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Read this story last night and i must say it got me thinking, isnt it about time britain changed the law so that people with a terminal illness could end their lives instead if having to travel to switerzerland to do this. the lady has got primary progressive multiple sclerosis, and feels that when the time gcomes she would like to beable to end her life. At the end of the day if an animal is suffering the option is their to put them to sleep , so why cant a human have the same option. just wondering what everone elses few on this matter was. I for one would like to think if it was me then i could say enough was enough and die with dignity.
telfordstar
27-Sep-08, 13:43
Read this story last night and i must say it got me thinking, isnt it about time britain changed the law so that people with a terminal illness could end their lives instead if having to travel to switerzerland to do this. the lady has got primary progressive multiple sclerosis, and feels that when the time gcomes she would like to beable to end her life. At the end of the day if an animal is suffering the option is their to put them to sleep , so why cant a human have the same option. just wondering what everone elses few on this matter was. I for one would like to think if it was me then i could say enough was enough and die with dignity.
Im with you on this one If it was me with such a terminal illness i would like to go with some pride and dignity before the stage of now being able to do a single thing for myself came upon me.
riggerboy
27-Sep-08, 13:50
im with you both, if / when a it comes to that i hope to have the freedom of choice and say enough is enough give me the big pill, have the chance to say goodbye and end the pain and misery, i have watched to many friends and family die from cancer, it the most awful and sorry way to go, i watched me dad die in pain and suffering if he was a dog we would have been charged with cruelty for allowing the animal to suffer so long.
northener
27-Sep-08, 13:51
Yes........we like to see ourselves as being part of a free-thinking individually based society.
Yet some members of our society would rather see fellow humans suffer excrutiating pain and a slow death because it offends their religion or their morals.[disgust]
Agreed 100%, the government never gave me life so why should they have the right to stop me ending it with the help of someone if i am SUFFERING from a terminal illness and proved to be of sound mind and capable of rational thought.
and if the you need someone to help you in your bid to end your sufferign then they could be sent to prison for up 14years, yet if they chance the law then the drugs used can end your suffering within 2-5 mins.
I am not disagreeing with some form of euthanasia but when could it apply? We need a definition of and a threshhold for 'suffering' which would make a reasonable person find life intolerable. I think that is the hardest thing to do for legislative purposes. And because the subject is so emotive, we have to have some definitions in place to avoid legal repurcussions.
Take the Shivo case, she wasn't even capable of suffering anything so should she be kept 'alive'.
Take a terminally ill cancer patient, has full faculties to make a decision, suffering definitely but would this apply?
Then take someone who has alzheimer's disease, possibly is or isn't suffering pain, can't make any decision either way and may even show signs that they are enjoying life but may even be suffering excruciatingly.
It is a total minefield and these are just a small selection of cases to consider.
i agree totally with assisted suicide. we dont watch animals suffer, so why our loved ones.
I am not disagreeing with some form of euthanasia but when could it apply? We need a definition of and a threshhold for 'suffering' which would make a reasonable person find life intolerable. I think that is the hardest thing to do for legislative purposes. And because the subject is so emotive, we have to have some definitions in place to avoid legal repurcussions.
It is a total minefield and these are just a small selection of cases to consider.
I agree Rheg, take someone such as Stephen Hawking, and I am only using him as an example, would you consider such as him for euthanasia?
telfordstar
27-Sep-08, 15:45
I agree Rheg, take someone such as Stephen Hawking, and I am only using him as an example, would you consider such as him for euthanasia?
Hes happy with is life hes a total genius why would he want to die but there is the occassion where folk are so ill and in the right frame of mind and wish to make that decision.
Hes happy with is life hes a total genius why would he want to die but there is the occassion where folk are so ill and in the right frame of mind and wish to make that decision.
Telfordstar, I only used Stephen Hawking as a graphic example, because many know of him and his condition, I never said he should want to die.
telfordstar
27-Sep-08, 15:58
Telfordstar, I only used Stephen Hawking as a graphic example, because many know of him and his condition, I never said he should want to die.
All i was saying was, if asked im sure hes happy to live. There are some folk with the right reasons when asked, would like to die.
Melancholy Man
27-Sep-08, 16:14
Agreed 100%, the government never gave me life so why should they have the right to stop me ending it if i am SUFFERING from a terminal illness and proved to be of sound mind and capable of rational thought.
What's to stop, then, a parent demanding control of a child's life because they "gave life". Or the religious arguing that "God gave life, and only God can take it away"?
there is such a debate with this, arguments on both sides, but surly it is a persons right to say enough is enough, i know some people with a terminal illness are happy to live their lives to the end if they are capable.
