Who is trying to legalise assisted suicide, and how?

On May 12 2006 the House of Lords will debate a Bill which, if passed by Parliament, will allow doctors to help certain patients to kill themselves.

Under the Assisted Dying for the Terminally Ill Bill (introduced by Lord Joffe), a doctor would be allowed to give a prescription for a lethal dose of drugs to an adult patient who was 'suffering unbearably' from a 'terminal illness', who requested such a prescription and who did 'not lack capacity' to make such a request. In the case of patients for whom it would be 'impossible or inappropriate' to take drugs by mouth, the doctor would be allowed to provide other means of self-administration.

The Bill (which follows a controversial Report from a Lords Select Committee) is not a Government proposal, but it has significant support in the House of Lords. It could make progress in Parliament in 2006, but is unlikely to become law without more government support. The risk, however, is real and serious.

Assisted suicide is where a doctor helps a patient to kill himself

What is the difference between assisted suicide and euthanasia?

Assisted suicide is where a doctor helps a patient to kill himself or herself by prescribing a lethal drug for the patient to take. This becomes euthanasia when the doctor gives the lethal drug himself (for example by administering a lethal injection).

Why do some people want to legalise assisted suicide?

Supporters of the Bill argue that:

1. Patients have the right to decide how and when they die, which extends to obtaining assistance to kill themselves.
2. Society has a duty to alleviate 'unbearable' suffering, even if this means helping patients to kill themselves.
   
3. Physician-assisted suicide is happening anyway, so it is better to legalise it and 'bring it out into the open' where it can be 'controlled'.

The hospice movement has shown what can be done to ensure a dignified and peaceful death

What is wrong with legalising assisted suicide?

1. The law's historic prohibition of assisted suicide recognizes the extreme vulnerability of the sick, the dying and the disabled. People who feel suicidal because of an illness or disability need to be cared for, not to be killed or helped to kill themselves. The law against assisted suicide reflects society's sound judgement that the lives of all patients are worthwhile, even when they lose sight of their own worth and ask for their lives to be ended. If assisted suicide became a treatment option, the so called 'right to die' could easily become the 'duty to die' for those who felt themselves to be a burden on others and therefore with an obligation to request early death.
   
2. There should never be a duty for doctors or others to help a person kill himself. Patients have the right to refuse medical treatment which is pointless or too burdensome, even if they foresee that death will come sooner. But there is a huge gulf between saying that a certain treatment is not worthwhile (and may be refused) and saying that one's life is not worthwhile (and should be terminated by assisted suicide).
   
3. Society does have a duty to alleviate suffering, but by killing the pain not by killing the patient. The problem is that many patients do not have access to good palliative care. The solution is to fund wider availability of palliative care, not eliminate those who need it. The hospice movement has shown what can be done to ensure a dignified and peaceful death. Doctors have for centuries regarded helping patients kill themselves as inconsistent with their role as healers, and the World Medical Association remains opposed to legalisation. True dignity in dying is dying naturally with one's physical, social and spiritual needs properly met.
   
4. There is little if any evidence that British doctors ever help patients kill themselves. There is, however, plenty of evidence that legalisation results in widespread abuse. In Holland, which has permitted assisted suicide and euthanasia for over twenty years, there has been widespread abuse, including the killing of thousands of patients who did not ask to be killed, lethal injections for disabled babies, and a massive cover-up of cases by doctors.

Would a law allowing assisted suicide but not euthanasia avoid abuse?

Supporters of the Bill claim that it would avoid the Dutch 'slippery slope' because it would allow only assisted suicide. They point to the US state of Oregon, in which assisted suicide has been legal since 1997, as an 'abuse free' example we should follow. But:

1. The evidence from Oregon does not show Oregon to be abuse-free. The Oregon health department relies on self-reporting by the very doctors who have practised assisted suicide. These reports are filed, but not investigated independently by the authorities.
2. The few cases which have been made public have often raised serious questions, such as whether the patient was pressured or clinically depressed.
   
3. Legalising assisted suicide for the terminally ill is a stepping-stone to legalising euthanasia and in both cases the intention is the same. If patients have a right to ask for a lethal prescription, why not for a lethal injection (particularly if they are physically unable to take the drugs or, having taken them, are suffering a lingering death)? As the Dutch have said, thinking that you can legalise one without the other is a 'fantasy'. The Bill allows the doctor to prescribe the means of administration if the patient cannot take the lethal prescription without help. This is euthanasia by the back door. And as Lord Joffe himself has admitted:
   
   'We are starting off, this is a first stage... I believe that this Bill initially should be limited, although I would prefer it to be of much wider application, but it is a new field and I think we should be cautious... But I can assure you that I would prefer that the law did apply to patients who were younger and who were not terminally ill but who were suffering unbearably, and if there is a move to insert this into the Bill I would support it.'
   

Legalising assisted suicide is allowing euthanasia by the back door

What should I do?

You should write to Members of the House of Lords (Peers) in your own words stating that you oppose any change in the law and support an urgent expansion in palliative care services. Good quality care should be available for all who could benefit from it.

You should also consider visiting your own MP to alert him or her to the fact that this Bill may later reach the House of Commons. You can find full contact details of Peers and MPs on the UK Parliament website at http://www.parliament.uk/directories/directories.cfm

You may also consider asking your doctor what his or her views are on assisted suicide and euthanasia, and if he or she has made them known to his or her professional association.

Opinions on this issue can often be coloured by the emotional appeal of an individual case where good quality palliative care was not given. It is important to make known to friends, relatives and colleagues the powerful arguments against legalising assisted suicide and the grave consequences for many vulnerable people of any change in the law.

It is important to make known to friends, relatives and colleagues the powerful arguments against legalising assisted suicide

What is the Care Not Killing Alliance?

Care not Killing is a new Alliance bringing together human rights groups, healthcare groups, palliative care groups, faith-based organisations and concerned individuals.

We seek to promote more and better palliative care, and to oppose moves to legalise assisted suicide and euthanasia.

To find out more, including links to other useful sites, to join the Alliance or make a donation write to us or visit our website at www.carenotkilling.org.uk

Promoting palliative care, opposing assisted suicide and euthanasia