Burnham

[AuroraSaab]

How many amendments were tabled? How many of those were 'sensible'?
What will it take for you to find the bill acceptable?

Here's some to think about. Should hospices that don't want to offer assisted dying be defunded? That's what one MP demanded this week.

We've already discussed assisted dying at length so no point going over all the arguments again but if this bill was so marvelous you have to wonder why so many disability rights groups, hospice campaigners, and doctors were against it's current iteration. Most of whom have no religious affiliation. We know from Canada and the Netherlands that what starts out as being about the terminally ill ends up being extended - without further legislation being brought.

 

[Psamathe]

Here's some to think about. Should hospices that don't want to offer assisted dying be defunded? That's what one MP demanded this week.

View attachment 17195 We've already discussed assisted dying at length so no point going over all the arguments again but if this bill was so marvelous you have to wonder why so many disability rights groups, hospice campaigners, and doctors were against it's current iteration. Most of whom have no religious affiliation. We know from Canada and the Netherlands that what starts out as being about the terminally ill ends up being extended - without further legislation being brought.

The difficulty is that a list of ammendments voted down is meaningless as what is relevant is why they were voted down eg other amendments that were accepted and added provided more protection.

eg two amendments one requiring 15 days cooling-off period, another requiring 30 day cooling off and 45 day period adopted but shock horror I list "15 day cooling off amendment voted down!". Ignore the idea of "cooling-off" amendments, I'm just illustrating why it's way more complex than a list of amendments voted down.

 

[bobzmyunkle]

Should hospices that don't want to offer assisted dying be defunded? That's what one MP demanded this week.

And was it part of the Bill? The answer is no.

We know from Canada and the Netherlands that what starts out as being about the terminally ill ends up being extended - without further legislation being brought.

Do we? Or is this just another part of your fear mongering?

 

[Psamathe]

Should hospices that don't want to offer assisted dying be defunded? That's what one MP demanded this week.

My impression is that most hospices still are not properly funded anyway.

And a lot would depend on the detail. Organisations accepting Government money to provide Government mandated services are expected to provide those services not cherry-pick the services what want to offer. Was cherry-picking allowed funded organisations would solve their funding crises by deciding not to provide more expensive services so Gov. income same for providing only the cheap easy services.

 

[AuroraSaab]

Feel free to Google it. Fear mongering also surrounds the idea that terminally ill people will inevitably die in prolonged pain and agony if they can't get assisted dying.

 

[AuroraSaab]

My impression is that most hospices still are not properly funded anyway.

75/80% funded by charity donations. I think properly funded palliative care would help.

Was cherry-picking allowed funded organisations would solve their funding crises by deciding not to provide more expensive services so Gov. income same for providing only the cheap easy services.

I would think assisted dying would help hospices; they get paid and it frees up a bed. And yet they don't want to do it, despite the financial incentives. Hospice care isn't cheap, nor easy.

 

[Psamathe]

75/80% funded by charity donations. I think properly funded palliative care would help.

My personal view is both. We should be properly funding hospice care.

Separate issue (for me) is we should be providing for people terminally ill to control how they die with adequate safeguards. But "adequate safeguards" is a very specialist consideration so must be determined by those with appropriate experience and training - which does not include me. I must trust their training and experience. Just like when I go to the NHS dentist I trust they will be offering me the best treatment for my best outcome as I cannot look at X-rays and assess my cracked tooth and root canal possibilities, etc.

And "adequate safeguards" can probably never be "perfect safeguards" but need to be judged in relation to the reality that is happening today eg where some are taking their own lived privately (when their partner is not there for comfort ...) often using whatever means are available and sometimes only partially successfully.

I do feel (given my lack of experience with protection of the vulnerable) that one "safeguard" I would like to see is mandatory and repeating scheduled reviews after set periods to identify shortcomings that have happened which would require identified gaps to be closed in legislation..

 

[Psamathe]

I would think assisted dying would help hospices; they get paid and it frees up a bed. And yet they don't want to do it, despite the financial incentives. Hospice care isn't cheap, nor easy.

I don't know how hospices are funded but I would expect for Government funding they'd get paid a lump sum based on their capacity (number of beds). So given they will be operating at capacity ie when one person dies that means a new patient is accepted so on that basis it would not affect their costs.

