Tory MP Edward Leigh, insists that palliative care can prevent pain. "There is no need for [the fear of dying in pain]. When I talk to consultants, practitioners, in palliative care, they say that they can manage pain." This is not correct.
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Not everyone has a fear of dying in pain. They fear not dying for a long time, unable to do anything for themselves, with no reason to exist. For as long as it takes for their mind to shut down after their body has ceased to work.
Indeed. There is an underlying assumption in those arguing against AD that continued existence unconditionally has inherently value, regardless of any amount of suffering or meaninglessness. As someone who leans towards philosophical pessimism, it is a stance I entirely disagree with.
A 2019 report by the Office of Health Economics found that 21% of palliative care patients dying in hospitals had unrelieved pain. Its modelling concluded that even if we achieved the perfect level of palliative care, 50,709 palliative care patients a year would still die in some level of pain.
Though it also means that 79% of palliative care patients were *not* in this unrelieved pain palliative care situation. I always feel uncomfortable when percentages are used to make a particular case in a difficult and complex debate.
To be fair they do use the term "manage" not "remove". To me that means turn something from agony down to a level that can be endured. I remember my father and the use of morphine when he was dying of prostate cancer.
The repeated references to patients vomiting up faeces in their final moments also show that even if we could prevent pain, we would not prevent suffering. Morphine can do a lot. it can't do everything.
Same for my partner with a spinal injury. If he gets a BAD pain flare its an absolute NIGHTMARE trying to get doctors to START with the nuclear option for pain control as thats the ONLY thing that alleviates (but does not get rid of) it. Last time they started him on effin paracetamol and codeine 😣
And morphine is no refuge from fear – my mum had the most awful nightmares and hallucinations on it, the non-opiate alternative got rid of that but was less effective against her pain.
My sweet Gran was the least racist person you would ever meet. (Dated a black guy for years after her divorce.) On morphine at the end and started racially abusing the nurses. The nurses were lovely and said it happens a lot. Inhibitions disappear and a lot of dark thoughts surface.
My husband found morphine worked well for him. Then his doctor changed him to fentanyl which didn’t work. With days left to live it was a barbaric change to make. End of life care is shit in the UK.
Recall bawling my eyes out on a train at Clapham Junction reading the blog (of a friend of a friend) of their final days with cancer. Torn between the miserable mental suffering induced by the morphine and the miserable physical pain without it 😢
Friend of mine found out morphine has no effect on him when he was screaming in pain in hospital, took the doctors quite a while to work out why he was still in pain
I'm allergic to all standard painkillers (sulphates in virtually all, and codeine makes me vomit). I'm actually quite terrified of what might happen if I were facing a protracted death, as palliative care would be a nightmare for me.
I hope my heart just switches itself off before this scenario.
My 89 yr old father broke his hip. On morphine, waiting for the operation he hallucinated, pulled out his drip, attacked the nurses, tried to climb out of bed so they had to make up a mattress on the floor. He came through the operation though.
I second that. When I was given morphine for acute pain following extensive spinal surgery, it left me with quite vivid hallucinations, daydreams, and yes, nightmares. Fortunately, in my case none were as traumatising as the pain, but the fact remains they were impossible to distinguish from reality
That story from earlier about the man who ended up choking to death on his own faeces is just horrendous. That kind of death is nightmare fuel and any kind human must want to find a way to prevent that kind of scenario, the impact not only on the individual but their family and friends.
My dad had no pain, but there's no way to eliminate suffering for weeks on end. His lack of dignity (through no fault of the NHS but just the nature of his situation) and other types of suffering far outweighed pain anyway.
As if to directly counter him, the next person up is Labour MP Doctor Peter Prinsley. "When I was a young doctor I thought it unconcionable. But now I am an old doctor, and I feel sure it's the right change."
"I have seen uncontrollable pain. Chocking. And I am sorry to say the frightful sight of a man bleeding to death while conscious as a cancer has eaten away at the corroted artery. I know the terrifying loss of dignity and control in the last days of life."
David Davis, Tory MP, says he'll vote for the bill. He also takes a shot at James Cleverly. "I say to those who make procedural comments in this," he says, peering over his glasses, "second reading is a point of principle, not a point of conclusion."
Thank you for live tweeting this debate Ian. It feels like the bad old days of Brexit. This is the first time that I’ve felt that Bluesky was truly immediate and interactive like the old Twitter.
Thank you so much. I’m from the States. You are so far ahead of us in this matter. I’m happy for the UK that you have gotten this far. My own mom removed her bladder catheter so she would go into a coma. She spent ten years, in bed, in pain. Her ashes are scattered in Bath.
Tory MP Alicia Kearns. "For those whose religious beliefs drive their arguments today, I will always defend your right to practice your faith... But to deny choice to others, especially those with only 6 months to live where their personal choice does you no harm, is wrong."
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I am not claiming that is either right or wrong.
(My C-sections and hysterectomy post-ops with just ibuprofen and paracetamol were _not fun_)
I hope my heart just switches itself off before this scenario.
That poor man and his poor family.
My dad had no pain, but there's no way to eliminate suffering for weeks on end. His lack of dignity (through no fault of the NHS but just the nature of his situation) and other types of suffering far outweighed pain anyway.