Starmer's vision quest

[icowden]

People with anorexia likely have capacity.

Usually, but it might be that by the stage that they are asking for assisted dying, that their capacity may be considered to be diminished. A mental health professional has to be satisfied that the person:

1. Understands what the decision is
2. Can remember what the decision is and any earlier discussions
3. Understands the impact of the decision - both pros and cons
4. Can communicate their decision

A 2022 study found that:

A total of 23% of physicians in Japan, 32% in the UK, and 35% in the USA reported that they believe patients with AN (anorexia nervosa) lack the capacity to make appropriate decisions. Physicians who considered patients with AN to have an impaired mental capacity placed significantly more emphasis on the level of psychopathological values, which are values caused by AN (and can be changed by recovery) that affect the ability to be rational, when assessing the mental capacity of these patients. Conversely, physicians who considered patients with AN to have full mental capacity placed significantly more weight on the ability to express a choice or preference.

A 2016 study found that

Diminished mental capacity occurs in a third of patients with severe anorexia nervosa and is associated with a low BMI, less appreciation of illness and treatment, previous treatment for anorexia nervosa, low social functioning and poor set shifting.

It's likely that someone wanting assisted dying is in that one third who are close to that anyway, and who have reduced mental capacity.

 

[AuroraSaab]

It refers to the scope of 'terminal illness' possibly being able to include conditions which would not be in themselves terminal but which rely on meds or therapy to keep the patient alive. Anorexia would be one of those. The wording is ambiguous enough to do so.

I would prefer the system to have better care for the disabled and better palliative care first before this flawed bill is pushed through into law.

The law isn't just for you. It will apply to everybody and as such any shortcomings that will never apply to you but might apply to others should be considered. It's not there just to give CycleChat gents the bespoke passing of their choice.

(Reply to Bob, not IC)

 

[Bazzer]

In every country that has assisted dying the rules have ended up covering those who aren't in physical pain or in distress but who have mental health conditions like depression or anorexia, or who simply don't have the support or money to cope adequately with their disability.

Your comment suggests that simply having a mental health condition such as anorexia, would bring you within the rules of countries that permit assisted dying. Unless you have another source, that certainly does not appear to be the case in the first country I checked; New Zealand.

Eligibility criteria​

There are strict eligibility criteria for assisted dying. Not everyone with a terminal illness will be eligible for assisted dying. The Act states that to be eligible, the person must meet all of the criteria. The person must be:

• aged 18 years or over
• a citizen or permanent resident of New Zealand
• suffering from a terminal illness that is likely to end their life within six months
• in an advanced state of irreversible decline in physical capability
• experiencing unbearable suffering that cannot be relieved in a manner that the person considers tolerable
• competent to make an informed decision about assisted dying.

A person cannot access assisted dying solely because they have a mental disorder or mental illness, have a disability or are of advanced age. However, people with these conditions may be eligible to access assisted dying if they meet the eligibility criteria.

https://www.tewhatuora.govt.nz/heal...-public/assisted-dying-eligibility-and-access

 

[AuroraSaab]

It may be that individual stats for the reasons for assisted dying are not available.

New Zealand has more protections in their legislation than the UK bill has. They still have issues though:

"The research found patients were requesting assisted dying not just because of physical pain but for "existential distress" - in some cases, related to "feeling a burden"."

https://www.rnz.co.nz/news/what-you...ed-dying-three-years-on-what-you-need-to-know

There were at least 60 cases of assisted dying of people solely with eating disorders in Canada in 12 years.

https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2024.1431771/full

 

[classic33]

Yes, I have, several times. Not nice, but I wouldn't consider it such a poor quality of life that I wanted to die.

So you'd be quite happy to continue "living" in a bed with machines doing your bodies work? Feeding, breathing, clearing out waste.
Not the monitors and not just in a hospital environment.

When we make laws that apply to everyone they have to take many things into account not just the wishes of particular individuals. It's not a question of whether assisted dying is right or wrong in principle - that's a moral question - it's a question of whether this legislation addresses the many concerns that passing this bill might result in.

