Give 'em the needle?

[Sandstorm]

I hated the way Wes Streeting talked it down and said we should improve palliative care instead as if that is in any way an adequate substitute for those who wish to die rather than suffer.

Quite. That kind of care is also extremely expensive and the current NHS finances won't support his view.

[Rhubarb & Custard]

The idea things will go wrong if assisted dying is allowed seems evidently true, but things are going wrong now, so it's hardly moving from a perfect to an imperfect system.

Myself I'm in favour of people not having to endure needless suffering, and I'd extend that to people who aren't capable of taking assistance themselves and would need help. I also happen to think a lot of people wouldn't choose it but would like to know it's there if they wanted to. I am however very glad drafting how this will work isn't on me, because this is truly a difficult needle to thread.

What should be in place over and over are sunset clauses so Parliament has to review this legislation to see if it's working as expected and consider revisions. Actually I think Parliament should generally be doing much more in the way of revision across vast swathes of legislation, and the notion they've got the time to piss off and work for GB News as they don't have a full-time job already is risible, as a for instance, but this certainly should be getting looked at over and over.

[Paddington Bear]

I hated the way Wes Streeting talked it down and said we should improve palliative care instead as if that is in any way an adequate substitute for those who wish to die rather than suffer.

Quite. That kind of care is also extremely expensive and the current NHS finances won't support his view.

Bringing us back once more to the obvious British moral hazard here - people should not feel obliged to kill themselves for the sake of the NHS

[petej]

The idea things will go wrong if assisted dying is allowed seems evidently true, but things are going wrong now, so it's hardly moving from a perfect to an imperfect system.

Myself I'm in favour of people not having to endure needless suffering, and I'd extend that to people who aren't capable of taking assistance themselves and would need help. I also happen to think a lot of people wouldn't choose it but would like to know it's there if they wanted to. I am however very glad drafting how this will work isn't on me, because this is truly a difficult needle to thread.

What should be in place over and over are sunset clauses so Parliament has to review this legislation to see if it's working as expected and consider revisions. Actually I think Parliament should generally be doing much more in the way of revision across vast swathes of legislation, and the notion they've got the time to piss off and work for GB News as they don't have a full-time job already is risible, as a for instance, but this certainly should be getting looked at over and over.

Agree on a difficult needle to thread and no one is going to be delighted either way. Makes sense that it is limited to terminally ill patients with life expectancy <6 months category.

My grandmother’s DNR was ignored, causing her weeks of agony and a death in hospital rather than her home of 60 years. Pure arrogance from the NHS staff involved (which could cut the other way and lead to very much assisted dying as well). Letting nature run its course is very very different to what this bill proposes

That is awful.

[Paddington Bear]

https://x.com/BBCNewsnight/status/1856472692448194795

Worth a watch to understand the level of intellectual rigour being applied to this bill by its parliamentary supporters.

[Rhubarb & Custard]

Agree on a difficult needle to thread and no one is going to be delighted either way. Makes sense that it is limited to terminally ill patients with life expectancy <6 months category.

it would also make sense for people suffering with some awful chronic conditions, and I'm being charitable allowing the descriptor chronic, would be included, many things can make sense in this as is often the case in an ethics quandary. but in this I'm a liberal who wants freedom of choice for the individual even if that makes others uncomfortable

[Sandstorm]

https://x.com/BBCNewsnight/status/1856472692448194795

Worth a watch to understand the level of intellectual rigour being applied to this bill by its parliamentary supporters.

Only watch this if you want to see a sitting (Lib Dem) MP waffle about absolutely fuck-all for 3.5 minutes. Jesus wept.

[Biffer]

Assistance to die should not be easier to access than assistance to live.

As per the thread posted by PB earlier, this legislation forces the Secretary of State for Health to make sure assisted suicide is available. There is no such duty to provide palliative care.

[Paddington Bear]

https://x.com/BBCNewsnight/status/1856472692448194795

Worth a watch to understand the level of intellectual rigour being applied to this bill by its parliamentary supporters.

Only watch this if you want to see a sitting (Lib Dem) MP waffle about absolutely fuck-all for 3.5 minutes. Jesus wept.

She’s a sponsor of the bill (this is a private members bill) and appears to be clueless about what it entails and safeguards she considers to be world leading. I’m understand why people support the principle but the practicalities of this are everything

[petej]

https://x.com/BBCNewsnight/status/1856472692448194795

Worth a watch to understand the level of intellectual rigour being applied to this bill by its parliamentary supporters.

Only watch this if you want to see a sitting (Lib Dem) MP waffle about absolutely fuck-all for 3.5 minutes. Jesus wept.

