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Marcos the black

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"People Before Profit TD Gino Kenny has brought a bill on assisted dying in Ireland back on the political agenda in recent weeks.

At a press conference this afternoon, Ms Phelan said people with terminal illnesses should be given the choice to die.

"No matter how good palliative care is, there is still a certain amount of suffering that palliative care often cannot get on top of," she said."

How do you feel about this? Should people have the right to choose how and when they end their life and do so with dignity?

It's a complicated and emotive topic and one which isn't black or white.
At a time when we calling all loss of life tragic should we allow people to end theirs where they are in pain and there is little or no chance of recovery or improvement?
 

Finbar10

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Bit of a can of worms really I think. There are cases where euthanasia seems to be the compassionate choice. As with almost everything, though, there are always going to be pros and cons. There will be situations where people would be glad to have this as an option (ugly painful terminal illnesses); however, I can also think of situations where it might generate a negative dynamic.

Imagine someone who has just been diagnosed with early-stage dementia and the future care is likely to fall on some loved one. In a situation with euthanasia available, the sufferer will have to perhaps distressingly consider imminent euthanasia (perhaps out of a desire not to burden the loved one) while they are still mentally competent. Something more to pile onto the situation.

Or a hard-pressed stressed-out carer potentially may become resentful. In a situation without availability of euthanasia, everyone may accept that life sometimes is just hard, there's no other choice, and they just have to get on with things. Having options isn’t always necessarily a good thing. In earlier times when life was often far harder, old people in some cultures, particularly when food was very short, might often just head off by themselves in winter snow to “go hunting” and never return. This though is not the case in the West anyway.

There is also the slippery slope argument: that while it is for the best of intentions, a certain line is being crossed, which can have somewhat corrosive effects on society over time (there can be upsides to coarse sub-optimal but easily arbitrated boundaries). Doctors and nurses are no longer just positive carers but are involved in actively ending lives too. The envelope of what's acceptable gets wider over time.

There was a long, very interesting and nuanced article in the Guardian some time back looking at this question with respect to the Netherlands. The Netherlands brought in a euthanasia framework with various protections 17 years ago. The Netherlands is one of the few examples of a country where euthanasia has been available for an appreciable length of time. It’s quite a balanced article, but certain evidence of the slippery slope does seem evident there (and it’s not all a bed of roses; the articles goes into both pros and cons of the Dutch experience). Plus it’s far yet from being the end of this particular experiment. I reckon we’ll probably have to come back there in another 20 years to get a final more definitive idea of the true trade offs between the lighter and darker sides of euthanasia there. IMO this is a very grey and ambiguous topic.
 

Catapulta

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PBP are a Death Cult

- those who are inconvenient and to be killed off.

They started with unborn humans

- now it is those who are old and frail and weak

They are a vile bunch no doubt about it!
 

tsarbomb

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I think in limited circumstances euthenasia is justified, but given the opportunity it will get out of hand and be used as an excuse to murder the elderly and sick.



The problem for Arends was that now when she attempted to respond to that distress by saying something like “Would you like me to help you to die”, the woman simply looked bewildered and said “Not yet” or “That’s going a bit far!”

And some seconds after the lethal drug had been given, the patient appeared to try to sit up, and had to be gently held back by her son-in-law


 

raetsel

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My brother was friendly with someone who was diagnosed with motor neurone disease and before his condition deteriorated to a level where he surrendered control of his own life to the care of others, he took a one way trip to Switzerland. It's a sad end to anyone's life but who are we to judge someone faced with another far more terrifying one-way journey into oblivion?
 

ShoutingIsLeadership

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People should definitely be left to die in agony and without dignity, just in case.
 

Granballoon

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They started with unborn humans

- now it is those who are old and frail and weak
Uh huh. Funny how your lot are not around to raise these unborn humans who you seem to fight so hard for; how exactly are you going to take these peoples' pain away as well? The only thing you really care about is that this stuff makes you feel bad. The thing you don't realize is that it makes everyone feel bad.
 

Emily Davison

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Hopefully with the support of brave people like Vicky Phelan this will pass. Anyone who has seen people at end of life know why this is so important. My mothers doctor gave us as much morphine as we needed. I will never forget her screaming at me and my brother in a hospital when the medics would not give her enough pain relief. The only stipulation she had on her treatment was no pain.
 

Emily Davison

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David Quinn, ultra Catholic of Iona was spinning on this on Newstalk yesterday. Saying palliative care doctors were against euthanasia. Saying palliative care is wonderful. Such nonsense when we all know that palliative care is euthanasia.
 

Lumpy Talbot

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No
I don't really think the problem is in allowing someone the autonomy to say they've had enough. I think that right only needs to be elucidated beyond any doubt of being under the influence of others.

So what we are talking about really is how we establish whether someone in a position where they say they wish to end their own life are making a rational and logical and understandable decision and free of the influence of others.

That's really the problem and the only real issue I think. It would be possible to design a process of steps which validates and verifies the wishes of the person concerned beyond legal doubt, if necessary signed off before witnesses, none of whom should have any conflict of interest in the process. That could be doctor, JP, a panel within the health service for the area and then that is the really practical concerns taken care of.
 

Lumpy Talbot

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No
We're going to get into 'term limit' style distractions on this unless we tie it legally to the process perhaps of making a will. And that would be why wills in such circumstances should be validated independently and the decision taken by the patient early enough to be clear of legal challenge, and you will get brawlers who would legally challenge someone dying in order to get at what they think is their due from an estate, a position no one else recognises.

