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The morality of keeping people alive as late as possible with an ageing population

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The Ham

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Quantity of life over quality is the priority of our society.

Our society wanted my grandparents to be kept alive with severe dementia, no dignity or quality of life whatsoever purely for the sake of keeping them alive; as a society we value keeping people alive no matter what over the well-being of young people. No-one has the willpower and ability to change it. This pandemic has exposed this ludicrous situation.

Mods note - Split from this thread:

Hopefully what is written below comes across as what it is intended as, which is just a series of statements and there's not any strong emotions behind it (as an example I'm aware that there's certainly cases where people being able to die more easily is the case would certainly be better). Rather I'm just trying to highlight where they maybe problems with a change from where we are at in an area fraught with a minefield of emotive issues (and certainly the intention is not to cause upset or division but with such topics it is easy to cause an emotional response from those who have had to deal with circumstances which are beyond my experience).

It is fairly much off topic (so feel to skip over it) to the extent that I also suggest that if people wish to discuss the implications further that a new thread is started.

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There's a significant moral issues with judging if someone should be given the ability to die before they actually do naturally.

Within the current situation it's still a difficult call, as even though there maybe families who accept that their relatives time has come, allowing them to be deliberately infected with Covid-19 (even with a DNR in place) may just result in undue suffering and take up NHS resources which could result others dying if the NHS is stretched too much.

Age is not guarantee that someone will die, as I'm aware of a relative of someone I know being mid nineties and only being aware that they had Covid-19 because they had a test before they were due to be vaccinated. Otherwise they had no symptoms.

Whilst it's clearly mentally hard on a lot of young people, few would argue that significant numbers will actually die and so the decision results in then suffering.

The problem is with how far are you willing to go? Do we do to the extent that there's too many over 70's taking up too many large family homes, which causes younger people to suffer due to them not being able to live in housing which perhaps better suits them which causes stress and financial hardship.

Whilst only my dad is currently over 70, both my and my wife's parents live in large 5 bedroom houses whilst we live (with 3 children) in a relatively small 3 bedroom house. Whilst it's possible that we might be able to get a larger house, locally it would cost us £100,000 for an extra bedroom, but even then actually the rest of the property would be reduced (typically going to a town house with a small kitchen and smaller garden).

We could move to a cheaper area, however that would come with quality of life issues which also has financial costs (currently I can walk to work, so can drop the children off at school/childcare if I couldn't walk/cycle to work, which would be the case with my current job and living in a cheaper area, then the children would need to be in wrap around care for longer and we'd have extra transport costs).

Now I'm not saying that we hard done by (we are fairly happy with what we have and with the course choses we've made), rather that there's an arguement that younger people can suffer in many different ways because of the impact of older people (especially if it's thought that there's too many of them) and that's it's difficult to know where the line should be in balancing between people being alive and the quality of life for everyone else.

As such the current position is that people are sometimes kept alive for longer than maybe it's good for them, however there's no risk of them being bumped off early.

Taking another personal example, if my grandparents (all the are in their 90's) were to die (and some of them have a lower quality of life then they would maybe like to have due to illness) then we'd probably inherit enough money to significantly help us with living in a larger house (either by moving or extending).

Now whilst I wouldn't wish to see my grandparents harm, there could definitely be cases (if the line shifted away from the status quo) where people would have a very strong pull towards helping their family members die as it would help them a lot financially.

Quite possibly to the extent where they would be commuting fraud (at least financially benefiting from overstating the case) and potentially murder (at least a planned killing, if it's legal or not may be within an area of grey). That's likely to cause a whole world of moral issues and isn't something that as a society that many are willing to investigate.

Until we are, then it's likely to cause other moral questions, but unless they are causing significant deaths it's not likely to change.

I once read something which was looking at a world where, due to limits being needed on population size everyone for to live until they were 40.

That's an extreme swing the other way from where we're at, but once the swing starts it's likely that it would overshoot where many (and that may only be 10% of the population, and so would still be very much in the minority) would be willing to let it go.

Anyway, as I've already suggested, this is fairly off topic and if anyone would like to discuss it much further I suggest that a new thread is started.
 
