Dying With Dignity

[Arthur Little]

Dignitas, actually. £5K ... and it's "all over" in under an hour! Within the past decade, more than 200 Britons have travelled to Zurich, Switzerland .. where they've decided to end their lives at the controversial, assisted suicide clinic ... appropriately-named, 'Dignitas'. And only this week, the widow of an unnamed 83-year-old - said to be from a wealthy professional background - claimed she was "extremely happy" at the dignified manner in which arrangements were handled, after her husband chose "death before dementia" ... believed to be the first case of
its kind in circumstances normally reserved for patients suffering from other incurable illnesses such as motor neurone disease or terminal-stage cancer.

Apparently, following medical confirmation that he was suffering from the early onset of this progressive, non-curable, disease, the elderly patient appears to have been adamant that he wanted to spare his close family the burden he felt his illness would, sooner or later, put them through as his condition steadily worsened.

Accordingly, at his own insistence, he had been referred to a psychiatrist who, in turn, issued a report stating that the man
was still of sound mind ... "mentally competent to choose to kill himself".

Last night, a campaigner for voluntary euthanasia told how the pensioner was "so grateful at the end".

[stevewool]

we all wish that Arthur to die with dignity, why oh why do we have to see our love ones go through pain and suffering,

[Terpe]

Given the title of the thread, it took me a little time to actually decide to read your post Arthur.

I agree with Steve in that we all want dignity when the time comes.
I do understand the reasoning for it for certain conditions.

I just wonder how easy it is to recognise that 'right time' when it comes to "death before dementia" though.
There are so many levels of dementia. Many of which I would personally NOT want to burden my family with.

But most commonly it's only diagnosed when it's already causing issues with being still of sound mind

[mickcant]

I have an 83 year old sister, who lost their only daughter in 2007 and her husband in 2009
She has gone downhill since, and seemed to give up when her husband too died,.

She had a fall last Christmas, three weeks later they found a tumour in her brain and operated,
She now has Dementia of some sort, social services said she could not live alone, so a granddaughter and family moved from their rented flat into her home (which she owns) but has became worse is very confused and angry, the day centre won't have her any more, and social services say they will do nothing because she has family with her.

She does not recognise anyone most of the time and keeps trying to call the police because she says her granddaughters husband has broken into the house!

There is no answer, but who in a case like this can or should end her life?
Mick.

[Terpe]

....There is no answer, but who in a case like this can or should end her life?
Mick.

That was exactly part of the point I made. There is no-one can legally make that decision now.
With regard to this Swiss company Dignitas, only SHE could have made such a decision WHEN she was deemed to be of sound mind.
The basic scenario you describe Mick is the by far the most common.
And yes, social services intervention is dependant on a number of issues and on a formal assessment.

Dementia is a major crisis in UK already
I have no idea on the incidence of dementia in Philippines, but it is described as being "a public health emergency" by the Dementia Society of the Philippines.

[Arthur Little]

Given the title of the thread, it took me a little time to actually decide to read your post Arthur.

Yes ... it's not the sort of thread that is likely to be most folks' "cup of tea"!

Tbh, though, my reasons for posting it here at all, were basically twofold:

1. Yesterday, it seemed to me there was an unsual dearth of posts generally, on the forum ... certainly of the sort that I felt inclined towards contributing my tuppenceworth to, at any rate.

2. And then, by chance, I happened to read a newspaper article on the aforementioned topic. Straightaway, it reminded me of an unusual conversation I had had with a widowed friend, recently - when he'd told me in no uncertain terms that, if ever the occasion were to arise where he was diagnosed with Alzheimer's disease, he'd prefer to "end it all" while still compos mentis.

... hence my [rather morbid] choice of subject in this particular instance.

[stevewool]

well they say that you should save for your funeral and that takes years to pay for ,so why cant something be set up like this , this could take years to happen but before you know it, you are not right in mind and sole and you have lost the chance to say what you are wanting to happen to yourself, just a thought while i am of sound mind , me thinks

[mickcant]

I've paid into a pre payment plan that adjust every year (well the premium goes up) and will be enough to cremate me, my ashes I want scattered at my late parents grave.
Mick.

[Terpe]

Slightly off-topic but I think many folks would be very surprised at the high cost of funerals these days.

[mickcant]

Slightly off-topic but I think many folks would be very surprised at the high cost of funerals these days.