Bad Manners
27-Sep-08, 16:31
It is a very difficult subject to make a decide either way I think it would depend on the individual curcumstances. on saying that I think its time we stopped this policy that everything is black and white as its a matter of breaking the law to assist should there no be a debate for being a legal framework to have some form of appeal that all sides of the argument is placed before a judge so as a decision could be made on a personal basis rather than making one rule that fits all. It is never an easy dicission to take a life but in certain cases it would be the better decision. A greater insight to living wills would also help as a persons views could be outline whilst still in a good state of mind.
put me down the minute i cant make up my mind. I dont want to put anyone in trouble, but my right to die when i want to die is up to me.IMO
Many people suffer too many years with conditions that get worse with every year passing and why should they not have the right to decide when they leave the land of the living.
Assisted suicide, in a controlled enviroment is ok, but people who live at home and have been assisted by a loved one, i do think is wrong,and so does the law.
Bringing it to the uk would be a great idea if only for the ones who are going to stop there own lives by one means or another if not helped.No man woman or child should livelife in pain, but until the law changes thats the unfortunate truth of the matter.
Although i dont advocate the right to assist a child to die.Cures may be found and a life may eb taken prematurely when hope may just be round the corner.
I agree Rheg, take someone such as Stephen Hawking, and I am only using him as an example, would you consider such as him for euthanasia?
I think most would agree that when we say 'suffering' we mean serious physical pain, not the inability to lead a normal active life.
I agree Rheg, take someone such as Stephen Hawking, and I am only using him as an example, would you consider such as him for euthanasia?
If you consider or propose someone for euthanasia it's called legal murder.
I believe in countries that allow for euthanasia, the decision can only be made by the person themselves, after consultation with more than one psyciatrist and a consultant doctor ( ie: not the doctor treating said patient).
There has to be a very sever control of euthanasia, that can never be carried out at the request of another than the patient, be they family, caretakers or officials (governamental), otherwise euthanasia becomes a way of hastening an inheritance, alleviating work and/or a money saving excercise, instead of a means to alleviating unecessary and futile suffering.
That said, I hope when and if it comes to that, that it will be an option open to myself. Always very well regulated.
northener
27-Sep-08, 19:27
I think Ju has hit the nail on the head.
It is a question of whether the individual can be genuinely said to have medical cause for termination of their own life and the mental capacity to make that decision.
I don't think that anyone is suggesting that anyone else be given the power of life or death over a given individual (except, as already happens, when there is no hope for the individual on a life support system through massive trauma or disease).
MM: Fair point on parents arguing about 'giving' life.
But that falls outside the scenario(s) here. That would be more in line with whether parental consent is needed for operations based on parents wishes or religious grounds. I don't think anyone would stand for parents attemting to terminate their child's life without a massive investigation as to whether this would be the right course of action for the child.
If you consider or propose someone for euthanasia it's called legal murder.
I believe in countries that allow for euthanasia, the decision can only be made by the person themselves, after consultation with more than one psyciatrist and a consultant doctor ( ie: not the doctor treating said patient).
There has to be a very sever control of euthanasia, that can never be carried out at the request of another than the patient, be they family, caretakers or officials (governamental), otherwise euthanasia becomes a way of hastening an inheritance, alleviating work and/or a money saving excercise, instead of a means to alleviating unecessary and futile suffering.
That said, I hope when and if it comes to that, that it will be an option open to myself. Always very well regulated.
Ju,
I agree fully with you , my original post was only to highlight, that great care and consideration must be taken before any decision can or is made to go down the road of euthanasia, Who has the final say, the patient if I may use that word, or the carers?
Take two people who have the same condition, Stephen Hawking who has a full life and career and another who finds life totally unbearable. How do you legislate that assisted suicide is legal for one but not the other, and is it 'suffering'.
Stephen hawkins knows his own mind even in the condition he's in. He can communicate with the world better than most.Anyone with his condition can see that although he may have motor skills, his mind is still sharp, no need to go for assisted suicide.There is hope in a hopeless situation.
northener
27-Sep-08, 20:19
Take two people who have the same condition, Stephen Hawking who has a full life and career and another who finds life totally unbearable. How do you legislate that assisted suicide is legal for one but not the other, and is it 'suffering'.
I don't believe there is any conflict there, Rheghead. Both suffer the same condition and I would assume in your scenario both are as capable of making informed decisions as the other.
I suppose the conflict there could lie with the individual as to whether their life was 'worth living'...again, that's personal choice. Unfortunately we are then skating on thin ice...as it could be argued that the individual is suffering from severe depression brought on by the disabilty and is not capable of making a rational informed decision at that point in time.
