News Euthanasia in the UK

rynnor

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http://www.bbc.co.uk/news/uk-england-20905820

I find this case disturbing for a number of reasons:

1. Hospital Trust went to court for the right to withold both resuscitation and treatment for Kidney disease - putting him on the 'Liverpool Care Pathway' against his families wishes.

2. The bloke caught the bugs that killed him when he attended that hospital.

3. The hospital has been given an injunction to keep their name secret - this is surely against the public interest - secret cases deciding on the fate of the poor :(
 

Deebs

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Boils down to my belief, let the suffering decide their fate. If I want to die then it is my choice noone elses. If I have not made a "will" then the state should keep me alive until I die.
 

mr.Blacky

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Don't know if there is more information but I did not read about that he caught the bug in the hospital.
I do not agree with the hospital deciding the right to live, that is first up to the patient then the family.

But keep you alive till you die? what if you needed a transplant, would that still be classed as keeping you alive?
 

Job

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Why dont they put people who have heart attacks and the heart wont restart on a heart lung machine till a donor becomes avialable..mainly i guess because it would require do much effort and resources.
 

opticle

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Have any of you ever actually seen CPR? Let alone given it? That is "resuscitation". It is fucking brutal and the survival rates are atrocious, as is the quality of life afterwards. Most likely if you are even were resuscitated, you would then spend weeks on intensive care like a vegetable, shitting yourself daily, with tubes in your lungs, stomach, bladder and veins, before finally dying. Making the decision to resuscitate people does not mean you withdraw treatment, it means you try not to condemn people to further suffering who have little chance of survival.

Sure, people have a right to survive if they wish - but do they have a right to force other people to do whatever it takes, regardless of the fact they know it is futile and regardless of the suffering it puts them through to attempt it? Particularly if going through that traumatic experience means there is no space or money left to do the same for the people who might actually have a hope of survival and quality of life otherwise? Because there wouldn't be. You are condemning more people to death and suffering that way.

It is not an easy decision and people do not take it lightly. But people with knowledge and understanding of the facts, not idealistic imaginings of how life works, have to do their best to make them. And at the end of the day, the law still makes it the Doctor's responsibility to decide what is the best and most right action to take in these situations. Medical staff are not slaves until the law changes. And should it? You want readers of the Sun and the Daily Mail to make those decisions? And if you think CPR should be given regardless.. when should it stop? Five cycles? Thirty? Do you have any idea how hard it is?

Also, the "Liverpool Care Pathway" exists to make people comfortable, nothing more. Don't believe all the bullshit you read in newspapers about the "Death Pathway". It is in no way like that and it can be reversed if the person improves. Again, it is not an easy decision taken lightly. Sometimes you have no choice but to give the person's body an opportunity to look after itself.

He contracted an infection and his condition worsened. He eventually suffered kidney failure and brain damage. The trust then decided it would not be in his best interest to resuscitate or treat him for his kidney condition.

This could have meant that he was no longer capable of swallowing safely, which means he would have to be fed by a tube for the rest of his life and is at constant risk of food/fluid/vomit entering his lungs and giving him further infections that would probably kill him before long. It could have meant he would also be incontinent of urine and faeces for the rest of his life and would piss and shit himself throughout the day, and have to lie in it until someone cleaned him, predisposing him to bedsores and further infections. Someone would have to be available to care for that, night and day. It may have meant he was no longer capable of breathing on his own, without a machine. It likely meant he would have to be connected to a machine for dialysis on a regular basis, and would be at constant risk of further infections and heart failure.

Where the fuck are you going to put these people, who are incapable of looking after themselves, and where are you going to find people to look after them, 24/7? There isn't enough money, or space or good people in the world. All you would be doing is condemning masses of people to suffer and many more to die due to a lack of resources.

Why dont they put people who have heart attacks and the heart wont restart on a heart lung machine till a donor becomes avialable..mainly i guess because it would require do much effort and resources.

Seriously?