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ABB125

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Mods note - Split from this thread:

Hopefully what is written below comes across as what it is intended as, which is just a series of statements and there's not any strong emotions behind it (as an example I'm aware that there's certainly cases where people being able to die more easily is the case would certainly be better). Rather I'm just trying to highlight where they maybe problems with a change from where we are at in an area fraught with a minefield of emotive issues (and certainly the intention is not to cause upset or division but with such topics it is easy to cause an emotional response from those who have had to deal with circumstances which are beyond my experience).

It is fairly much off topic (so feel to skip over it) to the extent that I also suggest that if people wish to discuss the implications further that a new thread is started.

----------------------------------------------------------

There's a significant moral issues with judging if someone should be given the ability to die before they actually do naturally.

Within the current situation it's still a difficult call, as even though there maybe families who accept that their relatives time has come, allowing them to be deliberately infected with Covid-19 (even with a DNR in place) may just result in undue suffering and take up NHS resources which could result others dying if the NHS is stretched too much.

Age is not guarantee that someone will die, as I'm aware of a relative of someone I know being mid nineties and only being aware that they had Covid-19 because they had a test before they were due to be vaccinated. Otherwise they had no symptoms.

Whilst it's clearly mentally hard on a lot of young people, few would argue that significant numbers will actually die and so the decision results in then suffering.

The problem is with how far are you willing to go? Do we do to the extent that there's too many over 70's taking up too many large family homes, which causes younger people to suffer due to them not being able to live in housing which perhaps better suits them which causes stress and financial hardship.

Whilst only my dad is currently over 70, both my and my wife's parents live in large 5 bedroom houses whilst we live (with 3 children) in a relatively small 3 bedroom house. Whilst it's possible that we might be able to get a larger house, locally it would cost us £100,000 for an extra bedroom, but even then actually the rest of the property would be reduced (typically going to a town house with a small kitchen and smaller garden).

We could move to a cheaper area, however that would come with quality of life issues which also has financial costs (currently I can walk to work, so can drop the children off at school/childcare if I couldn't walk/cycle to work, which would be the case with my current job and living in a cheaper area, then the children would need to be in wrap around care for longer and we'd have extra transport costs).

Now I'm not saying that we hard done by (we are fairly happy with what we have and with the course choses we've made), rather that there's an arguement that younger people can suffer in many different ways because of the impact of older people (especially if it's thought that there's too many of them) and that's it's difficult to know where the line should be in balancing between people being alive and the quality of life for everyone else.

As such the current position is that people are sometimes kept alive for longer than maybe it's good for them, however there's no risk of them being bumped off early.

Taking another personal example, if my grandparents (all the are in their 90's) were to die (and some of them have a lower quality of life then they would maybe like to have due to illness) then we'd probably inherit enough money to significantly help us with living in a larger house (either by moving or extending).

Now whilst I wouldn't wish to see my grandparents harm, there could definitely be cases (if the line shifted away from the status quo) where people would have a very strong pull towards helping their family members die as it would help them a lot financially.

Quite possibly to the extent where they would be commuting fraud (at least financially benefiting from overstating the case) and potentially murder (at least a planned killing, if it's legal or not may be within an area of grey). That's likely to cause a whole world of moral issues and isn't something that as a society that many are willing to investigate.

Until we are, then it's likely to cause other moral questions, but unless they are causing significant deaths it's not likely to change.

I once read something which was looking at a world where, due to limits being needed on population size everyone for to live until they were 40.

That's an extreme swing the other way from where we're at, but once the swing starts it's likely that it would overshoot where many (and that may only be 10% of the population, and so would still be very much in the minority) would be willing to let it go.

Anyway, as I've already suggested, this is fairly off topic and if anyone would like to discuss it much further I suggest that a new thread is started.
It's a tricky question, full of grey areas...