But, does someone wishing to end their own life make them 'severely depressed' or are they hard-headed pragmatists?....Dunno.
Stephen hawkins knows his own mind even in the condition he's in. He can communicate with the world better than most.Anyone with his condition can see that although he may have motor skills, his mind is still sharp, no need to go for assisted suicide.There is hope in a hopeless situation.
Justine, with respect, no one said Stephen Hawking was going to or needs to go down the euthanasia road, I initially used his name in this thread as a graphic example as everyone knows of him and his condition, but there may be others with his condition that do not have his strength and brilliant mind.
Take two people who have the same condition, Stephen Hawking who has a full life and career and another who finds life totally unbearable. How do you legislate that assisted suicide is legal for one but not the other, and is it 'suffering'.
You don't legislate that way. What you do is set out the conditions and circumstances which allow for a person to seek euthanasia. From that point it is the individual who has to make the concious decision to opt for it. Each person knows what they can bear. Similair pain can be felt differently by individuals (compare for example men who cut their finger and need general anestetic for the pain, while in the next room a mum is having a cold epiosotomy;)) So maybe S. Hawking would not opt for euthanasia yet someone else with the same disease could not bear his/her life. It always has to be a personal choice assisted by and evaluated and regulated by independant health professionals.
Justine, with respect, no one said Stephen Hawking was going to or needs to go down the euthanasia road, I initially used his name in this thread as a graphic example as everyone knows of him and his condition, but there may be others with his condition that do not have his strength and brilliant mind.
I understand that, i also understand that others in his condition may not have had the money to get the technology that he has to succeed the way he has done.Stephen hawkins may not have had such a good life if he had not had the funding.He may have ended up ina hospital as a total no-goer like most with his condition.
You don't legislate that way. What you do is set out the conditions and circumstances which allow for a person to seek euthanasia.
That is my whole point, how does a legislative body prescribe those parameters?:confused
Can it just mean that assisting suicide could be eventually legal for killing the fit and healthy if we go down that route? I don't know about you but I feel uncomfortable about that. Or possibly it is me that is wrong for valuing one life over another? Dunno.
btw c'mon soon-to-be 1K orger.:D
That is my whole point, how does a legislative body prescribe those parameters?:confused
Can it just mean that assisting suicide could be eventually legal for killing the fit and healthy if we go down that route? I don't know about you but I feel uncomfortable about that. Or possibly it is me that is wrong for valuing one life over another? Dunno.
btw c'mon soon-to-be 1K orger.:D
I wouldn't define a death wish as an unbearable and/or debilitating disease. I actually think the hypocratic oath is a pretty good guideline here: Do no harm.
I think if a person were asking to die, what the medical profession would have to ask themselves is if by not allowing euthanasia they would be doing harm. The answer with all diseases which are legislated for euthanasia in other countries is yes: futile (defined by me as no prospective improvement in terms of quality of life) suffering will ensue with the use of palliative care- they would be worse off. If a fit healthy person is asking to die and the medical board asks themselves if by not allowing euthanasia they would be doing harm the answer is no: the person is not worse off. If a depressed or mentally ill person is asking for euthanasia, they would be evaluated as to their fitness in asking for it-.
You can't legislate common sense. What you can legislate is protection for the vunerable patients who might feel "obliged" to take this route with robust criteria that define unsubjectively the circumstances ( the diseases, the prognosis, the mental and physical state of the patient) in which a person be allowed to choose euthanasia.
Obviously, just like with abortions, the option to assist suicide would be personal for medical personnel envolved.
I don't believe there is any conflict there, Rheghead. Both suffer the same condition and I would assume in your scenario both are as capable of making informed decisions as the other.
I suppose the conflict there could lie with the individual as to whether their life was 'worth living'...again, that's personal choice. Unfortunately we are then skating on thin ice...as it could be argued that the individual is suffering from severe depression brought on by the disabilty and is not capable of making a rational informed decision at that point in time.
But, does someone wishing to end their own life make them 'severely depressed' or are they hard-headed pragmatists?....Dunno.
