*rangers intensifies*

I've never been to Northern Ireland but I hear Dublin's great.

I thought this was an April fool's joke for a second.

https://www.theguardian.com/society/2024/apr/01/ministers-face-tory-revolt-over-plans-to-criminalise-rough-sleeping

Back to Dickens' time for all us via the state built slippery slope.

I'm serious about this. A return to laissez faire economics. Its always lurked around in the tory Party but since the loonies have taken over its now a policy.

"Here, let me assist you with that. "

"Why thank you dear, it's very heavy but I don't like to make a fu..."

BAM!

Just force them into doing the housework and chores of the workforce so they can spend more time at the office. When they can't even do that, bin them.

Yeah. In our current state I don’t trust anyone in authority to be making decisions about death. Too much opportunity for assisted dying to be seen as a way to cut care home expenditure, or to free up hospital beds.

If you're diagnosed with a terminal disease I see no reason why you shouldn't be allowed to choose.

This is a complex issue. One can list when it's good and when it's bad. Sadly the lines between choice and compulsion can blur.

I wouldn't trust any agency in the UK as things currently are to handle it.

Yup, free market forces and assisted dying is a very bad idea.

acemuzzy wrote:

SpaceGazelle wrote:

the sheer amount of people dying with prolonged pain.

I'm not sure we have accurate numbers for how many of those would choose assisted dying though

We won't know until we ask.

SpaceGazelle wrote:

If you're diagnosed with a terminal disease I see no reason why you shouldn't be allowed to choose.

SpaceGazelle wrote:

I don't really buy the argument that it's a slippery slope. You can have clear distinctions in the law and yes, there might be pressure from nefarious relatives in some cases but that doesn't balance with the sheer amount of people dying with prolonged pain.

OK, so here's the problem.

Firstly, you need to diagnose "terminal disease".  That's relatively easy I guess - "a disease for which there is no cure, and from which the patient is likely to die" being the standard line.  It's not that straight forward though, because there are loads of diseases that fit that brief,  but you can continue to move a relatively long and productive life.  (Like COPD or heart failure).  That's before you start to bring in the "life is a terminal disease" argument.

But OK, let's add some more layers to it - it needs to be a terminal disease, and the individual needs to be suffering from a level of ill health that would preclude them from simply ending their life themselves.  That's tightened it a fair bit, and made it more relevant (suicide is legal these days after all) - but now we've immediately added a caveat that involves other people, which means those other people might influence the decision making to some degree.

Which brings us to the second part of your requirement.  "Choice".  Choice is a bloody hard thing to pin down. The first question is what we do with people who can't make that choice.  Dementia is one of the most common terminal illnesses, and one where medical professionals regularly tie themselves in knots trying to determine choice because frequently the individual lacks the capacity to make those choices.  We'll make it easy for now and apply the cold medical approach to this - namely you assess their mental capacity.  If they have the capacity to understand, retain, assess and express the relevant information then we generally accept their decision however ill advised, and if they don't we have to decide for them.

Is that what we're going to do if people can't make the choice for themselves?  Are we going to decide for them?  If not, then you're saying that those people have, essentially, fewer rights than those who can make a decision. If we are then you've already created a situation in which someone else gets to make the decision to actively end another person's life (as opposed to simply letting nature take its course.)

There's the more difficult to establish question of their mental health as well. Do they have a rational desire to die, or are they severely depressed?  (Honestly, this is not as easy a question as you might imagine it to be.)

But perhaps we park all that for now - and say we'll only look at people who can make choices for themselves. Great.  But the problem remains - define "choice".  If someone "chooses" something, but you believe they have been coerced, is that still a choice? Right now I can guarantee you there are people up and down this country either being ushered against their will into a care home they don't want to be in because their relatives don't want to keep supporting them at home, or conversely not going to a care home because their relatives were rather hoping to grab the inheritance that might otherwise get spent on social care.  It's a depressingly common story. We have some safeguards against it, but honestly not many, and the minute someone says it's their "choice" we're rather obliged to go along with it. Are we going to extend that to death?

And what of the people that absolutely do choose to say, enter a care home, because they know that there is no care available for them at home? But would definitely have stayed at home had the state funded someone to help care for them and keep them where they wanted to be.  Is that really still their "choice"?  If you say it is, then do you remain as comfortable when the care home doesn't exist and they're offered "struggle alone or end your life" as the options?

The issue here isn't simply that legislating around assisted dying itself is difficult (and I've only scratched the surface of the complexities), but you then need to legislate for society as a whole. You have to guarantee a supportive infrastructure that wraps around people to ensure that they don't simply "choose" death as a rational alternative to a miserable existence created by a collective failure to continue to keep these people comfortable and safe.

Which brings us to the real kicker.  Right now there are very few conditions that inevitably result in people dying in prolonged pain. If nothing else, as it stands, if you have a terminal illness, doctors can quite legally keep upping your analgesia until it relieves your pain - and if you happen to die before it achieves that, so be it.  The problem is more that there are conditions in which life becomes unbearably unpleasant - these people need a level of support that simply isn't offered to them, but in many cases could be, but we've chosen not to invest in it. There isn't a debate about whether or not our society would provide the care necessary for people to chose to continue to live - the answer is we're already failing them so badly they're actively campaigning to die.  We need decent palliative care for everybody, not the ability to kill them.  

Finally, there's another bit to "choice" - whilst I've harped on about the evils of the state, and the wrangling of malevolent relatives, there is another reason why people might choose assisted dying that involves no cruelty at all.  Often - really often - I see people who regard themselves as a burden on their loved ones. The people they are "burdening" often wouldn't have it any other way, and love them desperately. But they perceive it as such none the less, and are often desperate to relieve this. I can imagine many good people will choose to end their existence purely to spare those they care about the "hardship" of supporting them. And it is a choice, and perhaps it's their right - but again I would rather that burden were carried, and they remained with us enjoying the company of the people they care for a little longer.

But we can already look at countries where assisted dying is allowed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2733179/

There's a broad agreement that it works. Where it has been implemented it has been deemed successful and the amount of doctors that now agree with the practice has gone up considerably in all the countries where it has become lawful. Are we so different that it couldn't work here?

davyK wrote:

SpaceGazelle wrote:

I don't really buy the argument that it's a slippery slope. You can have clear distinctions in the law and yes, there might be pressure from nefarious relatives in some cases but that doesn't balance with the sheer amount of people dying with prolonged pain.

I mean that when you encounter a misfortune your path on down can be compounded by the system. And it can very difficult to get out of it. Maybe you meant another slope statement? This thread is getting crowded..

The problem we have is that we just wait for bad stuff to happen because we have no say and we await our doom. In the countries that have implemented assisted dying there's much more discussion about end of life and crucially, it's often made before bad stuff happens. This openness seems to lead to healthy people talking about what they want with their doctors and family BEFORE the shit hits the fan. We don't do that here because we aren't given the options to make discussing these things openly worthwhile.