Assisted Suicide bill to be debated in parliament

[Nearly Sane]

Pro assisted dying MP's spot snag.

https://www.bbc.co.uk/news/articles/c4gmgvdkwkeo.amp

MPs seek to improve bill in ways they spoke abput during the debate using parliamentary process that they knew they were going to.

[jeremyp]

But I fear there will be many, when presented with a choice, will feel it is their duty, rather than their will, to opt to do what others consider is the right thing to do.

But you think it is their duty to continue to suffer. Don't talk about duty.

[ProfessorDavey]

Pro assisted dying MP's spot snag.

https://www.bbc.co.uk/news/articles/c4gmgvdkwkeo.amp

Isn't that the point of the process, that it can be amended/improved during the next phase.

I note that the article was no indication of how many MPs are in this group - I think just three are name-checked. And, of course, there will be other MPs who are the opposite - voting against at second reading but may vote in favour depending on any amendments.

I note one of the 'concerns' is that 'doctors present all options to patients' - well they are already required to do this as part of any consent process. Not to do so can (and has) resulting in negligence claims against medical professionals. So I suspect this is something that some MPs don't understand. Indeed the greater issue is those saying that doctors should only discuss assisted dying if a patient brings it up. This runs counter to the basic principles of consent in medical decision making, whereby all options should be clear to the patient.

So for a robust consent process, patients should be inform of all options available to them in an unbiased manner. That would include active treatment (if clinically indicated) and palliative care as well as assisted dying. It should also be clear in the information and in discussion that the choice is for the patient, and the patient alone, to make. Again this is standard consent stuff. Not to include one option (regardless of whether that is palliative, active treatment or assisted dying) would, in consent terms, be considered not to be providing adequate and sufficient information for the patient to make a choice and therefore render the consent invalid.

[jeremyp]

So for a robust consent process doctors (or other decision-making gatekeepers) should involve patients being informed of all options available to them in an unbiased manner. That would include active treatment (if clinically indicated) and palliative care as well as assisted dying. It should also be clear in the information and in discussion that the choice is for the patient, and the patient alone, to make. Again this is standard consent stuff. Not to include one option (regardless of whether that is palliative, active treatment or assisted dying) would, in consent terms, be considered not to be providing adequate and sufficient information for the patient to make a choice and therefore render the consent invalid.

This. The possible requirement for doctors not to mention assisted dying until the patient brings it up is in direct conflict with the doctor's duty to inform the patient of all the options (assuming assisted dying becomes legal).

[ProfessorDavey]

This. The possible requirement for doctors not to mention assisted dying until the patient brings it up is in direct conflict with the doctor's duty to inform the patient of all the options (assuming assisted dying becomes legal).

Absolutely - it would be the equivalent of a woman with an unplanned and unwanted pregnancy not being informed that termination is an option to consider.

[Walt Zingmatilder]

This. The possible requirement for doctors not to mention assisted dying until the patient brings it up is in direct conflict with the doctor's duty to inform the patient of all the options (assuming assisted dying becomes legal).

But they are options for palliative care, or cure. Where this is an option for oblivion (A notion based on philosophy).

Perhaps Doctor's in this field should wear body cam to show there has been no coercion.

Is the Doctor's assistance in line with her hippocratic oath, since you mention duty?

[ProfessorDavey]

But they are options for palliative care, or cure. Where this is an option for oblivion (A notion based on philosophy).

I note your rather hysterical terminology Vlad, which isn't really appropriate as this is a serious discussion, or rather should be. But to use your own terminology, palliative care is hastened oblivion (compared to ongoing active treatment), cessation of life sustaining treatment (e.g. turning off of life support) is oblivion, just as much as assisted dying.

But doctors will support patient choices in those matters, so why should they not in assisted dying. Remember that we have moved far, far beyond the world where the doctor dictated and the patient acquiesced.

Nope, for decades now the medical profession recognise that patient autonomy is determinative in decision making over medical matters. Hence, that it is well established that a competent patient may refuse a life saving blood transfusion even though they will die as a result, and even though doctors fully recognise that they could save that life but also recognise that their duty under autonomy is to step back and allow that person to die.

Perhaps Doctor's in this field should wear body cam to show there has been no coercion.

Why only in this case Vlad - if you are so concerned about doctor coercion, surely they'd need to wear body cams for all conversations about significant medical decisions where there may be a risk of coercion.

But remember that not only are doctors very well trained in the elements of consent (including the need for voluntariness), but also if a doctor coerces a patient or fails to provide relevant information that may have made the patient take an alternative decision they can be charged with negligence (and in this case a much more significant offence) and would be struck off. Why would a doctor risk their livelihood and their liberty to coerce a patient when they fully recognise that the decision must be the patient's and the patient's alone.

