Yes
Saimo Chahal, partner at law firm Bindmans in the human rights
department
Debbie Purdy’s judicial review has done much to raise awareness about the
issue of assisted dying. I too have thought much about the subject since
acting as Debbie’s solicitor. Debbie suffers from primary progressive
multiple sclerosis and, as her condition deteriorates, there may come a time
when it will become unbearable for her, at which point she may wish to end
her life. By that stage she will be physically incapable of doing so without
assistance. Section 2(1) of the Suicide Act 1961 prohibits assisting in a
suicide and therefore she would have to travel to Switzerland, where
assisted dying is legal.
The practice of assisted dying is also lawful in Belgium, the Netherlands,
Luxembourg and the US state of Oregon. Washington state voted in favour of
legalising assisted suicide last month.
The Director of Public Prosecutions has not prosecuted any of the Britons who
have accompanied a loved one to Switzerland to die. The DPP published the
reasons for not prosecuting this week. He announced that he will not
prosecute the parents of Daniel James for assisting Daniel to die and
essentially stated that it was not in the public interest to do so, although
there is enough evidence of the offence having been committed.
If that is the case, there is clearly a public interest in removing the doubt
around possible prosecution; British citizens have the right to know where
they stand. A clear prosecuting policy would alleviate the stress and
anxiety of family members considering accompanying loved ones abroad to die.
Article 8 of the European Convention on Human Rights promotes freedom of
choice and the right of individuals to personal autonomy. I believe the
option of assisted dying for mentally competent, terminally ill individuals
at the end of their lives should fall within the ambit of this right.
Opponents of such legislation suggest that vulnerable people may be affected
by a change in the law, but research published in the Journal of
Medical Ethics, on assisted dying in Oregon and the Netherlands,
confirms that there is no evidence of heightened risk for vulnerable groups.
On the contrary, evidence demonstrates that assisted dying provides greater
security through greater end-of-life choices.
It is far better to regulate assisted dying with safeguards to ensure it is
the individual’s choice, than to continue with the status quo, which fails
to protect vulnerable people by forcing them to travel abroad or ask their
doctors for help to die, and leads to “mercy killings” and botched suicides.
Evidence from countries where assisted dying is lawful shows that the numbers
of individuals opting for such a death are small, owing to the highly
regulated nature of the law in this area. Palliative care is not an answer
for some terminally ill people and it does not answer concerns about loss of
autonomy and dignity. Assisted dying legislation could provide choice at the
same time as protecting the vulnerable.
No
Dr Andrew Fergusson, former GP and head of communications, Christian
Medical Fellowship
Assisted suicide, quite simply, should not be legalised, and we are confident
there is no need to change the law. The Christian commandment “you shall not
murder” applies. We believe that assisted suicide is in the same moral and
medical category as euthanasia; it is euthanasia one step back. And if the
law is changed, we can’t possibly prevent abuse of it.
This week’s decision not to prosecute the parents of Daniel James shows that,
in that one extraordinary and tragic case, the law has tempered justice with
mercy; it is not a green light to changing the law. When we do this, three
things happen. First, and obviously, we do what the new law says; second, as
history teaches us, we go further than the law says; but third, and most
importantly, we change the climate of public opinion within which people
make moral and personal decisions.
If we change the law on assisted suicide, it’s going to put pressure on
vulnerable people – the terminally ill, the elderly, those with chronic
physical diseases and those with chronic mental health problems. Some people
with early dementia might have capacity to ask validly for assisted suicide,
but this would not be true of everyone with dementia. Many would be under
pressure. In order to protect a majority, a small but vocal minority must
forgo their claimed “right”.
I don’t believe anyone has a right to be killed by a doctor. We live in a
complex, interconnected society, and no man is an island. The death of each
one of us affects the death of everybody else. And while I wouldn’t want to
condemn anybody to having unnecessary medical treatment simply to be kept
alive for ever, the step towards changing the law is a step too far.
As a society, we are not open to discussing the fact that all of us are going
to die. The majority don’t even make a will, for example. We should talk to
family and friends about the medical treatment we would want and not want if
terminally ill. In my experience as a GP, I have found that many people have
an innate sense that their end is coming, and they say things like: “I’ve
had a good innings, Doctor. Please don’t send me into hospital.” So let’s
talk about death and dying.
We also need to make the principles and application of palliative care much
more universal. To a degree there is still a postcode lottery for palliative
care in Britain and, as such, it needs to be much better funded. We have to
shift the goals of healthcare from cure towards caring for terminally ill
patients in the precious time they have remaining.
We’re well into what’s going to be a significant economic downturn, and
numbers of elderly people in society are increasing, along with numbers of
people with Alzheimer’s. The NHS is not going to have billions to spend on
healthcare for much longer. We must keep the law as it is, and work harder
and do better to spend resources appropriately on palliative care, which
recognises that life has a natural end.