I think my pre payment plan is working on just under £4,000 for cremation more for a burial of course.

I could imagine I would be left in the mortuary for months if I left money to my sons and left it to them to dispose of me !

This happened with a woman I knew slightly, she died with no arrangements or funds and her funeral was months afterwards because her daughter could not get the money together, there is a grant but no very much as far as I know.
Mick.

[gWaPito]

I think my pre payment plan is working on just under £4,000 for cremation more for a burial of course.

I could imagine I would be left in the mortuary for months if I left money to my sons and left it to them to dispose of me !

This happened with a woman I knew slightly, she died with no arrangements or funds and her funeral was months afterwards because her daughter could not get the money together, there is a grant but no very much as far as I know.
Mick.

Can you believe it's been said that 45% do not have life insurance. .unbelievable isn't it. .my dad died 5 years ago yes, the funeral was expensive but they weren't on mother's back to cough. .they knew life insurance was going to pay for it so waited.

About death itself. .dad was a hypochondriac all his life up until his illness took a grip. .the weeks before he died he spoke of death. .he wasn't at all afraid. .he had regained his faith. .that gave him the strength and courage. .he prepared to die by putting all his papers in order. .something he never done before. .we didn't know what he'd done until after.

He was lucky. .we all were, he had a heart at home attack with his mind intact...so happened with loved one around him. ..June 1 wld of been his 83rd birthday. ..family had gathering at his graveside today.

Cheers
Mark

[mickcant]

Can you believe it's been said that 45% do not have life insurance. .unbelievable isn't it. .my dad died 5 years ago yes, the funeral was expensive but they weren't on mother's back to cough. .they knew life insurance was going to pay for it so waited.

About death itself. .dad was a hypochondriac all his life up until his illness took a grip. .the weeks before he died he spoke of death. .he wasn't at all afraid. .he had regained his faith. .that gave him the strength and courage. .he prepared to die by putting all his papers in order. .something he never done before. .we didn't know what he'd done until after.

He was lucky. .we all were, he had a heart at home attack with his mind intact...so happened with loved one around him. ..June 1 wld of been his 83rd birthday. ..family had gathering at his graveside today.

Cheers
Mark

Well Mark, that was as good as death can be I suppose, I am not worried about dying just how? and in what pain, plus I live alone!
Mick.

[gWaPito]

Well Mark, that was as good as death can be I suppose, I am not worried about dying just how? and in what pain, plus I live alone!
Mick.

Apologies for my mixed up post! You got the drift. .that's the main thing.

Mick, I'm going to be in the same boat as you. .All alone and all that doesn't go with it. .best you come up here to Swindon and live with me. .we can keep each other company. ...just like in that comedy 'The odd couple' Jack and Walter.

Btw. ..not sure about living accommodation. .most probably will be one of the town's hostels. ..happy days indeed.
At least we'll be sure of a pass through the gates of heaven.

[Terpe]

...June 1 wld of been his 83rd birthday. ..family had gathering at his graveside today...Cheers
Mark

Hope you managed OK today Mark. Really.

My old dad died March 1st 2012
Took me nearly a year to manage it and get back to some kind of normality. Don't know why.
He was a lifelong alcoholic and my childhood was pretty dam scary.

Me too Mick and Mark I'm the last and no family left at all. Well apart from the extended family over in the paradise islands.

Looks like it could be the three amigo's

[stevewool]

Can you believe it's been said that 45% do not have life insurance. .unbelievable isn't it

I have no life insurance

[cheekee]

Did anyone see the documentary when Terry Pratchett followed Peter Smedley on his last journey with Dignitas ?

[gWaPito]

Hope you managed OK today Mark. Really.

My old dad died March 1st 2012
Took me nearly a year to manage it and get back to some kind of normality. Don't know why.
He was a lifelong alcoholic and my childhood was pretty dam scary.

Me too Mick and Mark I'm the last and no family left at all. Well apart from the extended family over in the paradise islands.

Looks like it could be the three amigo's

Strange that Peter. .my dad was also a boozer and scary at home.

Without wanting to spread my misery over the threads. .yes, today was okay. .just as well I'm working it helps you not to think too much about it. .I'm currently leaving home for work in a state of numbness. .for want of a better word. But hey, life stills goes on.
I'm giving my sisters in Oz the earache now on Facebook. .I'm giving you boys a rest.

[robbie bobby]

Did anyone see the documentary when Terry Pratchett followed Peter Smedley on his last journey with Dignitas ?