Who actually knows the answer to that but I do know that severe depression brought on by the unability to to live a full life hampered by illness can have serious consequenses no matter what the age and the person who takes there own life in the process often leave behind a hurt grieving and stunned family trying to come to terms with the persons decision
There is a slightly different angle on assisted suicides, but done legaly by medical professionals, called DNR
How ever some patients came to realise that DNR was found written on their medical notes unknown to them or family members and all because of their age orcondition. Although alot of patients are unaware of it being on the records, many and most terminally people make that choise ahead of time.Just my opinion on this one.
purplelady
27-Sep-08, 23:02
Read this story last night and i must say it got me thinking, isnt it about time britain changed the law so that people with a terminal illness could end their lives instead if having to travel to switerzerland to do this. the lady has got primary progressive multiple sclerosis, and feels that when the time gcomes she would like to beable to end her life. At the end of the day if an animal is suffering the option is their to put them to sleep , so why cant a human have the same option. just wondering what everone elses few on this matter was. I for one would like to think if it was me then i could say enough was enough and die with dignity.I have to say am with you mandy on this one i think poeple should be able to make that choice i would hate to be so far gone need 24hr care
Welcomefamily
27-Sep-08, 23:10
Stephen hawkins knows his own mind even in the condition he's in. He can communicate with the world better than most.Anyone with his condition can see that although he may have motor skills, his mind is still sharp, no need to go for assisted suicide.There is hope in a hopeless situation.
I cant imagine him being suicidal until he knows if his theory is right or not, he could get a noble prize nomination if it is.
I think there is a major case for it, its would allow that person digity at death and some control. Death is never pleasant, even modern drugs that keep someone pain free can have nasty side effects such as respiratory depression which I cant imagine is a nice experience.
There is a slightly different angle on assisted suicides, but done legaly by medical professionals, called DNR
How ever some patients came to realise that DNR was found written on their medical notes unknown to them or family members and all because of their age orcondition. Although alot of patients are unaware of it being on the records, many and most terminally people make that choise ahead of time.Just my opinion on this one.
DNR is not assisted suicide. It stands for "Do not resussitate". In other words, to allow a person to pass away when they suffer cardiac or respiratory arrest, without performing invasive medical procedures. No one is actively procurring anyones death (ie: assisted suicide). Nature is being allowed to work.
A DNR is usually issued by the ill person themselves or (rarely) by a health care proxy. The family is always consulted when it is the doctors that feel that ressucitation will cause futile suffering (close family- not the cousin twice removed living across town). And DNR by indication of the medics is only carried out when judicially backed. So I do question your statement that so many patients do not know they are DNR on their charts. Simply not true.
Lolabelle
28-Sep-08, 10:16
These kinds of issues are always going to be difficult as it is so individual.
There will be people who will use any kind of euthanasia to dispose of unwanted old or unwell relatives etc.
Personally I would like to not be a burden on Dave or any other family members. If someone able bodied but mentally distraught or sick wants to commit suicide, they can find a way. Someone who is terminally ill and unable to do so themselves, well, I don't really know, I think they should have the opportunity to make the decision themselves. I know Dave wants the DNR thingy on his licence, but I would want to hang onto him, but I would support his decision, even if I didn't want to.
Valerie Campbell
28-Sep-08, 15:35
If people could legalise living wills, they could specify that under certain circumstances and with the approval of members of their families and their doctor, euthanasia could take place without the person/s helping with it facing prosecution. I think this is what many people fear. It's not the act of dying but the result if their loved one helps them. They face prosecution, so at the moment it's a no win situation. You either have to watch the person die in agony etc or take the law into your own hands and face jail which the dying person wouldn't want. Clarification is needed. And debate so all views can be considered.
DNR ...do not ressucitate.....only goes on patients notes with their knowledge. Terminally ill patients are asked if they want to be res sucitated and most say no, and then they are allowed to die rather than be saved. I know himself was asked this several times.
Also, i think terminally ill patients are allowed to die with dignity, without fear or anxiety, in this country, especially if they are at home, when the time comes , with a higher dose of morphine etc. They certainly dont die in agony.
Although i agree with this in certain medical cases ie terminally ill or progressive physical debilatating conditions it is such a grey area. And as a healthcare worker i know i for 1 could not help some1 to die even if it was legal i just couldn't. Im all for palliative care and keeping patients comfortable and try my best to maintain patients dignity
thought i would update what happened when the case went to court but most of you will know as it has been all over the news.
Multiple sclerosis sufferer Debbie Purdy must wait to learn whether she has won her legal battle to clarify the law on assisted suicide.
On the second day of the hearing at London's High Court, Lord Justice Scott Baker and Mr Justice Aikens reserved judgment on a case with important implications for many who are terminally ill.
Wheelchair-bound Ms Purdy intends, if life becomes unbearable because of her illness, to travel abroad to a clinic in Switzerland or Belgium where people can end their lives by lethal injection. But assisting suicide in the UK is unlawful and punishable by up to 14 years' imprisonment, and she fears that her husband, Cuban jazz violinist Omar Puente, 46, could face prosecution if he helps her.