She’s a sponsor of the bill (this is a private members bill) and appears to be clueless about what it entails and safeguards she considers to be world leading. I’m understand why people support the principle but the practicalities of this are everything

The journalist annoyed me more. Going for gotcha's. It is why I ignore lots of the media particularly, our deeply unserious political media and more inclined to read the bill. Ultimately the politicians aren't going to be dealing with the practicalities and they think top down not bottom up. The methodology and building the structures and processes will take time and I would assume with a bill like this would have several years before it becomes active. That level of detail won't be present at this time to claim world leading safeguards. Anyone with 3 brain cells would be looking at countries who allow this and looking at what bits are worth copying and what bits don't.

[mat the expat]

My main worries with this are

1. A society has more elderly single people, with only a niece or cousin responsible for them, the likelihood of convenient euthanasia will become more common.

2. As tech bro mentality creeps further into government, with a creeping hyperutility approach, safeguards will be cut back and cut back. Musk doesn’t want old people he has to pay for

I have a friend who is a senior palliative care doctor, and she gets quite angry about the way the public debate in this area is framed.

The first two points are odd

Bolded, frankly, it's not up to them to be angry. Doctors are allowed to be involved in the debate but this is 100% a personal decision

They provide the advice, not the emotion

[Paddington Bear]

My main worries with this are

1. A society has more elderly single people, with only a niece or cousin responsible for them, the likelihood of convenient euthanasia will become more common.

2. As tech bro mentality creeps further into government, with a creeping hyperutility approach, safeguards will be cut back and cut back. Musk doesn’t want old people he has to pay for

I have a friend who is a senior palliative care doctor, and she gets quite angry about the way the public debate in this area is framed.

The first two points are odd

Bolded, frankly, it's not up to them to be angry. Doctors are allowed to be involved in the debate but this is 100% a personal decision

They provide the advice, not the emotion

Under this bill doctors are *required* to offer assisted dying. As for a personal decision, clearly the major sticking point is around capacity and I’m sorry a large % of people absolutely cannot be trusted to care appropriately for the wishes of their elderly relatives, particularly in a society in which the elderly have wildly disproportionate housing based wealth, we see that time and again already.

[inactionman]

My main worries with this are

1. A society has more elderly single people, with only a niece or cousin responsible for them, the likelihood of convenient euthanasia will become more common.

2. As tech bro mentality creeps further into government, with a creeping hyperutility approach, safeguards will be cut back and cut back. Musk doesn’t want old people he has to pay for

I have a friend who is a senior palliative care doctor, and she gets quite angry about the way the public debate in this area is framed.

The first two points are odd

Bolded, frankly, it's not up to them to be angry. Doctors are allowed to be involved in the debate but this is 100% a personal decision

They provide the advice, not the emotion

Under this bill doctors are *required* to offer assisted dying. As for a personal decision, clearly the major sticking point is around capacity and I’m sorry a large % of people absolutely cannot be trusted to care appropriately for the wishes of their elderly relatives, particularly in a society in which the elderly have wildly disproportionate housing based wealth, we see that time and again already.

I'd presume the Power of Attorney stuff be adapted to exclude decisions about euthanasia? So that a guardian can make decisions about e.g. care homes but can't make a call on euthanasia unless expressly permitted to do so?

(I'm assuming that's what you're referring to here)

Auntie Dot may be happy for/resigned to her money-grabbing nieces and nephews to fight over her estate once she's gone, but not to allow them to overly hasten her departure to free up this estate.

[petej]

My main worries with this are

1. A society has more elderly single people, with only a niece or cousin responsible for them, the likelihood of convenient euthanasia will become more common.

2. As tech bro mentality creeps further into government, with a creeping hyperutility approach, safeguards will be cut back and cut back. Musk doesn’t want old people he has to pay for

I have a friend who is a senior palliative care doctor, and she gets quite angry about the way the public debate in this area is framed.

The first two points are odd

Bolded, frankly, it's not up to them to be angry. Doctors are allowed to be involved in the debate but this is 100% a personal decision

They provide the advice, not the emotion

Under this bill doctors are *required* to offer assisted dying. As for a personal decision, clearly the major sticking point is around capacity and I’m sorry a large % of people absolutely cannot be trusted to care appropriately for the wishes of their elderly relatives, particularly in a society in which the elderly have wildly disproportionate housing based wealth, we see that time and again already.