And who are you to say my decision is wrong?

It's not all about you. Nor is it just about other individuals on here who know what they want. It's about those who don't have people to advocate for them, who might be prone to exploitation or influence, who might feel that they could still have a pain free quality of life with the proper support. Those are the ones this legislation should be safeguarding.

I've never said it was "all about me", just voicing a personal opinion, that you don't like.
Pain free, if that is how you choose to define "quality of life" then you are clearly unaware of the rest that goes with it.

Your still being picky in which questions you want to answer, maybe this is because you have no experience on which to base an answer. But still you answer for all, why?

 

[bobzmyunkle]

The law isn't just for you. It will apply to everybody and as such any shortcomings that will never apply to you but might apply to others should be considered. It's not there just to give CycleChat gents the bespoke passing of their choice.

Not my point, at all. My point is that a person's dignity is something for that person themselves to decide. I.e. not you, not 'society', not a disabled support charity, or anyone else.

A discussion of anorexia inclusion linked below. Maybe we just disagree on who should be allowed to die.

“The prospects of her recovery overall approach zero… given that it is extremely unlikely that Ms L will recover from her anorexia it is not in her best interests to make attempts to reverse her weight loss which require coercion, restraint or sedation… in best interests to move to palliative care if L [is] in terminal stage of her illness.”

https://blogs.bmj.com/spcare/2025/0...norexia-be-coming-to-the-nhs-by-chelsea-roff/

 

[AuroraSaab]

So you'd be quite happy to continue "living" in a bed with machines doing your bodies work? Feeding, breathing, clearing out waste.

It would depend on individual circumstances.
I might or I might not. I don't think that people who are in those circumstances necessarily have no quality of life or that their lives aren't worthwhile.

And who are you to say my decision is wrong?
I've never said it was "all about me", just voicing a personal opinion, that you don't like.

Didn't say it was wrong. Whether I like it is neither here nor there because the legislation isn't about you or I. It applies to all and as such it requires safeguards that take into account many different circumstances. I don't think it does.

Your still being picky in which questions you want to answer, maybe this is because you have no experience on which to base an answer. But still you answer for all, why?

I'm not answering for all. I see you're off on another rant though.

 

[Psamathe]

.

People with anorexia likely have capacity.

Usually, but it might be that by the stage that they are asking for assisted dying, that their capacity may be considered to be diminished.

I'm not a medic but isn't anorexia a difficult one as my (non-legal) interpretation is that it would be excluded as it's a mental/psychological condition that can be treated. But in the later stages I thought it can cause kidney and/or liver failure which I thought tend to be irreversible. But by that stage we are talking about a terminal untreatable physical condition and the anorexia has become a "cause" (maybe like smoking can cause lung cancer).

Ian

 

[AuroraSaab]

Not my point, at all. My point is that a person's dignity is something for that person themselves to decide. I.e. not you, not 'society', not a disabled support charity, or anyone else.

But when assisted dying becomes part and parcel of NHS care, and doctor's are allowed to bring it up before patients have enquired about it, don't you think we will gradually drift towards disabled, old, and ill people feeling pressurised into it?

A discussion of anorexia inclusion linked below. Maybe we just disagree on who should be allowed to die.

“The prospects of her recovery overall approach zero… given that it is extremely unlikely that Ms L will recover from her anorexia it is not in her best interests to make attempts to reverse her weight loss which require coercion, restraint or sedation… in best interests to move to palliative care if L [is] in terminal stage of her illness.”

https://blogs.bmj.com/spcare/2025/0...norexia-be-coming-to-the-nhs-by-chelsea-roff/

It's only terminal if you don't treat it, just like kidney issues can be terminal if you don't treat them with dialysis. It is possible to recover from an eating disorder, just like it's possible to recover from depression. If you offer assisted dying to anorexics to ease their mental health issues you are essentially abandoning offering them treatment that will allow them to recover. The more you make it available, the more people will see it as their only option.