Is the Doctor's assistance in line with her hippocratic oath, since you mention duty?

Well the hippocratic oath isn't really a thing, but doctors are required to abide by strict professional ethical codes of practice, and right at the top of their duties in this regard will be to respect the autonomous decision making of a competent patient. So yes, were assisted dying to be legalised, supporting the free decision making of patients and respecting their decisions would be absolutely what that code of ethics would require, just as currently allowing a competent 25-year old to refuse a blood transfusion or have their life support turned off and therefore to die is also what that code of ethics would require.

[jeremyp]

But they are options for palliative care, or cure. Where this is an option for oblivion (A notion based on philosophy).

Nope.

If one of the options is cure, this law will not allow you to offer assisted dying.

Maybe you should try to understand what the bill says before talking crap about it.

Is the Doctor's assistance in line with her hippocratic oath, since you mention duty?

If I am in extreme pain with no hope of relief and no quality of life, I would regard it as harming me to make me carry on living.

[Outrider]

But they are options for palliative care, or cure. Where this is an option for oblivion (A notion based on philosophy).

Not quite, if the condition is cureable they aren't eligible to take advantage of this law, so the options are for palliative care (and, in some instances, still a degree of suffering), no treatment at all (and presumably a degree of suffering in more instances) or, in you words, oblivion (where there is no suffering).

Sounds like there are circumstances where there's a reduction in suffering.

Is the Doctor's assistance in line with her hippocratic oath, since you mention duty?

Given that not all doctors take the Hippocratic oath, and there is no requirement to do so in order to practice medicine, it seems somewhat moot. Even if you do consider it important, the oath itself has undergone many variations over time, and most medical schools have their own version, so it would depend in an absolute sense on which medical school they attended, whether that school required it or requested it...

O.

[ProfessorDavey]

Not quite, if the condition is cureable they aren't eligible to take advantage of this law, so the options are for palliative care (and, in some instances, still a degree of suffering), no treatment at all (and presumably a degree of suffering in more instances) or, in you words, oblivion (where there is no suffering).

Sounds like there are circumstances where there's a reduction in suffering.

Given that not all doctors take the Hippocratic oath, and there is no requirement to do so in order to practice medicine, it seems somewhat moot. Even if you do consider it important, the oath itself has undergone many variations over time, and most medical schools have their own version, so it would depend in an absolute sense on which medical school they attended, whether that school required it or requested it...

O.

As I said before, the Hippocratic oath isn't a thing anymore, beyond a kind of ceremonial tradition in some medical schools. Doctors and other medical professionals registered with the General Medical Council are, however, expected to abide by the professional standards set out in Good Medical Practice:

https://www.gmc-uk.org/-/media/documents/good-medical-practice-2024---english-102607294.pdf

[Walt Zingmatilder]

Nope.

If one of the options is cure, this law will not allow you to offer assisted dying.

What I am saying is for thousands of years that was the goal of the medical profession and the expectation of the public

Maybe you should try to understand what the bill says before talking crap about it.
If I am in extreme pain with no hope of relief and no quality of life, I would regard it as harming me to make me carry on living.

I’m not asking anyone to carry on living but then again I’m not asking for anyone to assist someone dying.

[Walt Zingmatilder]

Given that not all doctors take the Hippocratic oath, and there is no requirement to do so in order to practice medicine, it seems somewhat moot. Even if you do consider it important, the oath itself has undergone many variations over time, and most medical schools have their own version, so it would depend in an absolute sense on which medical school they attended, whether that school required it or requested it...

But there was no requirement for medicine and it’s practice to assist people in dying.
How do you propose to justify it’s introduction merely on the basis of ‘Things change’ or to put it technically, merely by arguing that it's Evolutionary?

[Gordon]

But there was no requirement for medicine and it’s practice to assist people in dying.
How do you propose to justify it’s introduction merely on the basis of ‘Things change’ or to put it technically, merely by arguing that it's Evolutionary?

Perhaps a better term would be 'social progress and enhanced personal autonomy', Vlad, since, as you may have noticed, as you make use of this relatively new-fangled internet thingy to post here, that 'things change'.

'Evolution' is the wrong term since, when it comes to this policy the vast number of people to whom it may be relevant will have done all the reproducing they are ever going to do - and that it may apply to some much younger people is desperately sad.

[Walt Zingmatilder]

Well the hippocratic oath isn't really a thing, but doctors are required to abide by strict professional ethical codes of practice, and right at the top of their duties in this regard will be to respect the autonomous decision making of a competent patient. So yes, were assisted dying to be legalised, supporting the free decision making of patients and respecting their decisions would be absolutely what that code of ethics would require, just as currently allowing a competent 25-year old to refuse a blood transfusion or have their life support turned off and therefore to die is also what that code of ethics would require.

