Evidence for physician-assisted suicide 'is far from reassuring'
3 min read
Commenting on Dignity in Dying's response to his debateon palliative care, Lord Farmer says achange to the law on assisted suicidecould put pressure on patientswho fear being a burden.
Dignity In Dying offers us a false choice - between unbearable suffering on the one hand and their 'modest' proposal for 'assisted dying' on the other.
In fact, the choice is a different one. On the one hand, we can work to make excellent palliative care universally available on the basis of need to those who are dying, and support the medical profession to help each patient in the terminal phase of an illness to consider for themselves which medical treatments may be too onerous relative to the extra time they could give someone.
Or we could licence doctors to provide people who feel suicidal with lethal drugs to kill themselves, changing not just the criminal law on encouraging and assisting suicide but our culture.
This is underpinned not just by the law but by national suicide prevention strategies - we respond compassionately and with whatever practical support is possible, even where we cannot resolve all issues, to those who want to kill themselves.
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That clear deterrent to encouraging or assisting suicide, enshrined in the criminal law, is tempered by discretion in terms of whether it is in the public interest to prosecute. So far, no family member has been prosecuted for the minor assistance constituted by going with a relative to Dignitas and that is understandable - but it is crucial that the law is clear to deter those who might consider putting pressure on inconvenient relatives to take their own life, perhaps playing on the real fear many have of being a burden.
Moreover, as this article by Professor of Palliative Medicine, Baroness Finlay, makes clear, we cannot say with any certainty that all is well with physician-assisted suicide in Oregon and Washington.
The evidence from other jurisdictions is far from reassuring. Oregon saw a rise of over 43 per cent in assisted suicides in 2014. In Washington State nearly two out of three of those who were supplied with lethal drugs in 2013 gave, as one of their reasons for requesting them, that they wanted to avoid being a burden on others.
There are no arrangements in place to scrutinise how requests for assisted suicide are being handled - whether the doctors who agree to consider them are conducting serious enquiries or ticking the boxes. We do know that some people who have ended their lives with legally-supplied lethal drugs had been suffering from undiagnosed clinical depression.
The claim that there have been no calls to extend Oregon's law no longer holds good. A bill that would increase the timeframe for terminal illness from six months to twelve months of life expectancy has been introduced – about which prognosis will be even less clear.
It is also wrong to say that because doctors can’t talk about assisting a suicide they can’t have good end of life discussions – doctors and nurses have those discussions all the time. Were the option of assisting their patients’ suicides to be on the table, such discussions would be far more fraught.
Pro-assisted dying charity, DIginity in Dying, responded to Lord Farmer saying, "Let’s be honest: there are no safeguards that would make some opponents reassured with assisted dying being made lawful. There are no conditions that would allow those opponents to countenance allowing a terminally ill patient to be assisted in this country to end their own lives." See Dignity in Dying's full response to Lord Farmer here.
