Assisted Suicide bill to be debated in parliament

[jeremyp]

And in the short term the demand on doctors may be such that the supply to other areas is not what it was. At least that is my reading of Streeting's comments, and is what is being looked into.

It seems like an excuse to me. If somebody is seriously ill and almost certainly going to die in less than six months, a lot of doctors' time is going to be spent on them either way.

[Nearly Sane]

It seems like an excuse to me. If somebody is seriously ill and almost certainly going to die in less than six months, a lot of doctors' time is going to be spent on them either way.

As covered when I put up the report, it is not an argument against assisted dying.

[jeremyp]

As covered when I put up the report, it is not an argument against assisted dying.

Well why are you bringing it up on this thread then? What do you hope to achieve?

[Nearly Sane]

Well why are you bringing it up on this thread then? What do you hope to achieve?

On a thread on assisted dying, you think what the Health Secretary is saying about its impact shouldn't be brought up?

[ProfessorDavey]

It is, indeed, an amazing post, and Gordon is an amazing person on this, and generally. I'm sure though that all MPs will also have amazing communications from people in similar situations arguing for, against, and everything in between. There is not a simple answer, as Gordon agrees.

But to an extent there is a really simply question at the heart of this debate - do you think that people approaching the end of their lives should be able to determine for themselves how and when they die.

[ProfessorDavey]

Streeting getting some pushback on being so open.

https://www.bbc.co.uk/news/articles/cpqdy9ndrndo

Problematic given Starmer's promise to get this discussed for his friend.

I'm a big fan of Streeting, but I do think he is at risk of overstepping the line with regard to the requirement for the government to be neutral on this matter.

So it is fine for him to say 'my personal view is ...' however if he says 'as Health Secretary I have come to the view that ...' then to my mind (and clearly others) he has overstepped the mark as he is aligning his view to his role in government, which is not compatible with the government being explicitly neutral.

So any minister should, of course, be able to give their view in their capacity as an MP, but they are not able to give their view in their capacity as a minister of government.

[Nearly Sane]

But to an extent there is a really simply question at the heart of this debate - do you think that people approaching the end of their lives should be able to determine for themselves how and when they die.

I think that's simplistic rather than smoke. Rake the 'approaching the end of their lifes' - thr bill covers people with less than 6 months, in the opinion, of the doctors, which is an arbitrary line and if someone is a boy outside that you don't want them to have the right? And it's not about the right to commit suicide but that the stare provides them a means to do that under certain circumstances, any of which are arbitrary and not covered by your phrasing of the question.

[ProfessorDavey]

I think that's simplistic rather than smoke. Rake the 'approaching the end of their lifes' - thr bill covers people with less than 6 months, in the opinion, of the doctors, which is an arbitrary line and if someone is a boy outside that you don't want them to have the right? And it's not about the right to commit suicide but that the stare provides them a means to do that under certain circumstances, any of which are arbitrary and not covered by your phrasing of the question.

But at the heart of the matter, there remains that rather simple question of principle. Of course the issues you mention need to be considered robustly, but those are matters of process, not matters of principle.

So I guess the question for those that are 'against' is whether they are against on principle or on process. My fear is that some hide behind the latter as cover to avoid being clear that they are actually against on principle. So that no matter how robust the process they will always find another reason to be against - because in reality they simply don't believe that people should have the right of self determination at the end of their lives.

So I guess my question for you NS is whether you are in favour or against the matter on principle.

[Nearly Sane]

But at the heart of the matter, there remains that rather simple question of principle. Of course the issues you mention need to be considered robustly, but those are matters of process, not matters of principle.

So I guess the question for those that are 'against' is whether they are against on principle or on process. My fear is that some hide behind the latter as cover to avoid being clear that they are actually against on principle. So that no matter how robust the process they will always find another reason to be against - because in reality they simply don't believe that people should have the right of self determination at the end of their lives.

So I guess my question for you NS is whether you are in favour or against the matter on principle.

No, there's principle there in the idea of whether the state should provide the means to commit suicide. Your phrasing of the question  both has process in ot, in terms of nearing the end of life, and would read more about preventing suicide of any type.

In theory, I'm not opposed to it but the complexities of practice, and my doubts about whether it's easy to make principles consistent with practice means that I think the are you for or against something like this again simplistic.


I think of the fact that part of the reason I'm opposed to the death penalty is that I think it courses society's attitude to death, and that that may have a detrimental effect overall. How do I balance that here that that could be a similar impact here that may not be changed by the consent of the person?


I can understand that this may seem evasive in that it's not an answer to your question but I just don't think it's as easy to approach what is complex such a simplistic fashion.