As far as I know the original oath from which other oaths, agreements, contracts etc. Descend contained the promise not to administer poison to a person. Presumably they had assisted suicide in mind here. Were they then wrong to do so? And if they were wrong, do you think this is another case of them being merely Bronze aged goat farmers. Again you seem to be justifying this on the grounds of ‘change happens’ and in your case, pulling the carpet of language used in the medical profession to cover what is a revolution in the definition of medicine.

I think you highlight the point that medical professionals will be thought of as negligent if they do not provide information of this. For you then the removal of competence from the profession must be worth it.

As it stands we have lawyers not sure what to do, and MP’s not sure if they can continue to see the bill through because of the risk of good doctors being vilified.

I see no justification in making doctors give information on it if you are also saying that a doctor’s involvement is voluntary.

[Steve H]

But there was no requirement for medicine and it’s practice to assist people in dying.
How do you propose to justify it’s introduction merely on the basis of ‘Things change’ or to put it technically, merely by arguing that it's Evolutionary?

Why don't you drop the silly-clever arguments, and consider the question with a modicum of compassion?
Also. as I've pointed out many time before. "it's" is short for "it is" or "it has". The word for "belonging to it" is "its", with no apostrophe.

[Walt Zingmatilder]

Perhaps a better term would be 'social progress and enhanced personal autonomy', Vlad, since, as you may have noticed, as you make use of this relatively new-fangled internet thingy to post here, that 'things change'.

'Evolution' is the wrong term since, when it comes to this policy the vast number of people to whom it may be relevant will have done all the reproducing they are ever going to do - and that it may apply to some much younger people is desperately sad.

I think you would have to outline the social progress being made here so that progress doesn’t merely mean change.

[Walt Zingmatilder]

Why don't you drop the silly-clever arguments, and consider the question with a modicum of compassion?
Also. as I've pointed out many time before. "it's" is short for "it is" or "it has". The word for "belonging to it" is "its", with no apostrophe.

I’m only doing what a devil’s advocate worth their salt would do and if any topic deserved a devil’s advocate, this is it.

If you are going to argue that assisted dying would be a voluntary matter then everything about it should be voluntary.

[Gordon]

I think you would have to outline the social progress being made here so that progress doesn’t merely mean change.

I would have thought that giving people the autonomy to truncate their personal suffering in certain circumstances would be an example of social progress.

[Nearly Sane]

I’m only doing what a devil’s advocate worth their salt would do and if any topic deserved a devil’s advocate, this is it.

If you are going to argue that assisted dying would be a voluntary matter then everything about it should be voluntary.

What about the proposal isn't voluntary?

[Gordon]

I’m only doing what a devil’s advocate worth their salt would do and if any topic deserved a devil’s advocate, this is it.

So you're working for the 'devil' now! That explains a great deal.

If you are going to argue that assisted dying would be a voluntary matter then everything about it should be voluntary.

Whether I choose to vote or not is a voluntary matter, but if I wish to do so arrangements are required to ensure that a) I am qualified in the first place, and b) there is the opportunity for me to do so.

[Steve H]

I’m only doing what a devil’s advocate worth their salt would do and if any topic deserved a devil’s advocate, this is it.

If you are going to argue that assisted dying would be a voluntary matter then everything about it should be voluntary.

This is exactly what i mean: stop treating it as a facile intellectual game, and treat the issue with the seriousness it deserves.

[Nearly Sane]

I would have thought that giving people the autonomy to truncate their personal suffering in certain circumstances would be an example of social progress.

To be fair, people have had the autonomy to end their personal suffering generally. This is a move to facilitating that by giving them specific means to do so, with the approval of the state.

[Walt Zingmatilder]

This is exactly what i mean: stop treating it as a facile intellectual game, and treat the issue with the seriousness it deserves.

I’ve only turned out here because there are lawyers who don’t know what to do and the definition of voluntary was apparently not settled by the bill. That’s no fucking game.

[Gordon]

I’ve only turned out here because there are lawyers who don’t know what to do and the definition of voluntary was apparently not settled by the bill. That’s no fucking game.

But the Bill isn't settled yet: it's a work in progress, and it is by no means certain that it will become law in England and Wales.

[Outrider]

But there was no requirement for medicine and it’s practice to assist people in dying.

And there were no vaccinations, which introduce a microscopic risk in order to massively reduce other risks. Medicine has had to develop more nuance as it has developed higher capacity, and as social mores change. This is another example of that - it's an emphasis shift from 'do no harm' to 'reduce harm'. Some will be comfortable with that, and others won't.

How do you propose to justify it’s introduction merely on the basis of ‘Things change’ or to put it technically, merely by arguing that it's Evolutionary?

I don't propose to justify it on the basis of either of those arguments, Mr Gummidge, maybe go put on your thinking head?

O.