medically Assisted Dying

Ruth Eyre-Pugh — Fri, 09 Dec 2016 16:08:41 GMT

[quote user="Ruth Eyre-Pugh"]

Last night on Radio 4 was the first in a series called "We need to talk about death", series 1 being called 'Stand by me'. Joan Bakewell chatted to many individuals, mainly discussing compassionate community care and where people want to die.

A district nurse said "sometimes dying takes a very long time."

Bakewell's tack was all about trying to 'reclaim death' so we as individuals have more say in the matter.

If you want to listen to the programme you can find it here:

http://www.bbc.co.uk/programmes/b083pd1p#play

The second series is called 'Ease my pain'.

[/quote]

and the link to it is here:

http://www.bbc.co.uk/programmes/b084bpjt

Very interesting I thought, especially the link between fear and level of pain. Also I imagine there are many parallels between the public's expectation of immediate out of hours pain relief for their loved ones, be it family or pets.

RE: Medically Assisted Dying

Richard Carter — Fri, 09 Dec 2016 10:21:38 GMT

Also very different responses depending on age, religious background and relationship to the patient - when my mother was in advanced Alzheimers and had got to the heavy duty care part with the lifting, carrying, bathing, feeding part with no coherent conscious brain activity, I could have helped her leave. My father on the other hand was in complete denial and was waiting for things to improve and so would never have given any consent even if euthanasia was available.

RE: Medically Assisted Dying

Hannah Wynne Richards — Fri, 09 Dec 2016 09:14:17 GMT

Very thought provoking.

Wynne

RE: Medically Assisted Dying

Iain Richards — Fri, 09 Dec 2016 08:43:17 GMT

One of my aforementioned aunts is now, baring some curious reversal of pathology, in her last days. A duodenal obstruction is causing reflux and has lead to some aspiration pneumonia. There is a possible degree of heart failure leading to plueral effusion. Although there are options - endoscopy and stent, or surgery; at 90, these are not really viable options. She asked me yesterday why she was in hospital, I explained the circumstances and she asked if she'd had surgery. I said no, it was too risky to which her reasonable response was, "What's the worst that could happen?" I explained that the worst would be the peritonitis from surgical complications. I then told her that her treatment was to make her comfortable so she could die in peace.

She's not in pain, just the discomfort of the NG tube and not being able to have a cup of tea. She's alert, but tired, although happy to see family. And when she closes her eyes and the breathing gets intermittent, I want the breathing to stop.

She's not raging at the dying of the light, so the only question is when she will die. Which makes me think about this thread. Many of us have posted our agreement with assisted death, it's logical. But when is the right time? That, I suspect, is the difficulty for most folk - we see it with pets. Perhaps the move towards assisted death needs to be a more frank discussion by the medical team, and one that doesn't avoid the words dying or death. Clinging to hope when hope is gone is a naturally human emotion and we probably do need to be told when that point is reached. Could I press a button to end that life, or do I really want the eyes to open and have one last smile?

RE: Medically Assisted Dying

Malcolm Buchanan — Wed, 07 Dec 2016 20:25:16 GMT

Respectfully, there is. The RCVS and BVA do this all the time.

RE: Medically Assisted Dying

Bob Russell — Mon, 05 Dec 2016 12:01:00 GMT

If you read the comments on this thread it is clear just how much upset and trauma a 'bad' death has caused. Guilt, helplessness and trauma even PTSD.

A good, quiet and painless death seems to create a sense of comfort and closure. True there are few posters that have discussed their experiences and they are vets well accustomed to the idea of euthanasia.

It is the patient that has to make the decision not family (unless based on the patients wishes).

With safeguards in place there should be a lot of comfort knowing the end can be quick and painless. The patient can still opt for a miserable, painful end if they wish!