Yes I saw it and it was not so pleasant to watch.It looked like towards the end he choked a little bit and who knows maybe he regretted it in the last few seconds.

It was a bit upsetting though and I knew the guy as he lived just up the road from me

[cheekee]

Yes I saw it and it was not so pleasant to watch.It looked like towards the end he choked a little bit and who knows maybe he regreted it in the last few seconds.

It was a bit upsetting though and I knew the guy as he lived just up the road from me

As a nurse I have sadly cared for and seen many people pass on.

He wasn't choking although it sounded that way.

The barbiturate was just depressing his respiratory drive rapidly.....

The disease he had doesn't have a nice ending sadly. He would have needed a ventilator at the terminal phase. He would have been bed bound.

I know this is a difficult emotive subject. Its a really difficult one. I am passionate about end of life care. I always make sure the patient is pain free and comfortable and that close ones, relatives and friends can participate in the process and are not scared by it. I give pain relief and sedative medication as I need to to keep them comfortable and be able to pass on in the most gentle way they can.

[robbie bobby]

As a nurse I have sadly cared for and seen many people pass on.

He wasn't choking although it sounded that way.

The barbiturate was just depressing his respiratory drive rapidly.....

The disease he had doesn't have a nice ending sadly. He would have needed a ventilator at the terminal phase. He would have been bed bound.

I know this is a difficult emotive subject. Its a really difficult one. I am passionate about end of life care. I always make sure the patient is pain free and comfortable and that close ones, relatives and friends can participate in the process and are not scared by it. I give pain relief and sedative medication as I need to to keep them comfortable and be able to pass on in the most gentle way they can.

Its a macabre subject and just leave it at that

[gWaPito]

Its a macabre subject and just leave it at that

Good thread Arthur, a thread of substance. .I first read this 0415hrs while eating my cereal before retiring to the sofa.

We talk a lot about taxes. .why not about death and it's ramifications. .it's going to affect all of us sooner or later.

[Arthur Little]

Good thread Arthur, a thread of substance. .I first read this 0415hrs while eating my cereal before retiring to the sofa.

Thanks, Mark ... your kind comment is much appreciated.

We talk a lot about taxes. .why not about death and it's ramifications. it's going to affect all of us sooner or later.

Indeed it IS ... NOTHING surer!

[Michael Parnham]

Death, something I must admit, never given any thought to. Only ever been to my stepfathers cremation and it was all over in about 15 mins. Don't know what one has to do in the event of death because I've never had any dealings with such things and nobody has ever struck up that kind of conversation in my presence so I have no idea what one has to do!

[joebloggs]

That was exactly part of the point I made. There is no-one can legally make that decision now.
With regard to this Swiss company Dignitas, only SHE could have made such a decision WHEN she was deemed to be of sound mind.
The basic scenario you describe Mick is the by far the most common.
And yes, social services intervention is dependant on a number of issues and on a formal assessment.

Dementia is a major crisis in UK already
I have no idea on the incidence of dementia in Philippines, but it is described as being "a public health emergency" by the Dementia Society of the Philippines.

and would anyone with a sound mind want to end their life? and who decides if they have a sound mind, a psychiatrist or psychologist ?

I've watched a murder trial (Jodi Aris) she slaughtered her ex b/f (she shot in the head, stabbed 27 times and she cut his throat from ear to ear) she claimed self defense also Domestic violence, the defense had 3 'expert' psychologist stating she suffered from DV and post traumatic stress disorder, the prosecution had 2 expert psychologist saying this was untrue


so don't expect 'experts' to agree if someone has capacity to decide, also that capacity (dementia etc) can fluctuate, they might want to die today but next week who knows.. and i don't think any MEDICAL doctors would not want to be involved in this.

[Doc Alan]

Of course death affects all of us, either indirectly ( loved ones, friends ) or – finally – directly. Dying with dignity is a laudable aim, which sadly can’t ever be realised for everyone.


Well done Arthur for raising the topic, rightly debated by some members ; understandably avoided by others ; and ultimately depending on society’s wishes, law, politics and finance.


Most doctors and other health workers have reservations about assisted suicide. They would prefer to diagnose early, and treat, cure or at least support patients to live as comfortable and long a life as possible.