So I can't even see the financial incentives. But also, the nature of hospices (particularly given the lengths they have to go to to raise funds) to me suggests they are doing it for the good of their patients rather than for a profitable outcome.

nb I do recognise that some venture capital investors have identified care nomes, even nursing care homes as a potential profit source to be squeezed for everything it can but my impression is the hospice system does not run in the same way.

 

[AuroraSaab]

If doctors who prescribe at the hospices can't be persuaded to get on board with it, they'll have to pay locum assisted dying doctors to do it. That does sound like a profitable gap in the market. Perhaps we'll eventually see assisted dying sold like funeral plans and Simply Cremation deals. Pay up front over 2 years and they'll sort it all out when the time comes.

 

[Psamathe]

If doctors who prescribe at the hospices can't be persuaded to get on board with it, they'll have to pay locum assisted dying doctors to do it. That does sound like a profitable gap in the market. Perhaps we'll eventually see assisted dying sold like funeral plans and Simply Cremation deals. Pay up front over 2 years and they'll sort it all out when the time comes.

Maybe that response has illustrated part of the challenges of this debate.

I've not seen the suggestion in relation to the Assisted Dying Bill that we'll see "see assisted dying sold like funeral plans and Simply Cremation deals. Pay up front over 2 years and they'll sort it all out when the time comes.. Maybe I missed it but I can see such suggestions being taken seriously in what is an important discussion.

Maybe you have shown how far some will resort to in trying to derail this important issue.

 

[AuroraSaab]

I was joking actually but I think it's likely that many doctors who work in/prescribe to hospices will want to be able to self exclude from providing assisted dying. Which does bring up issues of whether doctors and hospices will/should be forced to administer something they are against in principle. Maybe specialist clinics will develop that offer the service, as you get abroad. If you'd seen the previous discussion on this you'll see I take it very seriously.

 

[Psamathe]

I think it's likely that many doctors who work in/prescribe to hospices will want to be able to self exclude from providing assisted dying.

I wouldn't know but I can envisage it working the other way. Maybe those doctors are out to provide the best outcome for their patient and eg if they can no longer adequately address pain, maybe the best outcome is Assisted Dying and at that point it's the best help they could give.

I suspect that without working in a hospice and knowing a number of medics attending patients it would be difficult to know what approach many might take.

 

[Psamathe]

I was joking actually

Further challenging sensible discussion when somebody makes a point in line with their views but when challenged "it was a joke".

 

[farfromtheland]

Also I find it has highlighted how many MPs are basing their votes on their personal views rather than representing their electorate. Our system is "representative" not delegating decisions (despite what Burke might think). My impression from reports and speaches I've seen is too many MPs were talking about their vote based on their personal views.

As I'm now terminally ill (though not quite as terminally as Joanna Lumley) perhaps this gives my view some weight? An issue like this is a matter of conscience, and 'first do no harm' must also weigh heavily against public opinion in general. The most heard reason for opposing the bill as it stood is that palliative care is crap. No pressure then?

To make it harder I suspect most of the general public expressing views on "safeguards" have no experience of real world coercive behaviour, what can happen, how it can be hidden or detected, etc. I certainly have no such appreciation. Thus it's very possible that some "sensible amendments" would not be effective eg as those doing the coercing could easily bypass them ie well intended, appear to those of us not understanding such issues as sensible but reality in practice just ineffective.

Whatever one's views on the representative nature of parliamentary democracy, the House of Common's committee was stacked. Committees tend to be stacked, and guess what? They eliminated High Court Judge scrutiny in favour of a committee.

I met with supporters of Leadbetter's bill outside the HofC, and you may not believe me, but they sure talked like idiots - dressed in pink kit and shouting at vicars? If that's democracy I'm an f-ing chatbot.

 

[AuroraSaab]

Further challenging sensible discussion when somebody makes a point in line with their views but when challenged "it was a joke".

It was you that mentioned private companies seeking to benefit from nursing homes, my observation was just extrapolating that. It's in your imagination that I was suggesting it was part of the bill. I did no such thing.
We have had lengthy sensible discussions on this topic already. There's no individual consensus, nor a forum one, to be had. It's inevitably a complex and divisive issue.