Assisted Death

Acrylic-bob said:
I had a pretty low opinion of the NHS and its staff before this shocking death. My opinion of it and them now could not be any lower. I DREAD the day that I should have to rely on the NHS for anything. Let alone End of Life care.
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I have also experienced exactly the same thing here in Italy, witnessing the slow agonising death of my mother-in-law after she suffered a series of mini-strokes and was kept alive, to the distress of her family for over a month by intubation etc.

I truly hope something will change for the better in the not too distant future.
 
mobertol said:
As you high-light the main problem currently is the translation of the collective voice through the political system, which would then allow change.

Constant discussion and the sounding of the communal voice is the way to effect change in a democracy- so lets keep talking about even the most controversial of arguments which are part of all our lives.
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It all sounds wonderful, in theory. But in practice, The executive hears what it wants to hear and only what it wants to hear, despite frequent protestations to the contrary accompanied by copious quantities of crocodile tears. How many time times did we hear that labour were "Learning the lessons" after each and every cock up only to see them then carry on with business as usual? How many times will we have to hear 'Call me Dave' tell us he 'Gets it' before we all come to the conclusion that he is lying through his teeth?

We have a prime example in a thread currently being bumped up the board regarding our MP's decision to vote with his party and the government, against the wishes of his electorate in the issue of the EU referendum. Will he explain his decision? Will he come and discuss the matter with any of his former friends on this forum? Will he respond to anything that we now have to say to him on this or any other matter? What do you think!

A few years ago The French and the Dutch gave their opinion of the Lisbon Treaty in referendums. Did the Brussels executive take any notice? The Irish had to have two go's at getting the only answer acceptable to the executive.

You clearly have much more faith in the nature of representative democracy than I do. And I am sort of pleased that you are able to be less cynical than I am. For me, it seems nothing short of revolution will effect meaningful change. Perhaps I have lived too long.
 
Acrylic-bob said:
Margaret P, it is rare that I disagree with you, but on this occaision I feel I have to.

Like you, I have witnessed the administration of pain relief and palliative care to a person very close to me who was dying of cancer which left her unable to eat. Effectively, she starved to death. I also witnessed the apalling laxity, rudeness and general lack of care exhibited by the staff of Christies Hospital, Blackburn Royal, the local Hospice and the GP's service. If it had not been for the Macmillan nurse an elderly woman would have died in a deal more agony and fear than she eventually did. The experience was anything but cosy and reassuring and supportive. It scarred all of us who witnessed it. Moreso because we all knew it was largely unecessary but were powerless to do anything about it, no matter how loudly we remonstrated.

I had a pretty low opinion of the NHS and its staff before this shocking death. My opinion of it and them now could not be any lower. I DREAD the day that I should have to rely on the NHS for anything. Let alone End of Life care.
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I am really sorry to hear of your experience A-B and can understand why you felt you needed to disagree with me.
I have had a bad experience with the Christie Hospital....and when I was working it was always held up to us in the DGH as the epitome of care and service....but my experience didn't perceive it like that.

But then again, I did have many patients who were given excellent service from our local hospice and the palliative care team from there(they visited daily or more often if the need arose).....and it is that on which I base my comments.
I have been out of the NHS now for almost 10 years.......and I know things have become increasingly tough...resources limited etc.

End of life care is a very difficult and emotive subject......and dealing with the dying (and their relatives - who need just as much care as those who are at the end of their life) is a labour of love. It really needs dedicated services with nurses who really do care about those in their care.

I know when I trained, we were always taught to not get involved, but from my own experience, I cannot see how you can look after someone at the end stage of their life without some emotional involvement....because failing to become involved, means that you don't fully grasp the importance of getting it right.

That is my perspective on it anyway.
 
Acrylic-bob said:
You clearly have much more faith in the nature of representative democracy than I do. And I am sort of pleased that you are able to be less cynical than I am. For me, it seems nothing short of revolution will effect meaningful change. Perhaps I have lived too long.
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Possibly you are right - you are the realist, more worldly than myself, undoubtedly.

