I don't know enough about the Bill to comment properly on that, but my views on assisted suicide go a bit like this...

Doctors and nurses can stay the hell away from it. I wouldn't pay for the privilege either. But I would like to know that if I was in a position where I *was* dying, and until then I was going to gradually lose all dignity, all communication abilities, all control over my body, and depending on where exactly I was being treated I would be in a greater or lesser degree of pain while trapped in the prison of my wasting body and misfiring brain, just waiting to die... I would want to say to a loved one, please let me go before it gets to that stage. I would say it on tape, in front of witnesses, sign a document if I was capable, and then I would want them to be able to give me the means to overdose, and be allowed to "fail" to call an ambulance for me, without fear of prosecution.

I recall reading in the Times a year or so ago about a woman whose husband was bed-bound with a degenerative illness and was waiting to die. On several occasions he attempted to overdose while she was out shopping, and he wrote her letters explaining why. Eventually she gave in and on returning from the shops, found he'd done it again, and instead of calling an ambulance she held him while the drugs killed him, made him tidy, and called the doctor.

The time on her shopping receipt showed she hadn't administered the drugs, but she still got in legal trouble for not having called the ambulance.

I agree - something that allows the passive allowance of suicide with no worry about prosecution is much more sensible than telling doctors that they can kill people.

I'm sure you know exactly how perfect run, ethically sound and fault-free the NHS is...

*twitches*

I think you have decided tomorrow's post for me - it has pictures!

Well... a picture.

...of a floor.

where is it then?

Somewhere in WoW? ;-)

It's a tough decision for all parties involved. I have a hard time seeing the issue in the term of absolutes (anyone who wants to die should be killed vs. no one is allowed to take their own life). There is so much grey area it's hard to know where to begin. And the age old debate of emotion vs logic usually ensures the conversation ends up as an argument.

My girlfriend works as a student nurse and is considering specialising in palliative care. The stories she tells me of the people she meets and works with day in and day out break my (civilian) heart. Most of her stories don't have happy beginnings, middles or ends. The bad times tend to outweight the good times and too many people suffer and die alone, without any 'precious time with family and friends' to be had.

I agree with what Dr. Crippen has to say, but I could've done without the condescending attitude.

It's certainly not something for a doctor to decide though, nor is it a matter for blanket legislation.

I have a long-term illness. The medical profession can't cure it, they can just give me painkillers. It won't kill me - I've got a good 60 years left to live - but it's pretty restrictive. I had comments on my blog from a troll only this morning saying that people like me are clogging up the system and wasting NHS resources that are needed for normal people with acute, curable illnesses and we should just get on and die... I deleted it, because I have no intention of letting trolls overrun my blog, but as soon as I saw this post up here I did wonder if I should have left it.

Batsgirl, you know the troll was wrong. Ignore him. The NHS is for everyone, irrespective of personal status or condition. That particular troll picked a fight with me too, and I guarantee he won't win!

I agree with what Dr. Crippen has to say, but I could've done without the condescending attitude.

Oh that's just him...

You get used to it after a while.

;-)

A doctor with a condecending attitude? - surely not!

As an Oregon resident, I first want to say that it's nice to see Dr. Crippen slamming my state from all the way across the Atlantic. Thanks.

Second, I want to make sure it's clear (because it certainly was not from the article) that what we practice over here is physician-assisted suicide, not direct euthanasia. After a complex series of legal hurdles have been navigated -- including multiple verbal and written requests by the patient, witnesses, the certification that the patient is within six months of death from a terminal condition, etc -- a doctor may prescribe a lethal dose of medication to a patient. The doctor does not administer the medication, merely provides the means. The patient must be alert and oriented enough to self-administer the medication (pills, generally barbituates) -- this is not a case of shuffling granny off to her eternal reward with an overdose of IV morphine.

We've had physician-assisted suicide over here since 1998. About 250 people have ended their lives with it. Since 2002, the yearly numbers have been stable -- about 60 people get prescriptions every year, and about 30 or 40 use them. The complication rate is low -- 3 in 2005.

Anyway, my point is only this -- we have a carefully constructed system out here that works pretty well as an option for a small number of people each year. I'm not familiar with the NHS bill and obviously I'm not familiar with the NHS itself, but I would urge you to take a look at what Oregon has done and consider that this is not a black or white option.

More info at: http://egov.oregon.gov/DHS/ph/pas/

Thanks for thought-provoking material as always...

-- an Oregon EMT

10% of people who get these drugs and then use them have "complications"? What exactly does that mean?

Although I think being able to obtain, after all the very necessary legal whatnot to assure it's not abused, a dose of drugs that would definitely do the job would help - rather than a layperson trying to assemble a dose of bits and bobs that might do it and ending up making a bad situation worse.

The three complications documented in '05 were two cases of vomiting up some of the pills (at least one patient had been vomiting daily secondary to their illness). Both of these died anyway. The third was an individual who took the dose, became unconscious, regained consciousness 65 hours later, did not attempt again, and died two weeks later from underlying illness.

I feel that while the decision about physician-assisted suicide is one that everyone has to make on a personal level (both whether you'd do it and whether you'd support other people doing it), Oregon still has a pretty darn good system in place. I might add that every case is reviewed by the Health Department, which publishes annual reports and generally keeps a close eye on the system.

The day may very well come, as it did for me, when you are faced with the stark reality of a loved one in absolute agony and you can do little or nothing to help them. At that point it is my experience that the luxury of petty morality goes completely out of the window. I believe that if you help someone to die out of love and have to live with the consequences of that action for the rest of your life, then what right does anyone else have to JUDGE you and find you guilty.

It's difficult for anyone who is in the business of saving lives, like you Tom or Dr Crippen, to subscribe to Euthanasia or Assisted Suicide, and that is as it should be. I would be terribly concerned if health care professionals were all rushing to help the old and infirm "pass on".

They should also recognise that there *are* occasions when having a *choice* in the matter precludes any niceties of personal distaste. The bountous compassion they show for the ill should be extendable to the grotesque "living dead". Palliative care can be quite good, but often goes absolutely nowhere in maintaining any quality of life. Pain can be relieved but only at the loss of motor and/or cognitive functions. Would you define this as life? I wouldn't and I wouldn't like to be in that condition either.

Tom, please don't ascribe labels such as "kill patients". It's hurtful. Your blog is widely read and as such is a very powerful forum for your opinions. Fair enough, but as Uncle Ben says to Spiderman "With great power comes great responsibility". Use it wisely.

Thanks for the comment.

Look, it's a tricky one - but at the end of theday I don't think that medical professionals should be involved in killing patients (and it is killing people, not 'easing their pain' or 'ending their suffering', at the base level it's killing people).

The reasons for why I think this are long and complicated, but can be boiled down into two points.

a) I don't trust doctors (or any medical professional) that much - I know that we make mistakes.

b) You need to trust your Dr/nurse/medic - not worry that they are going to give you the needle and 'put you to sleep'.

I think that there may be a change in the law warranted for assisting with a suicide, and I'm all for killing yourself should the time come - but I just don't think that it should be a role performed by doctors (or nurse specialists).

People come here to read my opinions, I'm not the BBC and I don't even pretend to be un-biased. So I'm afraid I'm going to keep calling them as I see them.

Once more - thanks for an interesting comment.