For example, I have no objection to people with terminal illnesses wanting to "get it over and done with", especially if they're likely to suffer degraded health as the illness progresses. HOWEVER, there is the issue of potentially unscrupulous relatives who might encourage one course of action in order to benefit financially (or in some other way). There would need to be safeguards in place to prevent any "influence" on the person making the decision.
Another issue: what to do if, for example, someone is in a coma and extremely unlikely to wake up? They can't decide that they want the plug to be pulled on whatever machinery is keeping them alive.
Furthermore, medical advances might mean that someone who decided to end their life because of an illness could actually have been cured had they waited a few more years (although is it right that a person should potentially suffer a few years of agony in the hope that a cure can be found?).
And then there is the potential for legal action being taken by the deceased's family against the doctor/advisor/whoever that administered the death/put the idea into the deceased's mind etc. Some sort of legal document regarding the death would probably have to be signed by all relevant parties to ensure that once the death has occurred, no further action can be taken.

Lots of moral and ethical questions.
Personally I support the principle of euthanasia, but I can see that it would cause a huge number of issues, with many cans of worms would feel the bite of the tin opener...
 

RichT54

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I will shortly turn 67 and am increasingly getting the feeling of resentment directed towards older people for many of the reasons given above. Already some health issues are making themselves known, but my big fear would be to suffer 13 years of increasing dementia as my mother did before she passed away aged 93. I imagine this discussion will intensify over the next few years as the financial situation deteriorates due to covid and brexit. What value would my life have then?
 

WelshBluebird

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HOWEVER, there is the issue of potentially unscrupulous relatives who might encourage one course of action in order to benefit financially (or in some other way). There would need to be safeguards in place to prevent any "influence" on the person making the decision.
This is the big concern for me.

My gran had dementia and we as a family (my parents and I) looked after her for the first few years before involving the council and having carers visit to help her several times a day once it got worse (whilst still being involved ourselves when the carers weren't around).
It was horrific, both in terms of seeing someone you love lose the person they are, but also on the impact on us of losing a lot of our free time, and just the emotional and physical labour of it all.

Many people I know have made comments similar to saying "if I ended up like that I'd rather be shot" or whatever, basically saying they would want to take their own life if they were in that position. Based on my experience with my Gran, my concerns are that once it starts to happen you are too late to make that decision yourself as you are no longer of sane mind. That means someone else has to make that decision, presumably based on a living will or something similar. That leaves it wide open to abuse, especially when that person who has to make the decision is under the pressure that being a carer for a relative brings (and that is before you get into cases where a relative gets to benefit hugely from the inheritance they could get).

In terms of abuse, there's also the question how healthcare / carer staff. Sure, the vast majority are saints. It is a job that I could not do. But there are some utter ***** who use the job as a cover for crime. Stories of money being stolen, or staff being physically or mentally abusive to people they are caring for are not unheard of. It would terrify me if those people were in a position to shift the conversation to allowing someone to be "put to sleep" (for lack of a better phrase).

Then, there are also the moments of clarity that people do get. Even my gran, whilst she couldn't remember who I was most of the time, in her last few months asked my how my university course was going (I was about a year into my course when she passed away, and no other member of the family had been to university, so it is fairly obvious she was herself even for that short bit of time). It is a much easier conversation to have if you assume the person has totally gone when it comes to something like dementia, but the reality is far more complicated.

All of that isn't to say not remembering who anyone is or how to do anything is a life that is worth living, or a life I'd want to live, so I don't really know what the answer is!
 
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david1212

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Having seen the last years of life for both my parents fall below what would be considered a reasonable quality and dignity of life I have a strong view on this.

We have no issue ending the life of an animal at the point where it is considered inhuman to consider life extension but there is no option for ourselves.

Of course there are issues not least when taken on behalf or another when there is personal gain.

What I wish I could do right now is complete a detailed form that would give set of conditions that I consider to be the limit of acceptable quality and dignity of life. Then in the future these could be independently assessed by at least two people. If they are not met they are reviewed monthly. If after three months there is no significant improvement nor is this likely short of a biblical style miracle then my life would be terminated.
 

21C101

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To me there is a difference between not medicating except for that needed to keep them comfortable and not feeding/watering or "putting down" which crosses a line.