On what basis a large %? It will almost certainly be a small % because it nearly always is. The media love generating fear and in a population of 70 million 1%-0.1% is still 700,000 to 70,000 awful people to generate awful stories from. I suspect the proportion of awful people is far higher in parliament and senior media roles than in the general population.

[Rhubarb & Custard]

If people are that fussed they'll start volunteering en masse to assist/improve palliative care such people will not want the option, or maybe they don't actually care enough to do anything, in which case they don't really care

[Paddington Bear]

The first two points are odd

Bolded, frankly, it's not up to them to be angry. Doctors are allowed to be involved in the debate but this is 100% a personal decision

They provide the advice, not the emotion

Under this bill doctors are *required* to offer assisted dying. As for a personal decision, clearly the major sticking point is around capacity and I’m sorry a large % of people absolutely cannot be trusted to care appropriately for the wishes of their elderly relatives, particularly in a society in which the elderly have wildly disproportionate housing based wealth, we see that time and again already.

On what basis a large %? It will almost certainly be a small % because it nearly always is. The media love generating fear and in a population of 70 million 1%-0.1% is still 700,000 to 70,000 awful people to generate awful stories from. I suspect the proportion of awful people is far higher in parliament and senior media roles than in the general population.

Think I’ve mentioned before but I work occasionally on disputed probate and wills, I can promise you reasonably ordinary and otherwise outwardly respectable people act completely despicably when confronted with the possibility of free money. People will knock off their relatives for the purpose of taking their house/to prevent them from being an irritation etc etc if they are given a legal method of doing so

[Jockaline]

My great aunt died yesterday having had a five year long battle with dementia and other things, it absolutely would have been kinder and better had she fallen down the stairs at some point.

With that said, what you hear and see from Canada, Holland and elsewhere demonstrates that on this issue the slippery slope argument is very very real. This will be worse in a country with attitudes like ours to the health service, where ‘not being a burden’ on it can fall into being a moral duty. We also need to bear in mind the housing wealth the generation likely to face assisted dying possess. We will see some unspeakably evil things done if this is passed, no country has managed to put in place effective safeguards and we are uniquely vulnerable

The state becomes the beneficiary for a six months period after?

Having seen my father die a badly I'm all for a law change. I'm sure he asked me to put a pillow over him at one point, so out of it on meds and pain, but his desire to die was real as had been very clear about before things got bad. My mother, who had dementia, in contrast was allowed to die following an accident. We were told significant medical intervention, both in the short and long term, that would tried on someone younger and healthier, was not in her best interest. The family agreed with the assessment, but that too was hard to get your head around.

Loved ones dying is always hard. Medical advancements and life at all costs is a bit evil too, as doctors now unlike some in the past no longer have the courage or compassion to help people on their way. In some ways I'd rather it was up to doctors than the family involvement, taking into account that persons death will, but they don't want that on their shoulders and who can blame them.

[robmatic]

My main worries with this are

1. A society has more elderly single people, with only a niece or cousin responsible for them, the likelihood of convenient euthanasia will become more common.

2. As tech bro mentality creeps further into government, with a creeping hyperutility approach, safeguards will be cut back and cut back. Musk doesn’t want old people he has to pay for

I have a friend who is a senior palliative care doctor, and she gets quite angry about the way the public debate in this area is framed.

The first two points are odd

Bolded, frankly, it's not up to them to be angry. Doctors are allowed to be involved in the debate but this is 100% a personal decision

They provide the advice, not the emotion

Under this bill doctors are *required* to offer assisted dying. As for a personal decision, clearly the major sticking point is around capacity and I’m sorry a large % of people absolutely cannot be trusted to care appropriately for the wishes of their elderly relatives, particularly in a society in which the elderly have wildly disproportionate housing based wealth, we see that time and again already.

Yeah, I believe in the personal choice aspect and I can easily imagine circumstances where assisted dying would be suitable for me or my family members etc. but do I have faith that there wouldn't be uncomfortable numbers of cases of the facility being abused? Absolutely not.

[Sandstorm]

Under this bill doctors are *required* to offer assisted dying.

Getting rid of Lucy Letby was a premature decision?



I kid.

[Biffer]

My main worries with this are

1. A society has more elderly single people, with only a niece or cousin responsible for them, the likelihood of convenient euthanasia will become more common.

2. As tech bro mentality creeps further into government, with a creeping hyperutility approach, safeguards will be cut back and cut back. Musk doesn’t want old people he has to pay for

I have a friend who is a senior palliative care doctor, and she gets quite angry about the way the public debate in this area is framed.

The first two points are odd

Bolded, frankly, it's not up to them to be angry. Doctors are allowed to be involved in the debate but this is 100% a personal decision

They provide the advice, not the emotion

Should the Doctors be required to offer it? Are they not allowed to have any personal agency?