Her lawyers are seeking a High Court declaration that the Director of Public Prosecutions, Sir Ken Macdonald, is obliged under human rights laws to spell out in clearer terms the circumstances and the factors which might lead to a prosecution. But Dinah Rose QC, appearing for the DPP, argued the courts could offer her "no comfort".
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Ms Purdy, whose legal action is being supported by Dignity in Dying, formerly the Voluntary Euthanasia Society, has accused the DPP of "cowardice" for refusing to give further guidance on what she regards as an "inhumane" law.
Critics say any change in the law to make assisted suicide easier could put the vulnerable and disabled at risk of exploitation and abuse.
No one has yet been prosecuted for helping a loved one fly abroad to die. But Ms Purdy, 45, from Bradford, West Yorkshire, said: "As long as the DPP will not clarify his policy, I worry that as my husband is black and a foreigner, this makes him a more likely target for prosecution."
Her lawyers argued in court that she was entitled to know whether her husband would be at risk if he bought plane tickets, accompanied her abroad, or carried out other acts to help her die with dignity.
David Pannick QC, appearing for Ms Purdy, warned that a failure to win her legal battle could unnecessarily shorten her life.
He said: "Her dilemma is that she wants to delay her suicide as long as possible. If her husband is likely to be prosecuted, then she is much more likely to travel abroad to commit suicide sooner rather than later."
DNR is not assisted suicide. It stands for "Do not resussitate". In other words, to allow a person to pass away when they suffer cardiac or respiratory arrest, without performing invasive medical procedures. No one is actively procurring anyones death (ie: assisted suicide). Nature is being allowed to work.
A DNR is usually issued by the ill person themselves or (rarely) by a health care proxy. The family is always consulted when it is the doctors that feel that ressucitation will cause futile suffering (close family- not the cousin twice removed living across town). And DNR by indication of the medics is only carried out when judicially backed. So I do question your statement that so many patients do not know they are DNR on their charts. Simply not true.
I understand what DNR stands for:eek:
I brought it up because statistics show and i will go back to the story where i found the link and get the exact numbers, but its like something in the region of 36% of people in America have DNR on there notes and did NOT know about it. To me that is deciding when people should be helped and when they should not be.
No its not the same as assisted suicide, but it is doctors deciding who has the right to live and who does not.
Fran...
Not all patients know they have DNR on there records, some have had it put on by a doctor who has decided that the patient for one reason or nother dont deserve the right to be saved..Who makes the desision on that..
Doctors and humanitarians seem to make there mind up and the patients are left to wait their fate..
Alice in Blunderland
03-Oct-08, 16:41
There is a slightly different angle on assisted suicides, but done legaly by medical professionals, called DNR
How ever some patients came to realise that DNR was found written on their medical notes unknown to them or family members and all because of their age orcondition. Although alot of patients are unaware of it being on the records, many and most terminally people make that choise ahead of time.Just my opinion on this one.
Absoloubtly not true on this one Justine I can elaborate if you wish :)
DNR is a whole different ball game.
Alice in Blunderland
03-Oct-08, 17:01
I understand what DNR stands for:eek:
I brought it up because statistics show and i will go back to the story where i found the link and get the exact numbers, but its like something in the region of 36% of people in America have DNR on there notes and did NOT know about it. To me that is deciding when people should be helped and when they should not be.
No its not the same as assisted suicide, but it is doctors deciding who has the right to live and who does not.
Fran...
Not all patients know they have DNR on there records, some have had it put on by a doctor who has decided that the patient for one reason or nother dont deserve the right to be saved..Who makes the desision on that..
Doctors and humanitarians seem to make there mind up and the patients are left to wait their fate..
Do you truly believe doctors think like this that certain people dont deserve to live?..
DNR can only be instituted at the request of the person or after deliberation with close family and with legal intervention.
As for your "understanding that DNR and assisted suicide are diferent, I will quote yourself:
There is a slightly different angle on assisted suicides, but done legaly by medical professionals, called DNR
Now english might not be my first language, but that sentence defines assisted suicide and DNR as being slight variations of the same. To explain why they are not, I will quote myself:
DNR......to allow a person to pass away when they suffer cardiac or respiratory arrest, without performing invasive medical procedures......
That means that the person effectively dies and is brought back to life by violent/painful/invasive medical procedures instead of allowing natural death to ocurr. This is not the definition of suicide as per oxford dictionary:
suicide
• noun 1 the action of killing oneself intentionally. 2 a person who does this. 3 before another noun referring to a military operation carried out by people who do not expect to survive it: a suicide bomber. 4 a course of action which is disastrously damaging to one’s own interests.
• verb intentionally kill oneself.