[Gordon]

I think the problem with this being a principle is the implication that it at least 'should' apply to everyone - a kind of 'one size fits all' approach. I suspect that would miss the personal and the emotional aspects of those involved, where each case has its own bespoke circumstances.

If I were ever to go down that road it wouldn't be because I was taking advantage of a new established principle - it would be because was the best option for me and mine - and that applies equally if I decided against.

[ProfessorDavey]

I think the problem with this being a principle is the implication that it at least 'should' apply to everyone - a kind of 'one size fits all' approach. I suspect that would miss the personal and the emotional aspects of those involved, where each case has its own bespoke circumstances.

But that is why I framed the principle on the basis of self determination, in other words that each person should be allowed to choose the best option for themselves as an individual. So this is entirely the opposite of one size fits all. Freedom of the individual to choose is the only thing that would be applied to everyone - what that choice would be would be totally based on the individual, their circumstances and what feels right for them.

If I were ever to go down that road it wouldn't be because I was taking advantage of a new established principle - it would be because was the best option for me and mine - and that applies equally if I decided against.

But the principle would be that it is up to you to decide, so you would be taking advantage of that fundamental principle of self determination, regardless of whether that choice were to use assisted dying or not to.

[Nearly Sane]

But that is why I framed the principle on the basis of self determination, in other words that each person should be allowed to choose the best option for themselves as an individual. So this is entirely the opposite of one size fits all. Freedom of the individual to choose is the only thing that would be applied to everyone - what that choice would be would be totally based on the individual, their circumstances and what feels right for them.
But the principle would be that it is up to you to decide, so you would be taking advantage of that fundamental principle of self determination, regardless of whether that choice were to use assisted dying or not to.

If the bill restricts it to those who are given less than six months to live, then it doesn't apply to everyone.

[SteveH]

"Grassroots" anti-AD groups turn out to be astroturf.
https://www.theguardian.com/society/2024/nov/16/revealed-grassroots-campaigns-opposed-to-assisted-dying-financed-by-conservative-christian-pressure-groups

[Nearly Sane]

"Grassroots" anti-AD groups turn out to be astroturf.
https://www.theguardian.com/society/2024/nov/16/revealed-grassroots-campaigns-opposed-to-assisted-dying-financed-by-conservative-christian-pressure-groups

I'd be interested on Alan Burns take on the morality of those tactics, especially given he highlighted thar he's been misled by a video about homosexuality yesterday.

[Alan Burns]

I'd be interested on Alan Burns take on the morality of those tactics, especially given he highlighted thar he's been misled by a video about homosexuality yesterday.

Of course I agree that using deceit to promote a cause is wrong - even when the cause itself is morally justifiable.
The exposure of such tactics should not be used to condemn the cause - it can only be used to condemn the perpetrators of the deceit.

[Nearly Sane]

Of course I agree that using deceit to promote a cause is wrong - even when the cause itself morally justifiable.
The exposure of such tactics should not be used to condemn the cause - it can only be used to condemn the perpetrators of the deceit.

Agree.

[Gordon]

Interesting take from Harriet Harman about Streeting asking for costs information. She points out that could be a finding that assisted suicide might well turn out to be cheaper that keeping a terminally ill person alive.

By commissioning work to assess the cost of facilitating assisted dying – which he will have to publish – he will then of necessity have to balance that against the cost of the person staying alive. That leads you to the awful prospect that the research could find that it is cheaper for people to be doing assisted dying rather than staying alive, and that would really contaminate the argument,” said Harman, who is co-host of the podcast Electoral Dysfunction.

“It has to be an argument about individual choice and moral principle. It cannot be an argument about money.”

https://www.theguardian.com/society/2024/nov/17/cancel-study-into-the-cost-to-nhs-of-assisted-dying-harman-tells-streeting

[Nearly Sane]

Interesting take from Harriet Harman about Streeting asking for costs information. She points out that could be a finding that assisted suicide might well turn out to be cheaper that keeping a terminally ill person alive.

https://www.theguardian.com/society/2024/nov/17/cancel-study-into-the-cost-to-nhs-of-assisted-dying-harman-tells-streeting

As covered, I don't think this is just about cost, and Steve did raise it. The problem is that to reverse Harman's position here would be saying we shouldn't understand the impact in case it affects the decision I.e. we should refuse to have the information.

[SteveH]

Polly Toynbee, in the Guardian, opines that the safeguards are too strict, and I agree: each request must be signed  off by two doctors and a judge, and then there's a 14-day cooling-off period, so it could be three weeks before AD can be administered, by which time the patient may well have died naturally.. I assume this excessive stringency is a sop to the anti-choice miseries.

