Monday, 2 June 2008

Right to die……..

A controversial new "right to die" card is being offered to the public in Salford (England) that allows anyone to refuse treatment in a medical emergency.

Salford's card scheme was dreamed up by just one person. The woman is involved with social care services in Salford because she has a son with mental health problems. Available in pubs, banks, libraries, GP surgeries, even some churches and by Salford Council, the Advanced Decision to Refuse Treatment (ADRT) card sits snugly in a wallet or purse and instructs a doctor to withhold treatment should the carrier lose the capacity to make decisions, because of an accident or illness.

Its backers say it is a practical way of implementing the Mental Capacity Act, which came into force in 2007. The act allows adults to draw up "advance directives" stating what sort of treatment they don't want should they lose capacity. They build on the principle of "living wills" but, crucially, mean that doctors are legally bound to abide by a patient's wish to refuse life-sustaining treatment. Carrying the card alerts anyone who finds it that the patient has made decisions about treatment, and there is a detailed statement to be found with named relatives or friends and, ideally, their GP.

Pro-life campaigners say they could be snapped up in haste by people who haven't fully understood the complexity of the issues involved. One of their concerns is that the things people want when they are well are very different to those they want when they are unwell, their values change.

One person who is carrying the card said she started thinking seriously about her rights some years ago, while working as a nursing assistant. Having watched a young woman go through a slow and painful death from Huntington's disease and cancer, she knew she would never want a similar experience. She had seen her father go through it and knew what was coming, she said she didn't want to die like he had, but she hadn't written anything down and her mother and carers had to watch her go through exactly the same thing. It made me think about my options and my rights. Would I be able to make decisions if I knew what might be coming?

I can understand the reasoning behind the card and feel it is probably a good idea like carrying an organ donor card – which I do – but I can’t help but wonder what medic would have the time, in an emergency situation to try to determine if the patient was carrying any sort of card?

I am all for introducing the ‘opt out’ system, for both organ donorship and right to die, on a national computerised system, whereby if you’re NOT on it medics can harvest your organs and put you on life support. That would save carrying cards – the information would be there at the click of a button.

What do you think?


Crazy Working Mom said...

I've never heard of this card, but I think that your idea is brilliant!
CrAzY Working Mom

Unknown said...

The cards are a good idea. Here in the states one must have created what is called “A Living Will” in order for extraordinary life support not to be provided. The primary problem is that the medical facility must have a copy of the Living Will to act upon it. Most folks don’t carry their wills of any sort with them.

As for organ donation, one can authorize that by sign a spot on one’s driver’s license.

I think the idea of a national computer register is excellent. The problem with that here in the U.S. is that the various States have different laws governing both right to die and organ donation. Another slight problem is, believe it or not, there really are places in this country, including hospitals, which do not have Internet access.

Flowerpot said...

I've heard a lot about this card and also the thing about organ donorship - yes I agree, better to opt out rather than opt in.

Marjolein said...

But when they're taking you to hospital in an ambulance for example, it would be easier for the medics to trace such a card than to call to hospital and find someone who could check your status in a computer system.

Empress Bee (of the high sea) said...

i believe the right to die is the final freedom. but having said that, i don't think a medic should be looking for this. people can recover from things you would not think they could. i think a family member should have the document and produce it when needed. did you recently see the woman that had been dead for seventeen hours come back? and she is fine? yup. be careful what you wish for honey. and one other thing: the older you get (closer) the more you think about these things! ha ha ha

have a great day my friend!

smiles, bee

Marshall Family said...

I like the opt out idea very much, only thing is the government just don't want to dish our taxes out to pay for something we want and would rather use it towards somethign useless like a war which doesn't want to end :o)

cards are a good thing no doubt about it, rather like ICE (in case of emergency numbers) in ones phone but do the professionals have the time to look for this info?

The guv/nhs should really look into creating a database or adding these details (donor/right to die) onto our NHS records or somthing.

Akelamalu said...

I think the card is quite new Tisha.

I suppose not having internet access would complicate matters Nick. As for indicating on your driving licence re organ donation, that wouldn't work her because it's not compulsory to carry your driving licence here.