— DERIVATIVES suicidal adjective suicidally adverb.
— ORIGIN from Latin sui ‘of oneself’ + caedere ‘kill’.
And just incase you didn't get it at the begining of my post:
DNR can only be instituted at the request of the person or after deliberation with close family and with legal intervention.
From the British Medical Association: http://www.bma.org.uk/ap.nsf/AttachmentsByTitle/PDFCPRpatientinformation/$FILE/CPRpatientinformation.pdf?OpenElement&Highlight=2,DNR
Read it. You will learn that doctors are not out their deciding to let some live and others die because "they feel like it".
Alice in Blunderland
03-Oct-08, 18:17
DNAR "Do not attempt to resusicitate" is a form of treament given to people who have had cardiopulmonary arrest (which means either heart or breathing stops). It happens when somebody is very sick and about to die.
After successful CPR (cardio pulmonary resusitation) patients need to be cared for either in an Intensive care unit (on ventilation) or a coronary care unit.
The doctors make this decision after discussing with the patient. If the patient wishes then it is discussed with the family. It is a sensitive issue which is dealt with professionally in hospitals. Doctors are trained in "end of life issues".
A question "Can the patient with kidney failure on dialysis demand kidney transplant?"
The answer is "no" because it is a form of treatment with certain side effects and not appropriate for all patients with the same disease.
Likewise CPR would be futile in certain people and will cause more harm than good .
There is a guidance published jointly by British Medical Association, Royal College of Nursing and Resuscitation Council (UK) in October 2007. This document sets guiding principles based on ethics, legality and above all Human Rights Act 1998. The organisations (NHS Trusts) while making their own DNAR policies take this guidance into consideration.
Doctors making DNAR orders follow the strict guidance of their NHS Trusts or Health Boards (not their own personal thoughts).
On the other hand assisted suicide is altogether a different thing. In this a living person who is not having an imminent cardiopulmonary arrest is given life ending medications. You cannot combine these two different concepts.
If the members of this forum are intersted then an open session in the chat room on DNAR could be arranged for a health care professional to answer or an open session could be arrranged localy for a question time.
None of the above googled or read up on the internet and pertaining to UK not USA.
It appears that some people are unable to understand the difference between actively assisting somebody to die as opposed to not acting in a manner to repeatedly and artificially drag them back from the normal death process simply to have the satisfaction of proving it can be done in order to be able to watch them die again and again and again.
That is the attitude I find far more disgusting than just allowing somebody to pass quietly away when their natural time for death has come.
The case which has been in the media at the moment has been brought about by a woman who is terminally ill with an incurable progressive disease. She is of sound mind and has decided that she, at some date in the future at a time of her own choosing, wishes to have her life ended in a dignified manner rather than being in a position where she is incapable of doing anything for herself.
She asked for a decision to be made which would clarify the legal position her husband would put himself in if he participated in taking her to Switzerland so she could have her wishes carried out by a clinic which carries out assisted suicides. Would he, under those circumstances, be considered as having committed the offence of assisting in her suicide or would his actions be allowed under British Laws.
Her alternative course of action would be to travel under her own steam whilst she was still able to do so and long, long before she would either need or wish to in order to ensure her husband committed no offence.
After long and studied consideration and, no doubt, with the full majesty of the law the decision was, “Not got a clue”.
The decision, in England, lies with the Director of Public Prosecutions who hives it off to one of the local Crown Prosecutions Service who then make their own decision.
In other words, the only time you know if you have committed an offence is after you have completed the act at which stage it will be decided if you acted in a criminal manner or not.
The whole thing is a totally unsatisfactory fudge, which , in this day and age is quite normal, and the only time you will know if you have broken the law is after you have acted at which time it is already too late to avoid doing so.
Do it first and then we will decide if you shouldn’t have. Hell, even my most horrid school teachers (sorry to any teachers reading this) had a better sense of justice than that cop out.
There is a slightly different angle on assisted suicides, but done legaly by medical professionals, called DNR
How ever some patients came to realise that DNR was found written on their medical notes unknown to them or family members and all because of their age orcondition. Although alot of patients are unaware of it being on the records, many and most terminally people make that choise ahead of time.Just my opinion on this one.
Do not Resucitate DNR is only ever put on a patients notes with their agreement only, not decided by a doctor alone. i have been there when it was discussed with a terminally ill patient and their doctor. the patient had been asked several times over a period of time. The person did not want to be ressucitated if he collapsed etc. so DNR was put on his notes so that medical staff anywhere would n
know the patient did not want this done. there is no way a doctor decides who will live and who will not.This is never put on a patients notes without their knowlege and usually the knowlege of their family.