And also, I clearly said she gets angry about the way the debate is framed. You appear to have gone off onto a different decision than the one I'm talking about.

And again, because no one replied to it, the state making it easier to access assistance to die rather than assistance to live, with a legal obligation to offer one but not the other, is just plain wrong.

[Sandstorm]

And again, because no one replied to it, the state making it easier to access assistance to die rather than assistance to live, with a legal obligation to offer one but not the other, is just plain wrong.

I'm confused. We need a (new?) law to provide assistance to live? I thought that's what medical people did anyway/Hippocratic oath/professional conduct.....?

In my experience the patient needs a DNR in place, otherwise medical teams do everything they can to keep the patient alive.

[sockwithaticket]

And again, because no one replied to it, the state making it easier to access assistance to die rather than assistance to live, with a legal obligation to offer one but not the other, is just plain wrong.

I'm confused. We need a (new?) law to provide assistance to live? I thought that's what medical people did anyway/Hippocratic oath/professional conduct.....?

In my experience the patient needs a DNR in place, otherwise medical teams do everything they can to keep the patient alive.

Right? The default is assisting people to live.

[Biffer]

And again, because no one replied to it, the state making it easier to access assistance to die rather than assistance to live, with a legal obligation to offer one but not the other, is just plain wrong.

I'm confused. We need a (new?) law to provide assistance to live? I thought that's what medical people did anyway/Hippocratic oath/professional conduct.....?

In my experience the patient needs a DNR in place, otherwise medical teams do everything they can to keep the patient alive.

There is no legal obligation to provide palliative care.

This legislation puts a legal obligation in for assisted dying.

That's not right in my book.

[Sandstorm]

And again, because no one replied to it, the state making it easier to access assistance to die rather than assistance to live, with a legal obligation to offer one but not the other, is just plain wrong.

I'm confused. We need a (new?) law to provide assistance to live? I thought that's what medical people did anyway/Hippocratic oath/professional conduct.....?

In my experience the patient needs a DNR in place, otherwise medical teams do everything they can to keep the patient alive.

There is no legal obligation to provide palliative care.

This legislation puts a legal obligation in for assisted dying.

That's not right in my book.

I think you have this backwards. The legal part is to protect both patients and doctors when they decide together that they want to end a (fucking horrible final few months of) life. So no-one gets prosecuted afterwards.

There is no legal obligation or need for someone to provide or get care - it happens automatically in this country and that's a good thing.

[robmatic]

I'm confused. We need a (new?) law to provide assistance to live? I thought that's what medical people did anyway/Hippocratic oath/professional conduct.....?

In my experience the patient needs a DNR in place, otherwise medical teams do everything they can to keep the patient alive.

There is no legal obligation to provide palliative care.

This legislation puts a legal obligation in for assisted dying.

That's not right in my book.

I think you have this backwards. The legal part is to protect both patients and doctors when they decide together that they want to end a (fucking horrible final few months of) life. So no-one gets prosecuted afterwards.

There is no legal obligation or need for someone to provide or get care - it happens automatically in this country and that's a good thing.

Biffer is right here. Palliative care can be a lottery in the UK.

[inactionman]

My painful experience with palliative care for family members is that it frequently kicks in past the date it would have been needed, by which point the family have generally bodged through anyway - or the family member is already deceased.

[Sandstorm]

My painful experience with palliative care for family members is that it frequently kicks in past the date it would have been needed, by which point the family have generally bodged through anyway - or the family member is already deceased.

Yeah, but that's because the NHS is a shitshow. Not because there's a gap in the legal system that needs filling.

[inactionman]

My painful experience with palliative care for family members is that it frequently kicks in past the date it would have been needed, by which point the family have generally bodged through anyway - or the family member is already deceased.

Yeah, but that's because the NHS is a shitshow. Not because there's a gap in the legal system that needs filling.

That's a reasonable point - all I'd note that palliative care was significantly less impressive than the medical care my family members received, but that can be understood in terms of the complexity of e.g. arranging visiting nurses adbn home adaptations at relatively short notice.

[Biffer]

My painful experience with palliative care for family members is that it frequently kicks in past the date it would have been needed, by which point the family have generally bodged through anyway - or the family member is already deceased.

Yeah, but that's because the NHS is a shitshow. Not because there's a gap in the legal system that needs filling.

And yet people want to trust that shitshow to run assisted dying competently.