I've heard a lot of people say they like the idea of opting out better than having to carry a card Flowerpot

I was envisaging ambulances carrying a palm computer connected to the National database which would be easy for them to check Marjolein

I don't want to opt out of medical treatment at all Bee I just thought for those that do a National Computerised system would be better. I want every treatment that's going I don't want to die!

I so agree with you Emma Jayne!

maryt/theteach said...

Akalamalu, such a difficult question! I certainly don't want my life extended by artificial means but do I want to refuse emergency medical treatment- I don't know. It is just like carrying an organ donor card and I'm sure medical techs do go looking for the donor card when the possibility of harvesting organs is present... I believe in t he right to die - we have a right to say "No more." or "No, not at all." But I guess we always hope there's hope...right?

CG said...

I would like the right to choose to die in certain circumstances but somehow I'm not convinced by the idea of this card....

david mcmahon said...

Here in Australia, would-be organ donors go on a national register and have a special notation on driving licences.

Donnetta said...

Oh, I agree with cg. I'll just have to think about this a bit more. This is a tough one.

Julia Phillips Smith said...

My father-in-law told the medical team treating him "No heroics." That quickly turned into managing his departure from this earth - with no heroics, as he requested. When there is no point, there is no point. So far, with the three loved ones here in Canada I've been with as they passed away, the medical staff respected the wishes of the dying and didn't intervene unnecessarily. On the contrary, I saw only compassionate care of symptoms as the body slowly shut down of its own accord.

Travis Cody said...

I think that the first responsibility of emergency responders is to save life. That's what their focus is.

But at some point a victim's wallet or purse will be searched for identification. So my interpretation of such a card would be that once it is found, any further extraordinary measures would be stopped per the victim's wishes.

Just as I would expect medical personnel to find my organ donor permissions on my drivers license, I would expect them to see this card - were I to carry it - right behind my drivers license.

I do like the idea of a national registry. But for those who are not captured on such a thing, I like the idea of something I can carry on my person that can be quickly noted.

Good question today!

Ron said...

Wonderful thought provoking post, Akelamalu!

I agree with cg. I would definately want the right to die in certain circumstances (say, a long illness).

The idea of carrying a card for "organ donation" I can see (here in the States it's on your drivers license), however for the "right to die"...seems too general.

Again, I think it would depend on the situation.

Thanks for sharing this, dear lady!

x said...

hi, ake! this sounds like a good idea and i agree with you that instead of cards, a better way to know if a person wants to exercise his or her right to die and/donate organs ought to be used instead.

i wonder if here in the philippines, though, we can something like this. i would definitely donate an organ and would want to have the right to die. =D

Lo Kelween said...

I heard of this some time ago.i think it's a good idea. everybody has the 'right' to die. It eases pain from within and without in some ways.

Sandi McBride said...

If I've been in an accident and am unconscious I would want them to do all they can to save me if it is unconscious and not irreversible coma...I think Right to Life (or Death) cards for the terminally ill or DNR for those who are on the brink is enough. I know that I personally would rather not be hooked up to a thousand machines just to keep me's the thinking that makes a person whole...thought provoking post...thank you

buffalodick said...

I have strong feelings about the right to live- or die. I support assisted suicide from personal moments in my own family. My dog had to be put down about the same time my mother was in a coma she would never awaken from. My dog got treated with more compassion and dignity than my mother did...

Anonymous said...

That's interesting. How about a tattoo on a part of the body?

Marianne said...

Did you read about the retired nurse who had a tatoo saying do not revive put across her chest, because she is so worried that her wishes (even though she carries a card) will not be respected? As a retired nurse she had seen it all too many times.

Great post! x M

Mary said...

Here in Canada you can have a DNR card attached at the head of your hospital bed. (Do Not Resuscitate) However, we have to be very careful that we follow God's plan for us. I would not want to live as a vegetable but also would not want to die if I could heal and live a somewhat normal life. We need to use extreme caution when making these decisions. As someone else said in the comments, sometimes our priorities change.

Thanks for bringing up such a controversial subject.


KaiBlue said...

Aloha ..
I believe every soul and every human being has the right to choose how they live and how they die.
You raise some very interesting points..
Mahalo, Peace, Kai

G-Man said...

