Assisted Dying Debate

There are many strong held views on both sides of the debate.  We outline here some of the key arguments who both support and oppose Assisted Dying. These are not meant to be comprehensive and people may have other reasons for their views.  Like the British Medical Association, the IPF takes a neutral view.

Those  who oppose Assisted Dying often use the following arguments:

1.  Assisted Dying law, however well intended, would alter society’s attitude towards the elderly, seriously ill and disabled, and send the subliminal message that assisted dying is an option they “ought” to consider.
2. So-called “safeguards” are simply statements of what should happen in an ideal world.  They do not reflect the real-world stresses of clinical practice, terminal illness and family dynamics.  It is impossible to ensure that decisions are truly voluntary, and that any coercion or family pressure is detected.
3. For most patients, high-quality palliative care can effectively  alleviate distressing symptoms associated with the dying process..  We should be calling for universal access to high quality palliative care rather than legalising assisted dying.
4. The role of doctors is to support patients to live as well and as comfortably as possible until they die, not deliberately bring about their deaths.
5. Some patients (particularly those who are elderly, disabled or see themselves as a “burden”) already feel that their lives are undervalued and would fear that health professionals will simply “give up” their efforts to relive distress, seeing death as an easy solution.
6. Once the principle of assisted dying has become accepted, the process becomes normalised and it becomes easier to accept wider eligibility criteria through the use of anti-discrimination legislation.

And those who support assisted dying may use the following  arguments.

1. Even with access to specialist palliative care, some dying people will still experience severe, unbearable physical or emotional distress that cannot be relieved.  
2. Assisted dying is a legal option for over 150 million people around the world. In jurisdictions where it is lawful, there are eligibility criteria, safeguards and regulations in place to protect patients.
3. The guidance for end of life practices – such as withdrawal of life-sustaining treatment – already contains safeguards to ensure  decisions are voluntarily made.  There is no reason why these safeguards could not be used effectively in assisted dying legislation.
4. UK citizens travel to Switzerland to facilities like Dignitas, to avail themselves of assisted dying, assuming they have a funds.  Anyone who provides assistance – doctors, family or friends – is breaking the law.
5. Some people, knowing that they are dying, want to be able to exercise their autonomy and determine for themselves when and how they die, but need medical advice and support to achieve this.  Legislation would contain a conscientious objection clause to protect those healthcare professionals who did not want to participate.

Thanks to the BMA for this article.

The Assisted Dying Bill

Eligible:  Adults with terminal illness who are expected to die within 6 months will be eligible.  They must have mental capacity to make a choice and express a “cleat, settled and formed” wish, free from coercion or pressure.  The Bill excludes disability and mental illness as eligibility criteria.

Process:  The person must make 2 separate declarations of their wishes, which must be signed and witnessed.  They can change their mind at any time.  Two independent doctors must be satisfied that the person is eligible, and if necessary, consult a specialist or expert in mental capacity.  The application will then be heard by a High Court Judge.  The assisted death cannot take place for a further 14 days – unless the person’s death is imminent.  Life-ending medication must be self-administered by the patient.  It cannot be administered by a doctor or anyone else.  It will be illegal to coerce or pressure somebody to choose assisted death – punishable by up to 14 years in prison.

The Bill, which was debated on 29^th November did get through.  However there is a long way to go before it becomes law – going through both the Commons and the Lords.