Government Voting on Euthanasia

This political hot potato is being thrown around Parliament at the moment.

On the one hand, assisted suicide can end years of suffering and agonising pain for those dying a horrible, slow death. It saves NHS funds for people who actually want to live and it's an excuse to visit Switzerland and get one of those huge Toblerones.

On the other hand, an evil computer hacker could design a virus that makes every text-to-speak system say 'I want to die! I want to die!' over and over again whenever a severely disabled person wants a drink of water.

So are you 'fer it' or 'agin it'?

'fer it' - whatever I'm for.

The right to die should be inviolate, but should be surrounded by multiple layers of safety to stop convenience offing.

It shouldn't be an easy or quick choice.

But it should be matched by proper paliative care for those with terminal conditions. Funded by enforcing NHS policies on not buying drugs over £30,000 that provide minimal extension of life.

What sooty said.

Quote: sootyj @ July 8 2009, 11:53 AM BST

Funded by enforcing NHS policies on not buying drugs over £30,000 that provide minimal extension of life.

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Ah, but define "minimal" in this context.

I worked briefly in a project for adults with spinal/head injuries.
Some of the guys who were going to spend the rest of their lives on their backs, having some one else scratch their nose. And all to often the head pointing stuff just doesn't work or is too hard to use.
I hope under those circumstances some one would do the decent thing for me. We have an attitude to death in this country half sentimental and half cowardice that infuriates me. And in countires where there is euthenasia there has not been an avalanche of mercy killings, there are still old and disabled people.

Quote: Tim Walker @ July 8 2009, 11:57 AM BST

Ah, but define "minimal" in this context.

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I dunno 6 months to 2 years maximun. Or perhaps an over all cap? Most of the companies that make these drugs seem to be fairly straight up about how little they do.

This may sound a bit silly but...How about sending people that want to die on a round the world cruise?

If when they get back, they still want to die...then fair enough.

Yes that's silly, unless you're paying in which case I'd like to volunteer.

I've always been in favour of Euthanasia. But it does become cloudy when you go beyond people with severe disabilities etc. For example if someone is very depressed and has been for many years and wants to choose death I think they should be allowed to, but many would insist it's not OK unless it's a physical thing. The old suicide is a permanent solution to a temporary problem. I do accept it becomes more complicated when that person has a family though. And I also know I'll be in the minority where that's concerned. So I hope it's at least brought in for people with no quality of life or for those who are terminally ill and would prefer to end their days with a little dignity and not endure further pain and suffering.

They'll always be people totally against it but surely it would be easy enough for them to register somewhere that they never want it to happen to them, tell their family or doctor for a start! I'd never want to impose it on anyone but at the same time why should they impose the opposite on the rest of us?

Quote: sootyj @ July 8 2009, 12:01 PM BST

I dunno 6 months to 2 years maximun. Or perhaps an over all cap? Most of the companies that make these drugs seem to be fairly straight up about how little they do.

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But whatever the median extended survival periods, everyone begins as an n=1 study. Some may have much-prolonged remission with treatment. One might say when you're over 70, then 1-2 extra years is cost-inefficient. But what about 1-2 years if you're under 30? 6 months to 1 year longer allows many people to fulfil ambitions, see their kids get married, repair old wounds, put their house in order etc. Not reasons to spend extra resources in themselves. However, the individual circumstances have to be taken into account to some degree. This is a very difficult area, with outcomes not just based on the drug efficacy in question, but also the pathology of the disease, the co-morbidity of the patient and is rightly a headache. Plus, the only way any drugs eventually become cheaper, safer and more available is by thei use in clinical practice. Drugs companies are not faultless, of course, but they really do have to invest billions in research of new chemotherapies. This money has to be recouped somehow. (And remember, drug patents run out relatively quickly, which is why you have cheap aspirin, paracetamol, ibuprofen, plus cheap generic versions of very successful and safe specialist medicines which originally cost millions to develop.)

Quote: sootyj @ July 8 2009, 12:01 PM BST

Most of the companies that make these drugs seem to be fairly straight up about how little they do.

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Mostly what we're talking about here is cancer drugs. yes, companies are up front about what they do or don't do or how effective they are. Most of the stories that make the newspapers are where someone is refused £30k worth of drugs that has a slight chance of increasing their life span by about a year at most.

Usually, in other patients, the same drug might well extend life by many years or make a massive improvement in quality of life.

The one I'm working on at the moment seems to be great at second line breast cancer treatment (i.e. when something else has stopped working/failed to work) but is too toxic to use as first line treatment but is also effective for bladder and pancreatic cancers. Chances are NICE will only pass it for bladder as most people with pancreatic cancer don't find out until it's far too late at which point the drug is not much use routinely. But they might also allow its non-routine use if the pancreatic cancer is diagnosed early enough - where it might be an effective treatment instead of a mild life extender.