 

[bobzmyunkle]

But when assisted dying becomes part and parcel of NHS care, and doctor's are allowed to bring it up before patients have enquired about it, don't you think we will gradually drift towards disabled, old, and ill people feeling pressurised into it?

No I don't.

 

[BoldonLad]

If we reduce the population by millions, and most of those are of working age, you actually make the problem much worse. Same reasoning applies to restricting immigration too much.

What we need are fewer old people, but my understanding is that the demographic balance will reset itself to an extent when the glut of boomers passes through. Clearly it won't be the same as when we all used to smoke heavily and let cancer run it's course, active promote heart disease and die of TB or the plague, but it will be better than it is looking now.

At which point we will start suffering from the effects of low birth rates and start competing for young immigrants with counties that have been less xenophobic for the preceding generation.

I assume there are statistics to support this, but, I haven't looked them up.

One would expect the boomers (say 1946 - 56) to “ripple” through birth rates, but, the amplitude of the “bump” will slowly diminish, as members of the group's individual life styles vary, and, the "society impact" takes effect (eg a tendency for people to have fewer children, and/or a tendency to have children later in life).

If I did look up the birthrates, I would expect to see a "boom" with smaller amplitude in roughly the period 1966 - 1980, and, then another "boom" in roughly the period 1991 - 2010, again with the amplitude diminishing and the length of the time period increasing. So, just as we now have a "boom" in people in the age group 69 - 79, I would expect to see a similar but smaller "boom" in people aged 48 - 58, and, another, smaller "boom" in those aged 20 - 35.

The birthrate figures would need to be adjusted to remove the effects of immigration (actually, emmigration too, but, that probably isn't significant)

 

[BoldonLad]

It refers to the scope of 'terminal illness' possibly being able to include conditions which would not be in themselves terminal but which rely on meds or therapy to keep the patient alive. Anorexia would be one of those. The wording is ambiguous enough to do so.

I would prefer the system to have better care for the disabled and better palliative care first before this flawed bill is pushed through into law.

The law isn't just for you. It will apply to everybody and as such any shortcomings that will never apply to you but might apply to others should be considered. It's not there just to give CycleChat gents the bespoke passing of their choice.

(Reply to Bob, not IC)

By the same token, the law is not there just to give (say) a particular religious group the ability to impose their views on the rest of us, but, we have organised religion actively asking their adherents to lobby their MP.

 

[Bazzer]

It may be that individual stats for the reasons for assisted dying are not available.

New Zealand has more protections in their legislation than the UK bill has. They still have issues though:

"The research found patients were requesting assisted dying not just because of physical pain but for "existential distress" - in some cases, related to "feeling a burden"."

https://www.rnz.co.nz/news/what-you...ed-dying-three-years-on-what-you-need-to-know

There were at least 60 cases of assisted dying of people solely with eating disorders in Canada in 12 years.

https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2024.1431771/full

So not every country then which has an assisted dying law.
The same would also seem to apply to Belgium, which unusually, allows for assistance where unbearable mental suffering is caused by psychiatric disorder.
From what I can see, eating disorders accounted for 1.5% of around 1.5% who were deemed to have a qualifying psychiatric disorder.

 

[Stevo 666]

One year is not every year, which is what you alleged.

I think you misunderstand or didn't read my post properly - if those sorts of net immigration figures continue to be recorded in future years, then its not sustainable.

Here's what I wrote a few pages back just in case you 'misunderstand' again. I've put the relevant part in bold:
"I stand by my point above that increasing the net population of the UK by an amount more than a city the size of Manchester every year into the indefinite future isn't sustainable."

What's your view on that?

 

[icowden]

Here's what I wrote a few pages back just in case you 'misunderstand' again. I've put the relevant part in bold:
"I stand by my point above that increasing the net population of the UK by an amount more than a city the size of Manchester every year into the indefinite future isn't sustainable."

What's your view on that?

I agree. I also think we shouldn't feed cats cheese, we shouldn't paint big ben bright pink and we shouldn't expect flamingos to cook dinner.
Glad we agree that a thing that wasn't going to happen isn't going to happen. I'm just not sure why you brought it up.