UK legislation. Courts. End of life. Who decides?

It appears I may have some as yet unknown degenerative condition of some part of my nervous system which is as yet undiagnosed.
Now my story of care which I am getting here in the UK is irrelevant to my question of who decides my final fate. MRI scans, CT scans, pretty much everything available to discover what is broken with me is not the issue in this OP, I'm getting it from the NHS so I'm more than happy and not complaining.

The question in this thread is who finally decides how my fate pans out? Me or the state?

In the UK it is illegal for anyone to assist me to kill myself, and it is also illegal for doctors to give me a massive shot of morphine to end my life, even if I'm of sound mind and request the procedure due to no quality of life.
The only option legally available to UK doctors sanctioned by the state is death by removing nutrients/food so I would starve to death, no morphine shot for me because I'm human, yet it is illegal to starve a sick dog to death, you are expected to use drugs to kill them humanely.

My family and friends know if I am reaching a point where the future looks like having my ass wiped by carers and assisted to eat and drink then I don't want it. The trouble is though it is illegal for any of my loved ones to help me with that so my only option will be to see it coming and do it myself while I can.

Of course, in conversations with loved ones, everyone has agreed they'll help me on the sly, maybe scoring heroin off a dealer for me if my mobility prevents me doing it myself, then letting me inject myself. But the fact remains, all of that is illegal.

The British state only allows doctors to remove access to fluids/nutrition to either die slowly from starvation or dehydration.
I assert that is unethical and inhumane.

Thoughts welcome.
EDIT
Don't be concerned with 'sorry for your condition' in your replies here, it is what it is, I just used it as a good template for relevant discussion.
I'm solely considering the 'who decides how someone of sound mind dies" issue inspired by my own potential experiences.
Don't pull punches in this debate.

sorry to hear about your poor health as someone who has been involved in these decisions let me give you my view on this question at the heart of your OP.

The question in this thread is who finally decides how my fate pans out? Me or the state?

The simple answer is that the medical team who are looking after you decide your fate, the real answer however is slightly more complex.

As a adult who is deemed to have full mental capacity you can decide what treatments you do and do not accept, if you say you don't want chemo, nobody is going to force you, if you want a DNR order, its yours. This also applies if you have a individual who has a power of attorney legally applied (at least in Scotland but the rest of the UK has similar laws). In most cases though if your next of kin says "he would not want x, y an z" then those wishes will be respected.

Now in much the same way as you don't have any obligation to accept any treatment the opposite is kind of also true in so much as its not always a legal requirement for the medical team to offer you everything. Now this is much more complex but lets say its deemed that chemo would be ineffective for you then even if you request it they don't have to provide it, just like if you say you want to be resuscitated but the view of the medical team is that it would be futile then you will not be resuscitated.

This is a ethical minefield and I honestly do not believe it can be fully explored on a thread on ATS.

I would also add that nobody is really "starved to death", it just gets to a point where you either cannot independently take any oral diet or where it does not matter if you do or not and their is no obligation for other forms of nutrition to be provided. Nobody is starved to death rather they usually die because the sepsis gets to the point where their organs are all shutting down to the point where it no longer matters if they are getting nutrition or not. This idea that people are starved to death is a myth based on the ignorance of reporters who have never actually spent a single day caring for a dying person.

It comes to a point where providing things like food, fluids, anti-biotic, oxygen therapy and all the rest of it is only prolonging the inevitable and immolate death of a individual in that case it becomes a cruelty in my view to continue to provide these interventions. Watching someone die strapped into a NIV mask is not nice.

The decision to withdraw care is always done in consultation with family and if possible the patient but ultimately it is the decision of the mental team. Such decisions are not made lightly and those who make them are held accountable to the courts, NMC, GMC, RPS or whoever.

I personally believe that in the west our views on death and dying are totally messed up. Death is the inevitable final chapter of life, it will happen to us all and in the west I think we have developed this absurd idea that we should keep everyone alive for as long as possible regardless of their wishes or their quality of life. I think what is more important than this is to have a dignified and compassionate death, dying in your soiled bedsheets surrounded with tubes coming out of ever orifice as a bunch of strangers watch your poor family fall to bits its the opposite of that. We I believe need to change our focus from the current way we do things which is to say, preserve life at all costs no matter what towards a model that favours compassionate and dignified deaths.

When your time comes OP I hope your death is as compassionate and dignified as I hope my own one day will be, in your own bed surrounded by your family laughing hard at all the good memories you have gifted them.

originally posted by: CornishCeltGuy

The question in this thread is who finally decides how my fate pans out? Me or the state?