You can imagine this with a family farm in the balance. So it would all have to be legally certified as above board and free of influence so it is unchallengeable in terms of the express wishes of the patient concerned.

Later on when a patient may not be compos mentis because of medication regimes I'd be uncomfortable with.
 

Emily Davison

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Those procedures already exist Lumpy in places like The Netherlands. They have a very clear robust system with a proven track record.
 

rainmaker

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Hopefully with the support of brave people like Vicky Phelan this will pass. Anyone who has seen people at end of life know why this is so important. My mothers doctor gave us as much morphine as we needed. I will never forget her screaming at me and my brother in a hospital when the medics would not give her enough pain relief. The only stipulation she had on her treatment was no pain.
Heartbreaking experience - this is easily the most traumatic experience any of us will ever have and any option that can help alleviate suffering should be available.

Also, anyone wishing to influence against such legislation on religious grounds should have their views dismissed and then ignored.
 

Emily Davison

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Hear breaking experience - this is easily the most traumatic experience any of us will ever have and any option that can help alleviate suffering should be available.

Also, anyone wishing to influence against such legislation on religious grounds should have their views dismissed and then ignored.
We were very lucky, for reasons I can't go into. But I was able to discuss what happened during the weekend with the consultant - he was great and understood completely what had happened during the weekend when he was not there and he was mad as hell. Also, again for reasons I can't go into, my mothers GP trusted us completely by allowing us as much morphine as needed. As it happens we never had to increase the dose he had prescribed, but he did let us decide. So in the end my mother got what she wished and died peacefully at home.

We had to take turns minding her in the hospital when she had some light treatment initially. Nurses taking out the batteries on the TV remotes, and dosing all the patients such that they were all out of it is our reality. A matron, young, on the Monday tried to talk down to me when I had the temerity to read my mother's medical chart - we were monitoring what they gave her. And a special radio my sister gave my mother was stolen. Some people with too much power gone to their heads. They eventually gave up on us as we were there too much of the time for that week or two.

I have experience of Beaumont too because of my BIL, you don't want to ever end up there. Horrendous experince and far worse than my mother. I often hear Irish people on the radio praising the care and I'm absolutely amazed.

And yes there were very kind people. Especially the cleaning and food staff.
 

Finbar10

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The practice in the Netherlands was relatively uncontroversial for the first 10 or so years (typically people like late-stage cancer patients in a lot of pain). It's that in the past 10 years criteria have loosened somewhat (minors, those with psychological suffering, those no longer compos mentis, e.g. dementia patients with prior written statements of their wishes etc.) and more controversial cases have been cropping up. The Guardian article I linked to above does IMO give a balanced and rather nuanced look at the positives and negatives of the Dutch experience (and it's one of the very few examples of a country where there has been legal voluntary euthanasia for any substantial length of time).

I've read through the bill that Gino Kenny is proposing. It definitely has weaknesses (not hard to see that it started out as a private member's bill, seems to be identical to the 2015 John Halligan bill). I actually came across a much better drafted bill from New Zealand (who is having a referendum on whether to approve their bill in October).

The definition of terminal illness in the Irish bill is fairly vague. Most such bills specify something like unbearable or intolerable suffering or put a time limit (usually six months) or both (the NZ bill has both). This bill doesn't contain either. Would a seventy year old with several degenerate conditions with one eventually likely to kill him in the next 10 years, but currently feels fine, qualify? Possibly! 🤷‍♂️ The NZ criterion is a lot clearer and specifically excludes some things (advanced age, disability, mental illness).

Perhaps a worse flaw is that for one non-medical witness (who can't be in the will) and two medics needed to sanction assisted dying or euthanasia, there is no central register or supervising body. Why does that matter? Well, in the NZ bill, one also needs two medics to sanction the procedure. However, there they have to fill in forms justifying their decision and send them to a central register (and supervising body). The supervising body (SCENZ Group) actually appoints the independent medic. If the second independent medic refuses to sanction the procedure, they have to register this also. In the the case the two medics disagree there's a procedure to call in a psychiatrist from a government panel to make the final call. There's a provision that if one of the medic's feels undue external influence is being put on the patient, they must refuse and again have to send off a form with their reasons.

Contrast that with the proposed Irish bill. If a medic in the Irish case believes undue influence is being brought to bear, or for some other reason feels euthanasia in not appropriate, then they can indeed refuse to agree. However, that's the end of the matter. There is only any registration after the procedure has been carried out. There's nothing stopping the patient going off and looking around for another doctor or pair doctors until they find someone who will agree. The safeguards don't seem very well-thought out or robust to me. There's a concrete system of review set out in the New Zealand bill. In the Irish bill, there are a few lines about the Minister setting up some kind of review committee.
 

Catapulta

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Uh huh. Funny how your lot are not around to raise these unborn humans who you seem to fight so hard for; how exactly are you going to take these peoples' pain away as well? The only thing you really care about is that this stuff makes you feel bad. The thing you don't realize is that it makes everyone feel bad.
Whose 'you lot'?
 

Catapulta

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Hopefully with the support of brave people like Vicky Phelan this will pass. Anyone who has seen people at end of life know why this is so important. My mothers doctor gave us as much morphine as we needed. I will never forget her screaming at me and my brother in a hospital when the medics would not give her enough pain relief. The only stipulation she had on her treatment was no pain.
I've seen quite a number of people dying

- but none of them asked to be killed off.....
 

Emily Davison

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I've seen quite a number of people dying

- but none of them asked to be killed off.....
My grandmother, SIL, uncle, all dead, nor aunt, alive, were able to request mercy deaths, not killings.
Do you agree with palliative care homes?
 

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