Boils down to my belief, let the suffering decide their fate. If I want to die then it is my choice noone elses. If I have not made a "will" then the state should keep me alive until I die.

Seriously? How much do you want the state to do?

People need to wake up and accept that sometimes people die. It's shit, but it happens.
 

Scouse

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There isn't enough money, or space or good people in the world.

There's certainly enough money, there's definitely the space and you don't need good people - just well paid ones.

Having said that - apart from that I don't starkly disagree with a lot of your sentiment above.

BUT - having said that - I don't starkly disagree with many of the sentiments of the others.


/Scouse sits on fence shocker.
 

Raven

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Oh look. Another poorly written/researched BBC article.
 

Job

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Well i think yor explanation hits my accusation square on the head..not enough money or resources..technically posible..but unworkable in the real world until technology makes it feasable
 

rynnor

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Also, the "Liverpool Care Pathway" exists to make people comfortable, nothing more. Don't believe all the bullshit you read in newspapers about the "Death Pathway". It is in no way like that and it can be reversed if the person improves. Again, it is not an easy decision taken lightly. Sometimes you have no choice but to give the person's body an opportunity to look after itself.

It starves/dehydrates people to hasten their deaths thereby freeing up beds faster - problem is theres no really accurate way to tell if a person really is about to die so some people suffer on it un-neccesarily.

Resucitation is quite brutal but my suspicion in this case is that they didnt want to put him on a kidney dialysis machine due to shortages and the no resucitate rule helped them hasten him out the door.

Edit: I still cant see why the Hospital got the injunction preventing them being named - if this is just a normal medical decision why should they hide behind injunctions?

Its also not helpful because they clearly have a problem with hygiene and hospital infections and anonymity reduces the pressure to do anything about it.
 
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Chilly

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It's the same ethical question as whether to give someone an expensive course of drugs. There's a whole ethical framework in place to deciding that and it takes both societal and the individual's needs into account. At the end of the day, it's sometimes just too expensive to do things. Of course, if we sacked the navy and spent it all on drugs we'd have enough money for it all but we'd be fucked in any number of other ways.

That family should never have made it into the press. Nothing makes them particularly special, really. Both of my grandparents were in similar situations WRT quality of life (severe heart problems and alzheimers) and I honestly believe that the decisions, while quite brutal, to withdraw support were the correct ones. Of course I wanted them to live for ever, but that's childish.
 

rynnor

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There's a whole ethical framework in place to deciding that and it takes both societal and the individual's needs into account.

In practice its a party that has a view to the financial consequences that makes the decision - this fact robs it of an ethical basis.

These decisions should be looked at by a truly independant group if they are to be ethical.
 

Chilly

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In practice its a party that has a view to the financial consequences that makes the decision - this fact robs it of an ethical basis.

These decisions should be looked at by a truly independant group if they are to be ethical.
While technically true, they are still all doctors and doctors spend a lot of time studying ethics and training to make these calls. Even if there is a bit of a bias, I doubt there's a better way that's practical.
 

rynnor

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While technically true, they are still all doctors and doctors spend a lot of time studying ethics and training to make these calls. Even if there is a bit of a bias, I doubt there's a better way that's practical.

A panel with one medic and two non-medics would be ideal - wouldnt cost much either.

The problem with leaving it to medics is that they become de-humanised (its even encouraged in their training) and can only see 'quality of life' in terms of physical function - for that alone you need non-medics to balance that.
 

Rubber Bullets

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Well i think yor explanation hits my accusation square on the head..not enough money or resources..technically posible..but unworkable in the real world until technology makes it feasable

It's not about technology, or money, or even resources really. The real problem is that there were 80,000 deaths from coronary heart disease last year, and about the same number of heart attacks, someone dies of a heart attack every 7 minutes. And yet between 2011 and 2012 there were less than 4,000 organ transplant operations, and this despite over 18,000,000 people being on the transplant register!