You do. while you are of sound mind

In the UK it is illegal for anyone to assist me to kill myself, and it is also illegal for doctors to give me a massive shot of morphine to end my life, even if I'm of sound mind and request the procedure due to no quality of life.
The only option legally available to UK doctors sanctioned by the state is death by removing nutrients/food so I would starve to death, no morphine shot for me because I'm human, yet it is illegal to starve a sick dog to death, you are expected to use drugs to kill them humanely.

If anyone helps you its murder.

You do it its suicide, but you have achieved your aim!

My family and friends know if I am reaching a point where the future looks like having my ass wiped by carers and assisted to eat and drink then I don't want it. The trouble is though it is illegal for any of my loved ones to help me with that so my only option will be to see it coming and do it myself while I can.

Thats what I said

Of course, in conversations with loved ones, everyone has agreed they'll help me on the sly, maybe scoring heroin off a dealer for me if my mobility prevents me doing it myself, then letting me inject myself. But the fact remains, all of that is illegal.

There are much easier ways.

originally posted by: OtherSideOfTheCoin
I personally believe that int he west our views on death and dying are totally messed up. Death is the inevitable final chapter of life, it will happen to us all and in the west I think we have developed this absurd idea that we should keep everyone alive for as long as possible regardless of their wishes or their quality of life. I think what is more important than this is to have a dignified and compassionate death, dying in your soiled bedsheets surrounded with tubes coming out of ever orifice as a bunch of strangers watch your poor family fall to bits its the opposite of that.

Agreed, but it is illegal for anyone to assist me in making that choice.
I will have to do it myself before I'm incapable of doing it. If left too late then a nice shot of morphine is illegal for any healthcare professional to assist me...even while I am sound of mind.

The only way UK healthcare can legally end my life is through starvation or dehydration through removal of food/fluid which I may be unable to provide for myself. Slow euthanasia while suffering. My son/best mate cannot legally help me do it on my terms.

I assert that the legislation in the UK is inhamane for that reason.

a reply to: CornishCeltGuy

Sorry for your condition and I wish you the best

Yes as we have discussed in the other thread, the fact that you do not get to make the decision on your own health is unthinkable

Notice how other side of the coin admits that if you want to pay for chemo yourself, and the nhs says no, they can force you to not get chemo even if you want to pay for it yourself from an outside provider

This is insanity, a nightmare where judges determine what treatments are best for you, and where and when you should have to die

originally posted by: eletheia
There are much easier ways.

Of course, hose from the exhaust pipe from a car, whatever, my point remains, who the # is the state to say I cannot choose something other than removal of care and nutrients over something which involves less suffering when I make the decision while of sound mind?

a reply to: CornishCeltGuy

I support euthanasia but you are just flat out wrong to say that its happening in the UK with the removal of food and fluids.

When it gets to a point where you have terminal multiple organ failure then it does not matter if you if you have food or not you will die. If you can take food then you will be provided with food.

You are making it sound like we just stop feeding people witch is just simply not the reality.

a reply to: Grambler

Notice how other side of the coin admits that if you want to pay for chemo yourself, and the nhs says no, they can force you to not get chemo even if you want to pay for it yourself from an outside provider

Notice how I didn't actually say that....

if you want to go private then you can go private and if they are willing to give you chemo then go for it, but they NHS are not obliged to provide you with a treatment that is not going to offer up any benefit just because you want it after reading a few wiki pages or something.

originally posted by: Grambler
Notice how other side of the coin admits that if you want to pay for chemo yourself, and the nhs says no, they can force you to not get chemo even if you want to pay for it yourself from an outside provider

This is insanity, a nightmare where judges determine what treatments are best for you, and where and when you should have to die

It is insanity.
Illegal for my loved ones to assist me if I reach that point, and illegal for doctors to do it with a nice shot of morphine, but legal for them to withdraw nutrients so I starve slowly to death. Madness.

a reply to: OtherSideOfTheCoin

Well said. A rational view of it.

originally posted by: OtherSideOfTheCoin
a reply to: CornishCeltGuy

I support euthanasia but you are just flat out wrong to say that its happening in the UK with the removal of food and fluids.

When it gets to a point where you have terminal multiple organ failure then it does not matter if you if you have food or not you will die. If you can take food then you will be provided with food.

You are making it sound like we just stop feeding people witch is just simply not the reality.

The child in Liverpool is breathing with the help of ocassional mouth to mouth from his parents, but the doctors are authorised to withdraw fluids/nutrition with the intent that he dies. It seems that way to me, why not authorise a decent morphine overdose?
It is euthanasia just the same.

a reply to: CornishCeltGuy

but legal for them to withdraw nutrients so I starve slowly to death. Madness.