RE: Medically Assisted Dying

janine redman — Sat, 03 Dec 2016 20:29:26 GMT

If I knew I had a terminal illness which meant that I was in constant pain I would like to have the option of assisted dying. On those few occasions when I have been struck down by severe gastric bugs and am writhing on the floor wishing it would end it worries me that in some cases prolonging life is not humane. But it would have to be painful , terminal and with the patients wishes being adhered to. Pity however the family, as there is enough grief and self doubt when a family pet is euthanised that it may be a decision some family members could not cope with.

RE: Medically Assisted Dying

Jill Butterworth — Sat, 03 Dec 2016 19:23:29 GMT

Modern medicine has made protracted death far more likely than before, and I think we vets rightly become accustomed to only seeing and expecting a swift and painless end.

A GP friend called me recently to discuss euthanasia of their dying old dog and so I packed my bag to go. However, a few minutes later she called back to say that she and her husband (also a medic), had decided to allow 'things to happen naturally'. And so they did, and it took a couple of days... I was mortified, but then realised that this was what they were used to seeing and they saw nothing wrong.

I was working with a European vet friend recently when a relative of her's was euthanised back home, and she felt unable to discuss it with anyone except other vets. The relative was very happy with the decision as she knew what the alternative was.

We have all had the discussion of 'what does a few more days or weeks matter' in the greater scheme of things, once the end is in sight?

RE: Medically Assisted Dying

Hannah Wynne Richards — Sat, 03 Dec 2016 18:13:10 GMT

The impact on medical staff will be even greater if the same thing happens as happened with the Abortion Act.....................the theoretical safeguards to protect those ethically opposed become ignored, or staff are bullied to participate in order to secure jobs.

I'm also worried about coercion. My mother was affected by Alzeimer's . During the early stages, she had short bouts of confusion, but was normal the rest of the time. Someone unscrupulous could have easily persuaded her to sign away her life in one of her confused bouts, and then presented her to a doctor in one of her lucid phases. Eventually, she had to be admitted to a nursing home, and seemed to thoroughly enjoy her time there. She was a former human nurse, so was convinced she was on the staff! One of the carers told me "We've got 2 matrons, and one never goes off duty."

Not only might people be duped into ending their lives, others might be bullied into signing so as not to use up their capital.

The fact that Ruths and I are agreed, is a measure of how complex this matter is.

Wynne

RE: Medically Assisted Dying

Iain Richards — Sat, 03 Dec 2016 10:56:06 GMT

I've been watching this thread, tempered by my circumstances of watching two much loved aunts fade. One is 90 and fed up of living, but mentally alert. She'd press a button to end her life given the chance (I think). The other (103 - we breed tough) is physically sound but the memory is fading fast. She delights to hear news of family and I suspect she wouldn't end her life.

I don't feel we, as a profession, can influence the debate on human euthanasia simply because we perform it on a daily basis. We kill animals, so it's not the same. We can provide insight into the mechanics - pentobarbital is excellent - and we can also give insight into the impact on the medical staff. The latter doesn't get discussed much, but I know how I've felt after multiple killings (either pre-christmas run or 2001) so it will probably be worse for the doctors and nurses.

Should it be allowed by law? Well as pain and distress free death is possible, it should be available. How, mechanically and ethically, to do it? That's the tough question.

RE: Medically Assisted Dying

ruths — Sat, 03 Dec 2016 10:25:28 GMT

Respectfully- there us no veterinary profession's point of view on this.

mych the same as there is no 'female' point of view or 'black' point of view

the world is waaaay more complex than that.

My post earlier suggested that this is certai not an area where quantitavie data is preferable to qualitative

you have in no way got 'the veterinary' point of view from this conversation

I hope you book does well, I may go and download it and let you know what I (as an individual) thibk about it .

RE: Medically Assisted Dying

Hannah Wynne Richards — Sat, 03 Dec 2016 09:31:30 GMT

It's not something the veterinary profession should have a view on. Individual members are free to decide for themselves, but as individuals, not as a profession.

Wynne