Quote: Tim Walker @ July 8 2009, 1:28 PM BST

they really do have to invest billions in research of new chemotherapies. This money has to be recouped somehow. (And remember, drug patents run out relatively quickly, which is why you have cheap aspirin, paracetamol, ibuprofen, plus cheap generic versions of very successful and safe specialist medicines which originally cost millions to develop.)

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You're not kidding. The one I mentioned above - my job is basically to oversee it moving from bench-scale R&D product to routine manufacturing, ready to submit to the regulatory authorities for licensing. The first proper scale test of this was back in 2001 and it had been knocking about as a purely R&D thing for several years before that. Each batch of the active ingredient we use costs about £2million to make. That's just the active ingredient, that's not the final cost of making it, with all the other ingredients, the time, the equipment, the services to that equipment, the inspection of the product, the vials, stoppers and caps to fill it, the packaging for it to go into etc. etc. etc.

We'll probably get a ten-year patent out of it.

Quote: Tim Walker @ July 8 2009, 1:28 PM BST

But whatever the median extended survival periods, everyone begins as an n=1 study. Some may have much-prolonged remission with treatment. One might say when you're over 70, then 1-2 extra years is cost-inefficient. But what about 1-2 years if you're under 30? 6 months to 1 year longer allows many people to fulfil ambitions, see their kids get married, repair old wounds, put their house in order etc. Not reasons to spend extra resources in themselves. However, the individual circumstances have to be taken into account to some degree. This is a very difficult area, with outcomes not just based on the drug efficacy in question, but also the pathology of the disease, the co-morbidity of the patient and is rightly a headache. Plus, the only way any drugs eventually become cheaper, safer and more available is by thei use in clinical practice. Drugs companies are not faultless, of course, but they really do have to invest billions in research of new chemotherapies. This money has to be recouped somehow. (And remember, drug patents run out relatively quickly, which is why you have cheap aspirin, paracetamol, ibuprofen, plus cheap generic versions of very successful and safe specialist medicines which originally cost millions to develop.)

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Tim you're a GP aren't you? Putting all the statistics aside would you be willing to agree to Euthanasia in cases you know the history of?

Years ago I was in casualty and in the cubicle next to me I could hear a Doctor talking to a women with Motor Neurone Disease. She was quite elderly and kept choking and ending up there. He basically said in the nicest way possible way that he could help speed up the end for her. She said she was happy to continue for now - despite her illness she was quite chirpy and had a friend with her.

He's the kind of doctor I hope I encounter in that situation. I hope this doesn't sound made up because it did happen and I suspect to varying degrees it does go on quite a bit unofficially. I'd prefer to see Doctors like him protected as I think he was taking quite a risk there.

Could we rename this the "Bundle of Laughs" thread?

Quote: Jane P @ July 8 2009, 1:37 PM BST

Tim you're a GP aren't you? Putting all the statistics aside would you be willing to agree to Euthanasia in cases you know the history of?

Years ago I was in casualty and in the cubicle next to me I could hear a Doctor talking to a women with Motor Neurone Disease. She was quite elderly and kept choking and ending up there. He basically said in the nicest way possible way that he could help speed up the end for her. She said she was happy to continue for now - despite her illness she was quite chirpy and had a friend with her.

He's the kind of doctor I hope I encounter in that situation. I hope this doesn't sound made up because it did happen and I suspect to varying degrees it does go on quite a bit unofficially. I'd prefer to see Doctors like him protected as I think he was taking quite a risk there.

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Not a GP. An anaesthetist/ICU doctor. Previously I was a physician. I can't comment on the case you descrive above, suffice to say when I first qualified we didn't prolong life beyond dignity. The doctor's mantra is meant to be 'First do no harm' - and our professional bodies need to support us when doing no harm might mean witholding certain treatments, or hastening death with the patient's (and his or her family's) consent, support and understanding.

Quote: Tim Walker @ July 8 2009, 1:43 PM BST

Not a GP. An anaesthetist/ICU doctor. Previously I was a physician. I can't comment on the case you descrive above, suffice to say when I first qualified we didn't prolong life beyond dignity. The doctor's mantra is meant to be 'First do no harm' - and our professional bodies need to support us when doing no harm might mean witholding certain treatments, or hastening death with the patient's (and his or her family's) consent, support and understanding.

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Thanks Tim. Apologies for my confusion - I was remembering a less serious thread where you mentioned Chris Tarrant at a GP surgery or something.

No easy answers on this one are there?

Euthanasia is something that should be legal - just like suicide is now. If you want to die but can't kill yourself then perhaps you should be allowed to ask someone to kill you.

However, I can see the problem. Murder might increase.