Revolution is a word that is being bandied about rather a lot recently. If the traditional methods don't work then that is the inevitable conclusion, though I've honestly always believed that our democracy was too grown-up, no, "evolved" for that.

I am quite an idealist though so maybe I'll be proved wrong and you will turn out to be right.

Don't be too world-weary though A-b, you're not quite at the age of resignation yet...;):D
 
mobertol said:
I have also experienced exactly the same thing here in Italy, witnessing the slow agonising death of my mother-in-law after she suffered a series of mini-strokes and was kept alive, to the distress of her family for over a month by intubation etc.

I truly hope something will change for the better in the not too distant future.
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A 'living will' would or should have prevented that.....she would have not have been intubated and would have been allowed to succumb.
I don't know if you have the equivalent of living wills in Italy.

Sometimes the doctors will speak with relatives of seriously ill patients who are not expected to survive and will mark the notes DNR(do not resuscitate) but my own experience of this, is that the consultants that I worked with were very reluctant to mark this in the case notes...regardless of how hopeless the case was....and in the absence of such a record, it meant that if the patient arrested we had to attempt resuscitation. This is not good when you have a patient in the terminal stages of cancer.......all you are doing is prolonging their suffering and pain.
 
Which would be all very well, Margaret, if the NHS was just starting out. You could easily make allowances for the uncoordinated responses and lapses in care, respect, and humanity. But the NHS is not a recent invention. It has been lurching from crisis to crisis for seventy years, longer than I have been alive! How much more of this institutionalised incompetence do we have to take before we wake up and admit that it does not work and a new approach is needed?
 
Margaret Pilkington said:
Sometimes the doctors will speak with relatives of seriously ill patients who are not expected to survive and will mark the notes DNR(do not resuscitate)
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Which supposes that there are, more commonly, instances where doctors do not speak to relatives of the terminally ill and routinely mark the the notes DNR anyway.
 
I wish I had the answer for you.
All I can say is that I know how things should be done.
That can be a bind, because you have expectations....and frequently the service will not match your expectations.....and this is true even if you are paying privately.
I know of an old lady(in her 90's) she has no family in this country. She is well off and pays for her care.......and it is abysmal.
The young girls who come to deal with her personal needs do not speak english, or have only a very basic understanding.......they rush in and just do the minimum to tick the boxes on her care plan.
This lady lives in Eastbourne.......if she lived nearerI would undertake some of her care myself(well, I would if she would let me - she is an old friend of my mothers and frequently says she wishes I lived down there and would help her the way I help Ma).
 
Acrylic-bob said:
Which supposes that there are, more commonly, instances where doctors do not speak to relatives of the terminally ill and routinely mark the the notes DNR anyway.
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Well, I obviously cannot speak for what happens now, but it was not allowed when I was in charge of the ward. Notes marked withDNR had(it was policy) to have the consent of the consultant, who would first meet with relatives before marking the notes thus.

As I said in my previous post the problems arose when such patients who were terminally ill - end stage terminal, arrested and there was no order not to resuscititate...this meant resuscititation had to be attempted.
 
Margaret Pilkington said:
A 'living will' would or should have prevented that.....she would have not have been intubated and would have been allowed to succumb.
I don't know if you have the equivalent of living wills in Italy.

Sometimes the doctors will speak with relatives of seriously ill patients who are not expected to survive and will mark the notes DNR(do not resuscitate) but my own experience of this, is that the consultants that I worked with were very reluctant to mark this in the case notes...regardless of how hopeless the case was....and in the absence of such a record, it meant that if the patient arrested we had to attempt resuscitation. This is not good when you have a patient in the terminal stages of cancer.......all you are doing is prolonging their suffering and pain.
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This was 6 yrs ago Margaret, so living wills were not common. Also the doctors convinced my sister-in-law to continue the treatment, giving the impression that there could be some hope when effectively there was not.

By contrast we looked after my Father-in-law through lung cancer at home in 2001 and he had a much better "end", with good pain control and assistence once we had managed to get it in place..i think most patients would rather not be in hospital when they know they are terminal.
 