Admittedly there is a high family refusal rate in this country of 45%, but even if you doubled the number of donors to account for this, and had 36m on the register to double it again that would still only offer a potential 16,000 possible donors against well in excess of 100,000 cases who might benefit.

RB
 

Job

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Yes of course, we'll have to grow hearts and other organs and keep them as tissue matched spares, then we'll need emergency temporary means of keeping blood flow till they can open you up.
All very do-able..and one day people will be amazed we went about our business with no organ backup.
A small battery powered device that a paramedic or even first aider and stick into your femerol arteries and provide enough steady flow to keep your brain alive, or even some oxygen releasing compound that can supply the brain for an hour or so.
Is anyone working on this stuff?
 

Rubber Bullets

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Its also not helpful because they clearly have a problem with hygiene and hospital infections and anonymity reduces the pressure to do anything about it.

There is no evidence at all that they have a bigger or smaller problem than any other hospital. It's difficult to find up to date figures, but it looks like there are at least 100,000 hospital acquired infections each year, of which possibly 20% will die either directly or as a secondary factor. At best it is estimated that this number can be reduced by up to 40% through best practise, and in reality probably less. The bottom line is that, by their nature, hospitals are full of people who are either infectious or who are immunosuppressed or at least immunodeficient or have invasive type treatments, open wounds and operation sites all of which make them more susceptible to the infections around them.

RB
 

Rubber Bullets

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Yes of course, we'll have to grow hearts and other organs and keep them as tissue matched spares, then we'll need emergency temporary means of keeping blood flow till they can open you up.
All very do-able.

Not at the moment it's not do-able, but you're right, who knows in the future.

As far as the portable device to keep blood flowing, yes it does exist, though placing it is pretty specialised, not for a paramedic, and certainly not for a first aider, but interventional radiologists or cardiologists can put them in.

RB
 

Job

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Jesus f christ, that pump seems more dangerous than it's worth.
Possible side effects..filling your brain with blood clots or air bubbles.
 

Rubber Bullets

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Jesus f christ, that pump seems more dangerous than it's worth.
Possible side effects..filling your brain with blood clots or air bubbles.

Which is why it is a specialist job to put it in :)

I've not seen one used, but have colleagues who have. It is only as a last resort, but they do help to keep people alive.

RB
 

rynnor

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It seems odd to me that the medics can get a court order to effectively withold treatment that will kill someone but an individual cannot consent to his own euthanasia - isnt that a little bit twisted?
 

sayward

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Haven't read every word here but I don't know how I feel about the twins 'killed'in Belgium because they would go blind......
 

old.Tohtori

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Your life should be by your hand only, even in criminal situations.

If someone wants to pop off the mortal coil, then they should be allowed to do so and no one should be allowed to make that choice for you, no matter how "evil" or braindead you seem to be by current science and morals.
 

Hawkwind

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Have any of you ever actually seen CPR? Let alone given it? That is "resuscitation". It is fucking brutal and the survival rates are atrocious, as is the quality of life afterwards. Most likely if you are even were resuscitated, you would then spend weeks on intensive care like a vegetable, shitting yourself daily, with tubes in your lungs, stomach, bladder and veins, before finally dying. Making the decision to resuscitate people does not mean you withdraw treatment, it means you try not to condemn people to further suffering who have little chance of survival.


My father had a heart attack aged 64 and suffered from Angina for years. He was given CPR, fitted with a pacemaker and lived until 75. His quality of life was excellent during those years. So not the case everyone.
 

old.Tohtori

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I always thought i should get a card, kind of a counter to those "do not resuscitate" things, that says "Do every f*cking thing you can and never pull the plug, ever."
 

Hawkwind

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I always thought i should get a card, kind of a counter to those "do not resuscitate" things, that says "Do every f*cking thing you can and never pull the plug, ever."

Woody Allen - I'm not scared of death, I just don't want to be there when it happens.
 

old.Tohtori

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I'm not adherent to death, would be interesting to meet her/him/it, but i'd rather meet him over a coffee tomorrow then today ;)
 

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