Again we are not taking food away from anyone.

When you are so sick that you cannot eat and your kidneys have packed in, your liver is just building up toxins and your body is starting to shut down due to sepsis or your cancer has progressed to the point your totally cachexic and it's is killing you then their reaches a point where their is no point in providing nutritional support.

originally posted by: CornishCeltGuy

originally posted by: OtherSideOfTheCoin
a reply to: CornishCeltGuy

I support euthanasia but you are just flat out wrong to say that its happening in the UK with the removal of food and fluids.

When it gets to a point where you have terminal multiple organ failure then it does not matter if you if you have food or not you will die. If you can take food then you will be provided with food.

You are making it sound like we just stop feeding people witch is just simply not the reality.

The child in Liverpool is breathing with the help of ocassional mouth to mouth from his parents, but the doctors are authorised to withdraw fluids/nutrition with the intent that he dies. It seems that way to me, why not authorise a decent morphine overdose?
It is euthanasia just the same.

I am sorry but is this thread about who makes medical decisions regarding life and death or is it about Alfie Evans or is it about euthanasia because it seems like you are trying to mix up these three issues into one.

I dont quite know where you want to go with this.

originally posted by: CornishCeltGuy
Of course, hose from the exhaust pipe from a car, whatever, my point remains, who the # is the state to say I cannot choose something other than removal of care and nutrients over something which involves less suffering when I make the decision while of sound mind?

Because when Doctors, or family are involved in assisting it is assisting/procuring

a death which is murder. Suicide has a stigma, but in my eyes if you have come

to the end of the line, and dont do it in a sensational manner, who cares its your

life and you are in control of the end, in the same way as you have lived it......

Anyway thats how I see it.

Oops .....gremlins

originally posted by: OtherSideOfTheCoin
a reply to: CornishCeltGuy

I support euthanasia but you are just flat out wrong to say that its happening in the UK with the removal of food and fluids.

When it gets to a point where you have terminal multiple organ failure then it does not matter if you if you have food or not you will die. If you can take food then you will be provided with food.

You are making it sound like we just stop feeding people witch is just simply not the reality.

They will not give be Alfie a feeding tube, and are using the police to ensure that the family does not get the child to qualified doctors that do want to give him a feeding tube

So yes, they are starving him

originally posted by: OtherSideOfTheCoin
a reply to: Grambler

Notice how other side of the coin admits that if you want to pay for chemo yourself, and the nhs says no, they can force you to not get chemo even if you want to pay for it yourself from an outside provider

Notice how I didn't actually say that....

if you want to go private then you can go private and if they are willing to give you chemo then go for it, but they NHS are not obliged to provide you with a treatment that is not going to offer up any benefit just because you want it after reading a few wiki pages or something.

Perhaps I misread you

If you can just chose to go private why can Alfies parents not take him to Italy for care?

a reply to: OtherSideOfTheCoin

But what if it does?

The UK makes decisions on what treatments they will and won't provide based on cost effectiveness and a bell curve. True most people lie inside that curve, but what about the ones who lie on the outside and would be helped by those extraordinary measures?

What about conditions like migraine that are highly individual where not every sufferer responds the same way and sometimes, the disease needs to be treated with an individualized approach rather than simply saying, "Well, this is our approved therapy, and if it doesn't work for you ... well, here's your nice disability check."

a reply to: Grambler

Because The State has to be right. If a high profile case like that one escapes and, heaven forbid, the kid gets better (no matter how unlikely it is), then people might start to question the judgments from on high more often.

It's about power and control.

originally posted by: OtherSideOfTheCoin

originally posted by: CornishCeltGuy

originally posted by: OtherSideOfTheCoin
a reply to: CornishCeltGuy

I support euthanasia but you are just flat out wrong to say that its happening in the UK with the removal of food and fluids.

When it gets to a point where you have terminal multiple organ failure then it does not matter if you if you have food or not you will die. If you can take food then you will be provided with food.

You are making it sound like we just stop feeding people witch is just simply not the reality.

The child in Liverpool is breathing with the help of ocassional mouth to mouth from his parents, but the doctors are authorised to withdraw fluids/nutrition with the intent that he dies. It seems that way to me, why not authorise a decent morphine overdose?
It is euthanasia just the same.

I am sorry but is this thread about who makes medical decisions regarding life and death or is it about Alfie Evans or is it about euthanasia because it seems like you are trying to mix up these three issues into one.

I dont quite know where you want to go with this.

It was inspired by current events so a wide brush of discussion.
If it is relevant to 'end of life' decisions by the UK then such discussion is welcome here.
Nobody is forcing you to participate in this general discussion of the state deciding how someone dies.