Welcomefamily
04-Oct-08, 08:09
So if you had a client with dementia in the later stages of the condition, NOK live miles away and generally not interested as she is a hinderance and they want her house. She's is incontinent,need help feeding but other wise does not show evidence of distress other than the occasional tear during one of the moment of lucidity. She has what appears to be a heart attack? do you let her die?
British medical association guidance on ressucitation:
Does it matter how old I am or that I have a
disability (for ressucitation)?
No. What is important is:
• your state of health;
• your wishes; and
• the likelihood of the healthcare team being able to
achieve what you want.
Your age alone does not affect the decision, nor does
the fact that you have a disability.
What if I am unable to decide for myself?
England and Wales
Adults can choose somebody to make decisions for
them (a ‘proxy’) if later they cannot make decisions for
themselves. If you have not formally chosen a proxy
the healthcare professional in charge of your care will
make a decision about what is best for you. Your
family and friends are not allowed to decide for you but
it can be helpful for the healthcare team to talk to
them about your wishes. If there are people you do (or
do not) want to be asked about your care, you should
let the healthcare team know.
Northern Ireland
The healthcare professional in charge of your care will
make a decision about what is best for you. Your
family and friends are not allowed to decide for you.
But it can be helpful for the healthcare team to talk to
them about your wishes. If there are people you do (or
do not) want to be asked about your care, you should
let the healthcare team know.
Scotland
Adults can choose somebody to make decisions for
them (a ‘proxy’) by contacting a solicitor if they cannot
make decisions for themselves. If you have not formally
chosen a proxy the healthcare professional in charge of
your care will make a decision about what is best for
you. Your family and friends are not allowed to decide
for you. But it can be helpful for the healthcare team
to talk to them about your wishes. If there are people
you do (or do not) want to be asked about your care,
you should let the healthcare team know.
So welcomefamily, wether or not the patient you refer to is ressused depends on overall health, the reason for cardio/pulmonary arrest and what the prognosis of ressusing him/her would be.
I would put the question another way: how legitimate would it be to yank this person back from death in a painful way, that would leave the patient with lesions and symptoms, just to thwart his/her unpleasant family? The doctors responsibility is to the patient, NOT the family.
The reality is:
1) We are all going to die ( just as certainly as each of us were born!)
2) There comes a point at which every effort to prevent this happening no longer makes sense and is infact cruel, not only to the family, but, especially, to the patient.
3) Most people are able to recognize that point, if not in people, at least in their pets (Yes, I know animals are animals. But peoples pets are like a family to them. There are paralels with DNR and euthanasia in pets). In my experience, no matter how much a person wants to keep their pet with them, and even though greiving, they intuitively recognize the point at which they have to let go, for the benefit of their animal friend. In a hospital setting, with a person as a patient, and with consultation with a medical team, the decision to ressucitate or not is taken ALWAYS with the patients best interests foremost.
Alice in Blunderland
04-Oct-08, 08:49
WF
The answer to this question is very complex. The following factors would be taken into consideration:
1. To find out what were the patients wishes before developing dementia. The patient's GP would be consulted because he/she would have seen patient in health.
2. To find out whether patient has made any "Advanced decisions/directives"
3. To find out whether patient has nominated any welfare guairdian/attorney (before developing dementia)
4. If answer is "no" then it is the medical teams decision to see risks/benefits of CPR. DNAR does not mean that they don't get medical treatment. They get treatment for heart attack. If they have cardiopulmonary arrest then doing CPR would do more harm than good. Next of kin is involved in decision making. If they don't agree then an independent second opinion is sought.
5. Only 15% to 20% patients who have cardiopulmonary arrest are alive to go home (after successful CPR). It means cardiopulmonary arrest carries a very high mortality. We must understand that CPR is a form of treament. In doing CPR there are chances of fracturing ribs, sternum and puncturing of lungs.
6. Would you consider this humane to cause pain and distress to a dying patient (who after a life threatening disease and appropriate treatment is not responding). It has been shown the success rate of CPR in this set of patients is very low. CPR will prolong life for few minutes to hours.
To sum up the answer is "NO". You will treat this patient aggressively and if they develop cardiopulmonary arrest then refer to previous 6 points.:)
Welcomefamily
04-Oct-08, 09:11
WF
The answer to this question is very complex. The following factors would be taken into consideration:
1. To find out what were the patients wishes before developing dementia. The patient's GP would be consulted because he/she would have seen patient in health.
