Starmer's vision quest

[First Aspect]

So in scanned through this literature review paper that someone posted.
https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2024.1431771/full

The jist seems to be that there isn't much data. Of the 19 verified cases of anorexics proceeding through assisted dying, 17 were in countries without a "terminal illness" requirement. Almost all of those cases included people with multiple other comorbidoties, including but not limited to other medical conditions.

The authors, like people posting here, still cannot resist making "tip of the iceberg" speculations based on certain mental health conditions appearing in long lists of "other conditions". This is unhelpful.

As far as I can tell, if you include only jurisdictions with a "terminal" illness requirement and those with a "solely" exclusion that applies to mental illness, there are possibly, but not certainly, 2 cases in the US over the 12 year period studied.

This does not diminish the need for vigilance, but overall it seems to me to be compound whataboutery that is being used to underpin a preconceived opinion.

Objectively, if one were to start from the data without preconceptions, this particular concern and probably many others, simply would not register in relation to the proposed UK legislation.

 

[briantrumpet]

https://ncap.cyclechat.net/threads/assisted-dying-yes-or-no.731/

 

[AuroraSaab]

I don't know the details but the bill states

So it is reversible so they already don't qualify ie already covered by the law. Adding specific clauses that are already defined could potentially raise ambiguity as it raises the suggestion that eg whilst anorexia is specifically excluded bulimia isn't ...

Just because an amendment is rejected does not mean there is inadequate scrutiny and that there is inadequate safeguards.

Ian

If you stop eating and drinking then it becomes a physical illness which is inevitably terminal. That's what the eating disorder charities are worried about. It makes it an option for a mental health issue when we know suicidal ideation is part of anorexia.

 

[AuroraSaab]

That's a patronising attitude. Many people with mental health illnesses are perfectly capable of rational decision-making.

And many of them aren't because suicidal ideation is part of their illness. People spend months planning suicide so by that logic there's no point trying to prevent the 20 suicides a day we have in the UK because we should accept that some were rational decisions.

 

[Psamathe]

If you stop eating and drinking then it becomes a physical illness which is inevitably terminal

But it is reversable with treatment

For the purposes of this Act, a person is terminally ill if—
(a) the person has an inevitably progressive illness or disease which cannot be reversed by treatment

Does not say the patient has to accept that treatment, just that the disease/condition can be reversed with thretment.

If the condition progresses to eg kidney and/or liver failure to the extent that it cannot be treated then your condition becomes kidney and/or liver failure NOT anorexia (anorexia might be the cause but the condition is physical untreatable organ failure).

Ian

 

[AuroraSaab]

Objectively, if one were to start from the data without preconceptions, this particular concern and probably many others, simply would not register in relation to the proposed UK legislation.

It's not just about anorexia. None of the countries who introduced it seem to have intended for it to be for anything other than terminal physical illness. But it has invariably expanded - without further laws being passed - to wider conditions.

What we do have in the UK is less emphasis on individual rights and a wider recognition of social responsibility so my hope is that when this bill is passed the medical profession, others, and hospices - who seem to be against it - will self-regulate in a way that puts in the safeguards that have been voted down.

 

[AuroraSaab]

But it is reversable with treatment

Does not say the patient has to accept that treatment, just that the disease/condition can be reversed with thretment.

If the condition progresses to eg kidney and/or liver failure to the extent that it cannot be treated then your condition becomes kidney and/or liver failure NOT anorexia (anorexia might be the cause but the condition is physical untreatable organ failure).

Ian

So basically you're incentivising those with a mental health issue into not eating or drinking in order to make their mental health issue into a terminal physical illness ...

 

[Psamathe]

It's not just about anorexia. None of the countries who introduced it seem to have intended for it to be for anything other than terminal physical illness. But it has invariably expanded - without further laws being passed - to wider conditions.

I thought we (UK) were writing our own legislation on this, not just taking existing legislation from other countries (cut and paste including debatable shortcomings).

Seems often when it's pointed out that objections are actually already explicitly excluded they resort to " ... but 'Mission Creep'". Properly worded law cannot expand. And if it does Parliament can easily pass ammendments.

Ian

 

[First Aspect]

It's not just about anorexia. None of the countries who introduced it seem to have intended for it to be for anything other than terminal physical illness. But it has invariably expanded - without further laws being passed - to wider conditions.

What we do have in the UK is less emphasis on individual rights and a wider recognition of social responsibility so my hope is that when this bill is passed the medical profession, others, and hospices - who seem to be against it - will self-regulate in a way that puts in the safeguards that have been voted down.

