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Friday 28th October 2016

Assisted Dying

31st May 2006
31052006_old_woman_thinking1.jpgThe Background

A controversial Bill which would have given terminally ill patients the right to end their lives was blocked by the Lords on the 12 May after an impassioned seven-hour debate. Peers voted by 148 to 100, a majority of 48, to delay the Assisted Dying for the Terminally Ill Bill’s second reading for six months. The rarely used amendment to delay the bill was tabled by the Liberal Democrat peer and criminal lawyer Alex Carlile QC, who described the bill as "morally indefensible." More than 80 peers turned out to speak on the bill.

Lord Joffe's bill would give doctors the right to prescribe drugs that a terminally ill patient in severe pain could use to end their own life. The bill proposed that after signing a legal declaration that they wanted to die, patients could be prescribed a lethal dose of medication to take. Only people with less than six months to live, who were suffering unbearably and were deemed to be of sound mind and not depressed would be able to end their life under Lord Joffe's proposal. The principle underpinning the Bill is one of personal autonomy—the right of each individual to decide for himself or herself how best he or she should lead his or her life.

The peer's original private members' bill, first tabled in 2002, proposed enabling a competent adult who is suffering unbearably to receive medical assistance to die at his or own request. A Select Committee report, published last spring, called for a clear distinction between voluntary euthanasia - where a doctor hastens death at a patient's request - and physician-assisted suicide, where a doctor helps the patient to kill himself. Lord Joffe's concession to the committee was to remove voluntary euthanasia from the bill.

The Bill is modelled on the Oregon Death with Dignity Act, which has been in force in Oregon for eight years and which Lord Joffe in his speech to the House of Lord's says 'has operated satisfactorily with no credible evidence of abuse.'

The Debate in The Lords

The debate for the opposition was led by the Archbishop of Canterbury, Rowan Williams, who said that the bill sent out a message that "certain kinds of life are not worth living

Lord Carlile said the bill would end with doctors giving lethal drugs. The Lib Dem peer said: "Everybody in your Lordships' house knows that those who are moving this bill have the clear intention of it leading to voluntary euthanasia. That has always been the aim and it remains the aim now."

Baroness Chapman, in speaking of her own illness said ‘I have lost count of the number of times that I have been told by the medical profession, "This could be the beginning of the end".

Among those speaking up for the Bill were Lord Ashley of Stoke, the deaf disability rights campaigner and former Labour minister, who asked peers how the would feel if they were asked by a wife, husband or relative in unendurable pain to help them end their life.

Others supporting the bill included the Labour peers Baroness Margaret Jay and 92 year old Nora David, who said, "If I were terminally ill, I believe I would be the only person with the right to decide how I died and whether I preferred palliative care to assisted dying. It would provide me with an additional option on how to end my life, which I would find tremendously reassuring."

Arguments for the bill

Sheila McLean, the Director of the centre of law and ethics in medicine at Glasgow University, argued that the bill has tight safeguards, which would give patients better protection than the current situation under which, although euthanasia is illegal, research shows that it happens both with and without patients' consent.

The British Humanist Association (BHA) supports the Lords bill on assisted dying for the terminally ill on "compassionate" grounds. It claims that a majority of Christians support the bill, and argues that in claiming to speak for the elderly or terminally ill, religious leaders are "pre-empting any views that such people may themselves wish to express". The association believes "opposition to the bill is a denial of the potential choice and freedom that it will offer," and points out that the proposals do not introduce euthanasia.

Campaign group Dignity in Dying insists the Assisted Dying Bill would reduce violent suicides. It says new evidence from the US shows that similar laws in the state of Oregon have extended the lives of the vulnerable. Chief executive of Dignity in Dying, Deborah Annetts said: "This evidence suggests that for many terminally ill people, assisted dying legislation acts as an insurance policy. Just knowing that the option of a safe, legal peaceful death is there is enough to prolong life. She acknowledged that Palliative care had moved on, but added "Even with the high quality of our palliative care some people will still want this option.��?

Arguments against the bill

Opposition to the bill came from the church, pro-life groups, some medical professional groups and in particular those involved in palliative medicine.

The Disability Rights Commission (DRC) said that the absence of quality support and given the lack of palliative care services, the bill would put pressure on disabled people with a terminal illness to end their lives prematurely.

The president elect of the Royal Society of Medicine has argued that legalising assisted dying will violate the principle of "first do no harm". The bill "fundamentally changes the way doctors practice medicine and the way that those with distress are managed" said professor of palliative care Baroness Finlay.

The ProLife Alliance said that ‘Legislation that permits doctors to assist in suicide, fundamentally changes the role of doctor from someone who cures or cares to a killer.'

The Royal College of Physicians (RCP) has said it could not support legal change on assisted dying; however it added that 'irrespective of whether the present bill is enacted or not, it should be seen as a further signal to campaign for better care for dying patients.'

In a letter to the Times Professor Sam Ahmedzhai and colleagues from the field of Palliative Medicine protested strongly against the bill, saying that "We believe medically assisted dying is a bad solution to a difficult problem. Safeguards in the Assisted Dying Bill are woefully inadequate."

They conclude that the law should protect the vulnerable from the subtle pressures of society, the pressure of feeling a drain on scarce health care resources or a burden on the family. They finish with the poignant remark from a patient "Medically assisted dying is a temptation I do not wish to endure."

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