I am a nurse and work on a unit with quite a lot of the End of life patients. Including patients with MND and COPD which need careful management for breathlessness.
I don't support this legislation. My opposition is based on the fact that enabling someone to have a peaceful death involves a interplay of numerous environmental social and biological factors. The new legislation will need to fit into this complex environment without disrupting the practices which have built up to manage EOL care.
For example suffering for a patient will be significantly eased if the doctor explains clearly what is expected to happen and what the patient is likely to experience.
A patient with COPD, might be afraid to experience breathlessness. But the medical team explain how it will work, the nurses introduce it gradually and the patient does not suffer. Its the interplay of the technology, the professionals, the biological process and, obviously the patient and the beliefs and uncertainty.
Likewise a completely dependent MND patient will requite 16 full time nurses to provide for his needs. They might feel like a burden. Again its an interplay between the patients needs, symptoms and the professionals and technology we use to meet these needs.
If we overlay on this situations the knowledge that the patient could simply take their own life, its not clear to me that this would alleviate suffering.
My grandmother, who I visited today, is a 93yo COPD patient.
She can't breathe. She can't use the bathroom without help. She can't hardly move. She's hooked up to a nasal cannula 100% of the time. Albuterol breathing exercises 4x a day means she can't sleep more than six hours at a time because if she skips one, even on O2, she experiences suffocation.
She coughs so badly that she has constant rib/spine fractures so she's on and off narcotic painkillers that only make life bearable in doses enough to turn her brain into mush.
She wants to die. She's done. She won life. She's the last lady standing. Every single friend from her youth is gone. It's over.
I've already told her that when I get into my 60s I am going to stockpile a cache of painkillers and when the time comes go out on my own terms. There is an exact and precise 0.0% chance that my family is going to cry out in the hallway for days/weeks while I shit/piss myself in bed and slowly drown to death as my organs fail.
But it's too late for my grandmother because she waited until she was under the watchful eye of the skilled nursing facility nightmare.
In my idealized world, there is no violence, no accidents, and all diseases have been cured except for the inevitable and unstoppable phenomenon of heart failure and 100% of ALL deaths are medically-assisted suicide, decided on by the individual once they reach the point where your heart can no longer support independent living but before you get to the Morphine downward spiral.
I am a volunteer FF/EMT so I've seen my fair share of end of life patients in the last 25 years and apparently I am the only responsible adult in my family so I've handled the hospice phase for every member of my family for the last 20 years.
It is incomprehensible to me that anyone who has any exposure to death whatsoever does not fully support a person's right to determine the time and manner of their death-- even if it comes with problems.
The only reasons I can come up with for not supporting it are: a financial stake in prolonged expensive end-of-life care, the belief that the patients are too stupid to determine their fate, and/or trying to impose their personal religious beliefs on the masses.
Some reasons you didn't list: fear of abuse; fear of sweeping other problems under the rug (e.g. loneliness, poverty, lack of elderly care homes); fear of slipperly slope (e.g. extending the program to non-terminal diseases, mental problems etc..); fear of social pressure.
It's not that long ago that people were dying in hospitals while their relatives were forbidden from seeing them, and by the way hospitals were under immense pressure to free up beds.
I don't support this legislation. My opposition is based on the fact that enabling someone to have a peaceful death involves a interplay of numerous environmental social and biological factors. The new legislation will need to fit into this complex environment without disrupting the practices which have built up to manage EOL care.
For example suffering for a patient will be significantly eased if the doctor explains clearly what is expected to happen and what the patient is likely to experience.
A patient with COPD, might be afraid to experience breathlessness. But the medical team explain how it will work, the nurses introduce it gradually and the patient does not suffer. Its the interplay of the technology, the professionals, the biological process and, obviously the patient and the beliefs and uncertainty.
Likewise a completely dependent MND patient will requite 16 full time nurses to provide for his needs. They might feel like a burden. Again its an interplay between the patients needs, symptoms and the professionals and technology we use to meet these needs.
If we overlay on this situations the knowledge that the patient could simply take their own life, its not clear to me that this would alleviate suffering.