I am sorry but I do not think this is correct. One cannot use secondary legislation to turn the term "terminal condition" into "incurable non terminal condition" for example. And those countries in which the criterion is "irredeemable condition" selected that at the outset as distinct from terminal. It is intentionally broader.

You are also arguing against yourself, by saying on the one hand that the medical and other professionals are against it and so will self police, and on the other hand pointing to expansion of the boundaries of the legal definitions by medical and other professionals as your principal concern.

If you are against assisted dying in any form on moral grounds, that's fine and is an opinion that can be respected, even if one does not agree.

But this process of increasingly imaginative and convoluted "what ifs" is just unhelpful game of whackamole. That fact you are tying yourself in knots like this should tell you something.

 

[AuroraSaab]

Why was Naz Shah's ammendment voted down then? What you call 'What it's?' other people call looking at possible scenarios that might happen to vulnerable people.

When a parent worries about what will happen to their severely disabled child after they are gone, and whether a doctor or carer might put the idea in their head that their life isn't worth living, it's pretty callous of you to call that convoluted whataboutery.

I have some confidence that most medics will be cautious but I'd rather they didn't have to be. Of course, the ammendment for hospices to be exempt was voted down so they will be forced to take part in assisted dying despite their objections. The other effect may be that those medics who do wish to partake in the process might end up being those who are most enthusiastic.

 

[Psamathe]

But it is reversable with treatment

Does not say the patient has to accept that treatment, just that the disease/condition can be reversed with thretment.

If the condition progresses to eg kidney and/or liver failure to the extent that it cannot be treated then your condition becomes kidney and/or liver failure NOT anorexia (anorexia might be the cause but the condition is physical untreatable organ failure).

Ian

So basically you're incentivising those with a mental health issue into not eating or drinking in order to make their mental health issue into a terminal physical illness ...

No, I'm quoting what the proposed law states and that apparently means anorexia is excluded. Sorry but you are creating something I didn't say and this is where discussion gets just a daft waste of time.

There are a lot of behaviours that can cause serious medical conditions (self-inflicted) and that comes down more to how we treat mental illness ie to treat the anorexia and mental conditions.

Ian

 

[Psamathe]

For the purposes of this Act, a person is terminally ill if—
(1)(a) the person has an inevitably progressive illness or disease which cannot be reversed by treatment and ...

(3) For the avoidance of doubt, a person is not to be considered to be terminally ill only because they are a person with a disability or mental disorder (or both).

I don't know the details but the bill states

So it is reversible so they already don't qualify ie already covered by the law. Adding specific clauses that are already defined could potentially raise ambiguity as it raises the suggestion that eg whilst anorexia is specifically excluded bulimia isn't ...

Just because an amendment is rejected does not mean there is inadequate scrutiny and that there is inadequate safeguards.

Ian

I've already raised one possible reason but you keep throwing the same "but ..." out like it's some sort of proof the safeguards are flawed. There are reasons. Anorexia is already excluded.

Ian

 

[icowden]

In the meantime, for those that like this sort of thing, Henry Morris has an exclusive day in the life interview with Sir Keir
https://mrhenrymorris.substack.com/p/exclusive-my-interview-with-keir

 

[First Aspect]

So basically you're incentivising those with a mental health issue into not eating or drinking in order to make their mental health issue into a terminal physical illness ...

There goes another mole.

You probably need to be more informed about anoexia before posting bollocks reasoning like this.

 

[First Aspect]

Why was Naz Shah's ammendment voted down then? What you call 'What it's?' other people call looking at possible scenarios that might happen to vulnerable people.

When a parent worries about what will happen to their severely disabled child after they are gone, and whether a doctor or carer might put the idea in their head that their life isn't worth living, it's pretty callous of you to call that convoluted whataboutery.

I have some confidence that most medics will be cautious but I'd rather they didn't have to be. Of course, the ammendment for hospices to be exempt was voted down so they will be forced to take part in assisted dying despite their objections. The other effect may be that those medics who do wish to partake in the process might end up being those who are most enthusiastic.

As I say, whackamole. We talk about anorexia, which is refuted, so you pivot to me being callous about some other unrelated group.

It is analgous to me saying I don't like tomatoes and you accusing me of being against fruit.

No, I am not callous about disabled people. Happy to have a new and fact based discussion about concerns there.

For info, my late brother was profoundly disabled and I've just moved the length of the country to be closer to my still very much alive and vulnerable disabled brother in law. So fair warning - be very careful what else you level at me on this topic please.