You have touched on a very controversial subject Ake.
Have you ever heard of Dr James Kevorkian over there?
He's from where Buff and myself reside..he went to prison, for his beliefs...G

Anonymous said...

I thinkit's a good idea. There would be complications - there always are - but better than relying on cards in possibly missing wallets.

Akelamalu said...

I wouldn't want to be kept alive by machine either Teach.

I'm not sure about the card either CG.

We have donor cards here David but there's not enough people carry them apparently. An opt out system would make people decide and give so many others the chance of life because everyone would be considered a donor unless on the system.

It is a tough question Donnetta, you don't have to answer I just wanted to make people think.

I believe the patient knows when they've had enough don't you Julia?

Because we are not required to carry any identification Trav the liklihood of medics actually finding a donor card or right to die is limited - I quite often pop out with just a handful of change in my pocket. A national register would make it so much easier.

It needs a lot of thought, that's for sure Ron.

Thanks for your input Acey. Do you have donor cards in the Philippines?

I agree with you Elween.

"It's the thinking that makes a person whole" - I so agree Sandi

Oh you hit the nail on the head there Buff, thankyou.

Someone else suggested that in the papers recently - a bar code or such tattooed on the body - but not everybody could stand the pain of a tattoo!

I didn't see that Marrianne but at least they couldn't ignore her wishes could they?

We can have DNR put on our hospital notes here too Mary and of course our priorities change with illness, but we should have the choice shouldn't we?

Welcome Kaibluecreations and thankyou for your input. Peace to you too.

I have just googled James Kervorkian g-man and I admire what he has done to help people. It takes great courage and compassion to do such a thing. Though I have to say it is not a new thing he is doing he is just honest and brave enough to be open about it.

Exactly the way I feel about it Citizen.

Neoma said...

I think each person should have the righ to decide, however I know of a few instances where a persons wishes weren't honored even thought they had it in writing they didn't want extreme measures to keep them alive.

I WISH they would put things in one big major database that we could all access. When we used to belong to Kaiser Medical, each and every time we went we had to give them our address, our phone, and other info. They didn't even have it in their own computer. She always said they were working on it, we had Kaiser for 15 years, and they were still working on it. haha

Odat said...

It's difficult. My Mom has a Living Will and I'm her health care proxy (I make the final decision for her). My hub had a DNR, (do not resuscitate). I would only want to live if I knew my quality of life would be such that I could still enjoy it.

Laura Jane Williams said...

That is such an interesting post, Akelamalu. I guess it makes sense because we all have to right to chose how to live our lives, even if our decisions mean dying... food for thought which I shall ponder...


Linda said...

I think you're right in that people who are administering emergency aid really wouldn't have time to sort through a person's belongings to find a card like that. There has to be a better way to make one's wishes known and your suggestion sounds spot on to me.

It really is quite the subject to bring up, though, and I'm sure that everyone has a different opinion on something like this. I'm quite sure I wouldn't want to be kept alive by artificial means but I've yet to put that in a living will or otherwise - which reminds me that I should!

Jeff B said...

The churches are probably up in arms because it raises the question of whether or not we are trying to play God by deciding between life and death.

I'm secure in knowing where I'm headed to after this life so being hooked up to life support machines has absolutely no appeal to me at all.

The big one here is for those who would have to make the tough decisions. I can not imagine how difficult it would be to terminate life support for my wife or child aor anyone else I care about if I didn't know their intentions.

Akelamalu said...

I suppose until all medical establishments get online there's not much hope of having a national database is there Nea. Nice to see you back honey, I missed you. xx

Possibly a very difficult decision ahead of you Odat, I don't envy you m'dear. xx

It's good that you're thinking about it GIM, not a pleasant subject but one which affects all of us at some time. x

It is an emotive subject Linda.

I wouldn't like to be in the position of having to give permission to turn of the life support of someone either Jeff, hopefully it will never happen.

Raven said...

Opt out sounds like a smart system. However it works, I think people should have a right to die on their own terms. My mother's living will got lost. I had to make some awful decisions at the end of her life. Hospitals are prone to put people through absurd procedures for not true good. I don't want to be tossed away, but I don't want to be a living vegetable either.

Akelamalu said...

How awful for you Raven, it could be so much easier couldn't it with a national database of people's wishes>

Anonymous said...