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Very interesting discussion on End of Life care - join us

FireFire LondonPosts: 10,886


  • punkdocpunkdoc Sheffield, Derbyshire border.Posts: 9,737
    I hope you have better luck with this one.
    Southern trees bear a strange fruit
    Blood on the leaves and blood at the root
  • LynLyn DevonPosts: 18,444
    I had a terrible time with end of life care, looking after both my parents.  I’m reminded of the trauma everyday at some time. Unless you’ve actually been through this, there’s not much to debate.
    Gardening on the wild, windy west side of Dartmoor. 

  • B3B3 Posts: 18,694
    I have found the thread moving and thought-provoking . The issues need to be discussed openly. I hope the right to die issues have been addressed before my time comes but it is never going to happen if discussion is suppressed
    In London. Keen but lazy.
  • FireFire LondonPosts: 10,886
    The thread does get more nuanced as it goes on.
  • josusa47josusa47 Posts: 3,532
    edited July 2018
    I feel some of the contributions have blurred the distinction between allowing and helping someone to die.  The old rhyme had it right: 

    "Thou shalt not kill, but needst not strive
    Officiously to keep alive."

    If a person is at death's door, I don't think there is any crime, legally or morally, in refraining from trying to resuscitate them.  But a deliberate action intended to shorten the person's life is a crime, and in my opinion should remain so. 

    Some contributors who have written in support of euthanasia have suggested that the alternative is "leaving them to suffer". The opponents of euthanasia are not, I think, in favour of prolonging anyone's suffering.  The Hospice movement has made great advances in palliative care, including domiciliary care. Most people, if asked where they'd prefer to die, say "At home", but hardly anyone does.  

    I don't know enough about medicine to know whether a situation can occur in which a dying person could be in such pain that the only effective dose of pain relief would be a fatal overdose. In that situation, I think the law would have to rest on the question of intention: the temporary relief of suffering, or the ending of it by ending life?  

    Some people have drawn a comparison with euthanasia of animals, which I don't think stands up. That decision is made by the animal's owner because it can't be made by the animal.  A terminally sick animal can't tell the vet whether its quality of life is impaired beyond endurance. Animals can be legally kept in cages and surgically neutered, but I don't hear demands for changes in the law so we can treat our relatives the same.
  • FairygirlFairygirl west central ScotlandPosts: 39,309

  • fidgetbonesfidgetbones Posts: 15,336
    It varies much from place to place.
    In Gateshead, my mother in law with end stage  Alzheimers had been on end of life care for nearly five years. Her final chest infection, she went to hospital in an ambulance. Two days in, they said she wouldn't survive the week. Sister in law wanted her home. A special bed, oxygen, three carers round the clock was arranged within a few hours. She went home and died two days later.

    My father , in hospital in Mansfield, was on a ward with Alzheimers patients, didn't have Alzheimers, even though they kept doing the tests. He wanted to come home. No arrangements could be made. He was moved into a single room. He was hallucinating as his organs shut down and was screaming in pain. I had to have a paddy with the doctor who wouldn't prescribe analgesia of any sort, or any tranquilliser. We eventually got a consultant from A & E up to the ward to see him. We knew there was going to be no miracle, and we finally got him calm and not in pain. A geriatric consultant arrived and decided there was nothing wrong with him, that he couldn't sort out.  He said we were premature with end of life discussion. He listened to his chest, nothing wrong with it. He swept out with a statement that we would discuss it further the next day. An hour later my dad died, with me and my mum there. We waited three hours for a doctor to come and certify death, to no avail. My brother and sister arrived after a 70 mile drive. Eventually we all went back to Mums as she was getting upset.  We went back the next day for the death certificate. We were handed a bag of someone elses clothes and shoes. The Death Certificate stated he died of Pneumonia, when in fact his lungs were probably the only thing that still worked properly. He was breathing well, until he didn't.  I refused to accept it, and the Coroner decided to have another word with the consultant who finally changed it to Heart  and kidney failure, after I said  that I would see them in Court. The retired vicar who lived across the road, and did the service for his funeral, said that they all die of Pneumonia in Kings Mill. It looks better for their statistics. 
  • raisingirlraisingirl East Devon, on the Edge of Exmoor.Posts: 4,703
    edited July 2018
    josusa47 said:
    I would speculate from this comment that you've not yet found yourself in the position where someone you know has suffered some form of crisis and ended up on the various machines and apparatus that our technologically advanced society has provided to maintain life. Once all hope of recovery has been extinguished but life is being artificially sustained, one is faced with a decision whether to switch off the machines. At that point, the distinction you draw is in fact very blurred. 'Allowing' death feels like killing when you're the one deciding to switch the machine off. And then comes the waiting to see if they die quickly at that point, or linger for weeks or even months, getting no better, no worse. The body's will to survive can be tenacious, even when the mind has long since surrendered the fight. Finally then comes the decision I mentioned, to withdraw food which is being artificially 'piped in' to them, so they effectively starve. Starvation is not a painless death, but to administer morphine is to assist dying in those circumstances so it is banned.

    In theory it's a simple choice of letting nature take its course or intervening to prolong life. But actually, because we have medical abilities now that the old rhyme could not envisage, it can be far less clear cut. 
    “There is no military solution
    Doesn't always end up as something worse”
  • raisingirlraisingirl East Devon, on the Edge of Exmoor.Posts: 4,703
    @fidgetbones That's appalling.  :(
    “There is no military solution
    Doesn't always end up as something worse”
  • FairygirlFairygirl west central ScotlandPosts: 39,309
    How horrific fidget. There's clearly searingly different experiences depending on where you are. That old phrase 'postcode lottery' was never more appropriate. I'm incredibly fortunate that I've never had to be in that situation, and the medical staff who looked after my Mum when she was dying, and that includes talking to my Dad about the reality, were beyond wonderful, and a credit to their profession. 

    R'girl - I think you worded that beautifully. I don't think many people realise that switching off a machine means people starve to death, but you're right - starvation and dehydration. I hope my children are never put in that position with  me.
    We're not [or rather, doctors aren't ] allowed to administer an 'end product'. I've been saying for years that, just because we have the capability to keep someone alive, it doesn't mean we should. It's clearly something that needs addressing, but whether it ever will is another matter.

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