To be honest hopsital is not the right place for end stage terminal care.
Patients are much better in their own homes with the right suppost services in place...but that is the key.......right support services and the support must be aimed at the family as well as the patient.
 
Margaret Pilkington said:
I wish I had the answer for you.
All I can say is that I know how things should be done.
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I was reading an article on care at the end of life the other day and it shocked me to discover that the one thing the elderly fear most is not dying, but going into hospital. I am talking here of people over retirement age.

That is so, so, wrong!


Personally I blame television series like Holby City. They are dramas and they naturally present life in a hospital as edgy, exciting and mawkishly sentimental all wrapped up in youthful idealism with 'attitude'. We are all depressingly aware that the younger generation have a difficulty separating fact from fiction. It is hardly surprising therefore that the idea of nursing as a vocation has gone out of the window and that for this celebrity obsessed generation the idea of doing anything that involves contact with bodily fluids or bodily waste is beneath them and that consequently they regard those who produce such things as equally beneath them. Sadly, from there it is but the very shortest of steps to considering such people as less than human and, quite frankly, a nuisance, really.
 
It as watching Emergency Ward 10 that made me want to become a nurse....but that was way back when TV was somehow gentler.
I agree that people don't seem to want to go into nursing....as you say the young folk(or at least some of them) are much more interested in getting celebrity status.
The people who do choose to go into nursing sometimes do it for the wrong reasons...but that isn't their fault, it is the selectors failure to recognise this.

I loved my nursing career. It was like being paid for something I enjoyed...yes, it was hard work, yes there were days when I came home and wondered what the heck I had let myself in for.....but it was the most satisfying job ever....but again, it was spoiled by making it university based. Caring is something that does not need a university education. It takes common sense and application, it takes kindness and compassion...show me a university that can teach these things.
 
MargaretR said:
If you think that your governments care about individuals - think again.
There is a policy in operation to reduce world population.

If you happen to be a 'useless eater' beware.
Laws to make suicide easier will happen, but will be restricted to non productive members of society. There will be the added bonus of benefit and NHS savings.

The law is more preferable (to governments) than the expensive alternative of providing effective pain relief and palliative care, which are rarely provided.

So you think you are being given a choice? - it is Hobsons choice!
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The world according to Zog, I'm certainly glad I don't exist in it.
 
Acrylic-bob said:
Which would be all very well, Margaret, if the NHS was just starting out. You could easily make allowances for the uncoordinated responses and lapses in care, respect, and humanity. But the NHS is not a recent invention. It has been lurching from crisis to crisis for seventy years, longer than I have been alive! How much more of this institutionalised incompetence do we have to take before we wake up and admit that it does not work and a new approach is needed?
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I was sorry to read your terrible experience that became some one close to you Bob, but as somebody who has spent more than there fair share on wards in six hospitals over the past 30 years, I only have praise for the doctors nurses and related professions, without whom I wouldn't be here today, I have never had any cause to complain, except about the food in my first ever stay in hospital Bury General, apart from that I feel very humble and indebted to those wonderful people for the first class care I've received. The only complaint I've ever had is with the administration side of NHS, which really does leave a lot to be desiredand is certainly top heavy
 
Margaret Pilkington said:
It ws watching Emergency Ward 10 that made me want to become a nurse....but that was way back when TV was somehow gentler.
quote]

The one we used to watch avidly in the mid 70's was " Angels" -do you remember that one Margaret. It was quite unromantic and not a bit like E.R. or the all-action series that have followed.
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Margaret Pilkington said:
It as watching Emergency Ward 10 that made me want to become a nurse....but that was way back when TV was somehow gentler.
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Ah those were the days... Nurse Carole Young... Did you know they have brought out some episodes on DVD?

Totally agree about the foolishness of requiring degrees for nursing.
 
claytonx said:
My opinion is that I do not agree with assisted death.
There again it could change with a deterioration in health.
You have heard people say that it was a blessing in disguise, when the event happens in some cases.
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In other words: no, yes, maybe!
 
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