The GMC has reminded us that encouraging or assisting suicide is a criminal offence. Some believe there’s a case for strictly controlled legalisation of assisted dying for terminally ill mentally competent adults. Already the “ Liverpool care pathway “ is standard practice in many UK hospitals and hospices – under this, doctors allow a dying patient ( or family ) to choose whether to prolong life-support or let them die ( with life-shortening pain killers ).


The first reported case of a UK person with early dementia choosing to end their life at “ Dignitas “ in Switzerland is in the context of an estimated 800,000 with various forms of dementia in the UK. The only estimate I have seen for the Philippines is 200,000 ( improbably low ). Only around 200 of all UK residents have travelled to Dignitas to die since 2002. The annual total assisted deaths in Swiss residents is around 300 ( 0.5% of all deaths ).


Dying with dignity is not, in my opinion, primarily about the minority who wish assisted suicide – although the debate about that seems likely to continue, with strong opinions on either side.


Most people, wherever they live, hope for a good life, and not to die prematurely ( aged less than 65 ), from whatever cause. In the UK, a majority ( 3/5 ) die in hospital, only 1/5 die at home, and the rest in care homes, hospices or elsewhere ( accidents, suicides etc ). More would prefer to die at home, surrounded / supported by family and friends ; but also with better community support. Many have said they want the familiarity and reassurance once taken for granted from their own doctor, not from an “ out-of-hours “ locum, or A and E doctor.


How different it is in the Philippines. Non-communicable diseases ( like cardiovascular diseases, cancers, lung ailments, and diabetes ) take their toll, as in the UK - but only 3/5 deaths, compared to 9/10 deaths in the UK . Communicable diseases ( like TB ), maternal and perinatal conditions account for the remainder. Implementation of the Reproductive Health Act would reduce avoidable deaths occurring DAILY, either in childbirth or in infants – LONG before they reach the hoped-for life expectancy of three score years and ten ( 70 ).


In the Philippines 3/5 of the population die without seeing a doctor / other healthcare worker. Most die at home, supported as best they can by family. How THEY must wish for a dignified death, only after receiving adequate health care ! The Philippine economy is healthy. It’s to be hoped more resources ( healthcare workers, drugs, infrastructure, etc ) are made available for care of its citizens.


“ Assisted living “ - improved comprehensive health care available to all, whether for dementia, cancer, heart disease or other illness – is what most health care workers would wish for, in the UK and the Philippines. That depends on how much the population want – and the respective governments can afford - to spend on resources.

[Arthur Little]

Many thanks, Alan ... for a thought~provoking, balanced approach to such a difficult, emotive subject, based on your own views as a particularly well-informed, highly qualified medical expert.

[gWaPito]

and would anyone with a sound mind want to end their life? and who decides if they have a sound mind, a psychiatrist or psychologist ?

I've watched a murder trial (Jodi Aris) she slaughtered her ex b/f (she shot in the head, stabbed 27 times and she cut his throat from ear to ear) she claimed self defense also Domestic violence, the defense had 3 'expert' psychologist stating she suffered from DV and post traumatic stress disorder, the prosecution had 2 expert psychologist saying this was untrue


so don't expect 'experts' to agree if someone has capacity to decide, also that capacity (dementia etc) can fluctuate, they might want to die today but next week who knows.. and i don't think any MEDICAL doctors would not want to be involved in this.

Good post Joe

I hope you've managed to un twist your knickers. .. earlier I was being my sarcastic self...no offence intended

[gWaPito]

Many thanks, Alan ... for a thought-provoking, well~balanced reply based on the views of a well-informed, highly qualified medical expert such as yourself.

Exactly Arthur Totally agree. Well worth giving Alan a rep.

[joebloggs]

Good post Joe

I hope you've managed to un twist your knickers. .. earlier I was being my sarcastic self...no offence intended

, you should know me by now, water off a ducks back

still I hope things some how work out for you Mark

[joebloggs]

one of the most harrowing situations I've been in was having to take my moms dog to the vets to be humanely 'put down' she had cancer and many other things wrong with her. i had been in that situation before a few times, I always help hold the dog while the vet injected it, and slowly but peacefully the dog would die.

not this time thou, the dog which I had lived with for more than 12yrs, even thou she was very weak and seemed to have lost the will to live, she struggled and managed to put up a fight when the vet injected her, it seemed like at least a minute of her in severe pain and gasping form breath and struggling before she died. never again i said i would own a dog.

this was only a 'dog' but imagine if if was a relative