2. To find out whether patient has made any "Advanced decisions/directives"
3. To find out whether patient has nominated any welfare guairdian/attorney (before developing dementia)
4. If answer is "no" then it is the medical teams decision to see risks/benefits of CPR. DNAR does not mean that they don't get medical treatment. They get treatment for heart attack. If they have cardiopulmonary arrest then doing CPR would do more harm than good. Next of kin is involved in decision making. If they don't agree then an independent second opinion is sought.
5. Only 15% to 20% patients who have cardiopulmonary arrest are alive to go home (after successful CPR). It means cardiopulmonary arrest carries a very high mortality. We must understand that CPR is a form of treament. In doing CPR there are chances of fracturing ribs, sternum and puncturing of lungs.
6. Would you consider this humane to cause pain and distress to a dying patient (who after a life threatening disease and appropriate treatment is not responding). It has been shown the success rate of CPR in this set of patients is very low. CPR will prolong life for few minutes to hours.
To sum up the answer is "NO". You will treat this patient aggressively and if they develop cardiopulmonary arrest then refer to previous 6 points.:)
I am certainly totally in agreement with both of you on that, however the point I was making is that across many non hospital environment that case can be seen many times over, however who makes that final choice? because that final choice will be based upon many other factors. How busy the staff are as to even if they are checked, do the staff have a good enough command of English to be able to read the notes, do they actually know CPR and do they care.
It is all of the other none related factors that will influence the final action. I can think of about another 60 influences that will decide as to the answer to that question. I get the feeling you are both talking about acute environments.
Alice in Blunderland
04-Oct-08, 09:25
If you are talking about Nursing Homes then it is patient's GP who makes the decision. If there is no decision and somebody has cardiopulmonary arrest then a 999 call is to be made like anywhere in community (own homes, streets, bars etc).
I cannot comment on staff's command of English. I know there are sectors where you don't get good English speaking staff. The choice is "No staff" at all and close the facility or a little compromise on language. Moreover it is unlawful to check language skills of EU citizens when shortlisting for a job.
It is the responsibity of the managment of Nursing Home to keep checks on their staff and appropriate SOP (standard operating procedures) in place.
It is all of the other none related factors that will influence the final action. I can think of about another 60 influences that will decide as to the answer to that question. I get the feeling you are both talking about acute environments.
Caridio pulmonary arrest is an accute situation. DNR applies only in cardio pulmonary arrest and has nothing to do with euthanasia or assisted suicide. It is sometimes refered to as passive euthanasia ( ie: person is allowed to die without intervention to reverse cardio pulmonary arrest). I prefer ADN (allow to die naturally). If the patient falls ill, they are transported to the enviroment where they can be treated ( which is not the care home, nor is it by the care takers).
highlander
04-Oct-08, 10:32
I for one am glad that Alice in Blunderland and Ju have given us the true facts on this matter, there could be many family's faced with a loved one in hospital and worried that some of the information on here was not accurite.
Alice in Blunderland
04-Oct-08, 10:38
I for one am glad that Alice in Blunderland and Ju have given us the true facts on this matter, there could be many family's faced with a loved one in hospital and worried that some of the information on here was not accurite.
:D agree with you here Highlander
I understand what DNR stands for:eek:
I brought it up because statistics show and i will go back to the story where i found the link and get the exact numbers, but its like something in the region of 36% of people in America have DNR on there notes and did NOT know about it. To me that is deciding when people should be helped and when they should not be.
No its not the same as assisted suicide, but it is doctors deciding who has the right to live and who does not.
Fran...
Not all patients know they have DNR on there records, some have had it put on by a doctor who has decided that the patient for one reason or nother dont deserve the right to be saved..Who makes the desision on that..
Doctors and humanitarians seem to make there mind up and the patients are left to wait their fate..
Where are you getting your information from?
My information is from personal experience and from my work enviroment/training etc.
I have thought long and hard about the above discussion and I have thought long and hard about posting but I will so that anyone who has a close one in hospital makes sure DNR is not included on the patient notes without consultation.
I know someone who had DNR on their notes without being consulted. A nurse read it and asked the patient if they had agreed to it. The patient said no and I can assure you that they were perfectly capable of making their own decisions at the time and certainly no close family had been consulted.
The note was struck off.
(To Alice and others who have clarified the rules of DNR, thank you; you have made things very clear and understandable.)
Welcomefamily
04-Oct-08, 19:42
I prefer ADN (allow to die naturally). If the patient falls ill, they are transported to the enviroment where they can be treated ( which is not the care home, nor is it by the care takers).
Yes a much better saying, the area of death has always been a very difficult area with many grey areas, I think it would be in everyones interest to move forward with a legal acceptance of living wills and then a legal frame work put forward.
On a number of occasions I have looked at area and the medical risk issues from a human factors point of view.
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