[Sandstorm]

My painful experience with palliative care for family members is that it frequently kicks in past the date it would have been needed, by which point the family have generally bodged through anyway - or the family member is already deceased.

Yeah, but that's because the NHS is a shitshow. Not because there's a gap in the legal system that needs filling.

And yet people want to trust that shitshow to run assisted dying competently.

Also a fair point. Although they do need a judge to sign off.........oh wait. We want competent people in all aspects of this plan? Oh dear.

[Biffer]

Yeah, but that's because the NHS is a shitshow. Not because there's a gap in the legal system that needs filling.

And yet people want to trust that shitshow to run assisted dying competently.

Also a fair point. Although they do need a judge to sign off.........oh wait. We want competent people in all aspects of this plan? Oh dear.

It's likely to be thousands per year, if not tens of thousands, if you use Canada and Oregon as comparitors. There are fewer than 20 family division judges in England and Wales. Not sure where all these are getting signed off.

[Paddington Bear]

And yet people want to trust that shitshow to run assisted dying competently.

Also a fair point. Although they do need a judge to sign off.........oh wait. We want competent people in all aspects of this plan? Oh dear.

It's likely to be thousands per year, if not tens of thousands, if you use Canada and Oregon as comparitors. There are fewer than 20 family division judges in England and Wales. Not sure where all these are getting signed off.

The way that they’ve worded the bill means that District Judges would be able to take these decisions. I would not wish a DJ having power over life and death upon my worst enemy…

[Biffer]

Also a fair point. Although they do need a judge to sign off.........oh wait. We want competent people in all aspects of this plan? Oh dear.

It's likely to be thousands per year, if not tens of thousands, if you use Canada and Oregon as comparitors. There are fewer than 20 family division judges in England and Wales. Not sure where all these are getting signed off.

The way that they’ve worded the bill means that District Judges would be able to take these decisions. I would not wish a DJ having power over life and death upon my worst enemy…

And yet the media has been reporting high court continuously. This is what I mean about the framing of the debate - nobody at the BBC, Sky or any of the papers is actually focusing on the legislation and tearing it a part for the flimsy piece of law it is.

[petej]

My painful experience with palliative care for family members is that it frequently kicks in past the date it would have been needed, by which point the family have generally bodged through anyway - or the family member is already deceased.

Yeah, but that's because the NHS is a shitshow. Not because there's a gap in the legal system that needs filling.

And yet people want to trust that shitshow to run assisted dying competently.

We are the country of short term shit thinking leading to worse outcomes and greater long term costs.

[Biffer]

Yeah, but that's because the NHS is a shitshow. Not because there's a gap in the legal system that needs filling.

And yet people want to trust that shitshow to run assisted dying competently.

We are the country of short term shit thinking leading to worse outcomes and greater long term costs.

We love as a country to put the big headline 'we're doing this!' but then aren't willing to spend money to put the infrastructure and people in to actually deliver it.

[Slick]

Yeah, but that's because the NHS is a shitshow. Not because there's a gap in the legal system that needs filling.

And yet people want to trust that shitshow to run assisted dying competently.

We are the country of short term shit thinking leading to worse outcomes and greater long term costs.

I'm sure I heard a brass band striking up the national anthem in the background as I read that

[petej]

And yet people want to trust that shitshow to run assisted dying competently.

We are the country of short term shit thinking leading to worse outcomes and greater long term costs.

I'm sure I heard a brass band striking up the national anthem in the background as I read that

We are genuinely world leading at it.

[Uncle fester]

And that's why you need the Swiss system. There's no question about personal choice there, soundness of mind to make that choice maybe but the choice is coming from the person at least.

[Enzedder]

We will see some unspeakably evil things done if this is passed, no country has managed to put in place effective safeguards and we are uniquely vulnerable

Guess how many "unspeakably evil" things we have had since we introduced assisted dieing?

Think low, very very low... think even lower and you're getting close.

It's an emotive subject but how about we leave the choice to those in the firing line? It is not compulsory.

[fishfoodie]

And yet people want to trust that shitshow to run assisted dying competently.

We are the country of short term shit thinking leading to worse outcomes and greater long term costs.

We love as a country to put the big headline 'we're doing this!' but then aren't willing to spend money to put the infrastructure and people in to actually deliver it.

Yeah, you've got two giant currently floating islands that you paid billions for that are testimony to that; & meanwhile the Government had to sign an treaty with the Germans so that their subs could patrol UK waters, as the Navy's spent all their budget on the carriers, & now the infrastructure for building, maintaining, & decommissions nuclear subs is in a fucking shocking state, to the point where they can't launch the fucking subs that have been built !