While on one side callous relatives wanting someone gone is a factor, on the other side is going to extraprdinary lengths to revive someone and keep them alive rather than letting nature take its course.

While Covid has brought this into relief, I suspect the powers that be are panicked more by the fact that the great and good I suspect have more liklihood of a history of drug use and prevalence of certain medical conditions that make them more vulnerable to covid, than over caution about working class grannies.
 
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Scotrail12

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I don't think it's moral at all to keep someone alive just for the sake of them being alive. And it certainly gives me horror when I hear that future generations (including my own potentially) are apparently able to live for even longer than current generations. That bothers me because there is a lack of clarity on the quality of life. Are they just going to keep people alive for 20 extra years in a care home not able to do anything? I would definitely say that that is the biggest worry.

I want to live with a good quality of life and value quantity over quality. I do not want to be in any kind of state which is below the standards of a good quality of life at any point. If I couldn't do anything for myself and didn't know who I was or where I am, then frankly I wouldn't want to be there. And if I had kids, I certainly would not want to be a burden on them either.
 

WelshBluebird

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It's whether someone wants to stay alive that matters.
  1. The issue is, in a lot of these cases, the person in question doesn't necessarily have the mental capacity to decide such a thing for themselves.
  2. If it is just a question of the person wanting to stay alive - why do we try to stop people of all ages from taking their own lives by means of suicide? By your logic surely we should just let them?
If I couldn't do anything for myself and didn't know who I was or where I am, then frankly I wouldn't want to be there
But in terms of something like assisted dying etc, how do you make that decision?
If you "don't know who you are" then you certainly aren't going to be in any fit mental state to make such a huge decision, so presumably it would have to be based on a prearranged decision by the likes of a living will or similar, and in that case as I said in my original post, what safeguards do we put in place to make sure that isn't be abused?
And if I had kids, I certainly would not want to be a burden on them either.
Another bit I find an issue with, as people see "burden" as very different things.
Even before my Gran had anything wrong with her, she would often see us helping her out with shopping etc (as she was a little less mobile) as her being a burden on us. Of course she wasn't - we were just helping a close relative. But it is subjective to the person isn't it, not objective. The only people who can answer truthfully are the people who are helping / caring, and quite often they aren't in a fit state to make such a decision either (or as I've said a few times now, are in a position where they can abuse that power greatly if they so want).
 

Scotrail12

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But in terms of something like assisted dying etc, how do you make that decision?
If you "don't know who you are" then you certainly aren't going to be in any fit mental state to make such a huge decision, so presumably it would have to be based on a prearranged decision by the likes of a living will or similar, and in that case as I said in my original post, what safeguards do we put in place to make sure that isn't be abused?

Another bit I find an issue with, as people see "burden" as very different things.
Even before my Gran had anything wrong with her, she would often see us helping her out with shopping etc (as she was a little less mobile) as her being a burden on us. Of course she wasn't - we were just helping a close relative. But it is subjective to the person isn't it, not objective. The only people who can answer truthfully are the people who are helping / caring, and quite often they aren't in a fit state to make such a decision either (or as I've said a few times now, are in a position where they can abuse that power greatly if they so want).
I'd probably look into getting a living will (definitely before I had kids old enough to have any input on it, hence avoiding potential abuse) and would try and have it in an official document that I wouldn't want to remain alive if in a sub standard quality of life, particularly if it's one that I wouldn't be able to come back from.

I've probably got 55-60 years before I'm elderly so hopefully in that time, assisted suicide will be legalised here.
 

WelshBluebird

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I'd probably look into getting a living will (definitely before I had kids old enough to have any input on it, hence avoiding potential abuse) and would try and have it in an official document that I wouldn't want to remain alive if in a sub standard quality of life, particularly if it's one that I wouldn't be able to come back from.

I've probably got 55-60 years before I'm elderly so hopefully in that time, assisted suicide will be legalised here.
I guess the problem is, in terms of the NHS, for a living will type document you have to specifically specify what kind of treatments you do not want to have. You can't just say "don't treat me" as far as I am aware. And even if you could, there still has to be some kind of judgement about if you are in that state, and that is where it is open to abuse.
 
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