[jeremyp]

But to an extent there is a really simply question at the heart of this debate - do you think that people approaching the end of their lives should be able to determine for themselves how and when they die.

I don't think it is.

Suicide is not illegal. This bill is about whether people can assist you to end your life without breaking the law.

[jeremyp]

Polly Toynbee, in the Guardian, opines that the safeguards are too strict, and I agree: each request must be signed  off by two doctors and a judge, and then there's a 14-day cooling-off period, so it could be three weeks before AD can be administered

I think that may be optimistic at present. You have to find two doctors first and have them review the case. Then you have to find a judge and have them review the case. I'd be surprised if you could get all of that done in a week.

by which time the patient may well have died naturally.

I woulds argue that that is a good outcome. It would be far worse if the patient had to live through several weeks of unnecessary suffering because of the bureaucracy required.

I assume this excessive stringency is a sop to the anti-choice miseries.

Yes, probably, but, it's a start. If we run it this way and find that there are no - or very few - cases of attempted abuse, we might then be able to think about how the criteria can be relaxed a bit, safely.

In my opinion, the proposal is better than the status quo, if not perfect, and should thus be accepted.

[ProfessorDavey]

Polly Toynbee, in the Guardian, opines that the safeguards are too strict, and I agree: each request must be signed  off by two doctors and a judge, and then there's a 14-day cooling-off period, so it could be three weeks before AD can be administered, by which time the patient may well have died naturally.. I assume this excessive stringency is a sop to the anti-choice miseries.

Interesting point. I thought the proposal had a built in cooling off period as the person themselves has to administer the medication - the doctors only prescribe/dispense.

I imagine how this would work in practice is that individuals would begin the process well in advance of need, have the medication available which they may or may not take at a later stage.

[ProfessorDavey]

I don't think it is.

Suicide is not illegal. This bill is about whether people can assist you to end your life without breaking the law.

True - but surely the people we are talking about are unable (or likely to be unable effectively) to take their own lives, hence the need to be assisted. So this comes back to the question of self-determination. If you are in the late stages of a terminal illness and want to die then you will need some level of assistance to support that choice.

[ProfessorDavey]

No, there's principle there in the idea of whether the state should provide the means to commit suicide.

Yes I agree there is also principle around who should or should not cover the costs for assisted dying, but I would argue that this principle is clearly secondary to the main principle as to whether terminally ill people should lawfully have the ability to have assistance to end their lives.

But there is another point. Unless I've got this badly wrong I don't think the Bill, if enacted, would require assisted dying to be provided on the NHS. Rather I think it make assisted dying lawful (subject to the limitations in the Bill), but is silent on how that provision would be funded. In fact I think the only part of the Bill that actually refers to the NHS is a clause which is specifically about how a separate decision may be taken as to whether assisted dying might be provided under the NHS. So there would need to be a completely separate decision on NHS funding which is not part of the Bill at all which would require separate affirmative action.

So again, my understanding is that were the Bill to become law it would only be permitted under private provision until or unless a completely separate decision to allow it under the NHS was taken. Interestingly the separate decision on NHS provision is under the authority of the Secretary of State, who is currently, of course, Wes Streeting. So we could easily envisage a situation where assisted dying is legalised but regulations aren't brought forward to allow it under the NHS.

[Nearly Sane]

Yes I agree there is also principle around who should or should not cover the costs for assisted dying, but I would argue that this principle is clearly secondary to the main principle as to whether terminally ill people should lawfully have the ability to have assistance to end their lives.

But there is another point. Unless I've got this badly wrong I don't think the Bill, if enacted, would require assisted dying to be provided on the NHS. Rather I think it make assisted dying lawful (subject to the limitations in the Bill), but is silent on how that provision would be funded. In fact I think the only part of the Bill that actually refers to the NHS is a clause which is specifically about how a separate decision may be taken as to whether assisted dying might be provided under the NHS. So there would need to be a completely separate decision on NHS funding which is not part of the Bill at all which would require separate affirmative action.

So again, my understanding is that were the Bill to become law it would only be permitted under private provision until or unless a completely separate decision to allow it under the NHS was taken. Interestingly the separate decision on NHS provision is under the authority of the Secretary of State, who is currently, of course, Wes Streeting. So we could easily envisage a situation where assisted dying is legalised but regulations aren't brought forward to allow it under the NHS.

No matter if the medication is provided by the state, the process as described by the bill will involve the approval of the state.