This article is from the March issue of Total Politics
David Winnick MP says YES
It would do no harm in this debate for both sides to understand and respect their opponents’ viewpoint. Those who wish to see a change in the law, with maximum safeguards, do not want to see the terminally ill encouraged to end their lives. And the other side – fearful of any change, including the ‘slippery slope’ argument – are no more indifferent to the sufferings and pain of those involved than we are.
I recognise the deeply-held religious beliefs of people who look upon assisted dying as somehow undermining the sanctity of life. Nevertheless, as recent events show, the controversial issue is not going away. The latest and important contribution to the debate is, of course, the report by the Commission on Assisted Dying, chaired by the former lord chancellor, Charles Falconer. Critics will say he had already made up his mind, but other Commission members included a president of the College of Medicine, other doctors, a former commissioner of the Met, the present Canon of Windsor and others.
The issue of assisted dying came before the law lords some two years ago as a result of a case brought by Debbie Purdy, who has an incurable disease. She wanted to know if her partner would be likely to face prosecution in Britain after accompanying her on a trip to Switzerland. The Suicide Act 1961, updated by the Coroners and Justice Act 2009, makes assisting a suicide punishable by up to 14 years’ imprisonment.
The director of public prosecutions was instructed by the law lords to draw up guidelines indicating the various factors for and against prosecution in such cases. At least the published guidelines clarify the legal position somewhat, but they do not change the law. Only Parliament can do that.
I fully support every possible improvement in palliative care; the large majority of the terminally ill do not, and won’t have, any wish to end their lives by assisted means. But isn’t assisted dying an alternative to such care? In Oregon, USA, where the change I am proposing has been in place since 1994, the number who die naturally in hospice care has actually doubled since that date. In the Netherlands, with a similar law, healthcare is characterised by the emphasis on specialist palliative care as delivered in hospitals, hospices, day-centres and homes. Again, the same applies in Belgium.
Peter Lyon, medical director for the end-of-life organisation Compassion and Choices of Oregon, told Lord Falconer’s Commission the following: “One of the best things that comes from having this law is how much better hospice care has become in Oregon in the last 15 years.” It would seem that fewer than a hundred cases of assisted dying occur per year. I wouldn’t support anything that lessened such care near to death; indeed, with others, I campaigned over the years for a hospice in my borough, and I’m glad to say it has now been built.
The Commission sets out the required strong safeguards. It would be necessary for two independent doctors to assess the individual, make sure the person has been fully informed of all the other treatment and end-of-life care available, and be satisfied over a settled intention to die.
As for eligibility, the recommendations are that one must be over 18, and have a diagnosis of terminal illness; the choice must be entirely voluntary and not influenced by others. And there needs to be the mental capacity to make fully informed choice, and not be impaired by problems such as depression.
Where the Commission is not likely to satisfy either side is where it states the criteria should be that death from the terminal illness is likely to occur within the following 12 months. That, I accept, is not practical these days. Assisted dying is a highly sensitive issue, but that should not be a reason for the Commons to ignore it, which it has up to now.
I would be willing to see a clause in any bill that would suspend the legislation after five years. If, over that period, conclusive evidence showed that abuses and pressure to die had been brought to bear on those with terminal illnesses, it would be difficult to obtain a parliamentary majority again to bring the law back into operation.
David Winnick is the Labour MP for Walsall North
Nadine Dorries says NO
Euthanasia hit the headlines again at the beginning of 2012 for all the wrong reasons. During 2011, Lord Falconer assembled a Commission, which has now produced a report recommending a change in the law so that those who assist someone in the act of suicide will no longer be committing an illegal act.
The report was swiftly discredited. Almost everyone who sat on the Commission was known to be in favour of legalising assisted suicide, each sitting member having been handpicked by Lord Falconer. The report was funded by Sir Terry Pratchett, a known campaigner for reform of the law, and someone who believes that a patient suffering from dementia should be euthanised if they ask for it.
There are numerous reasons why the report crashed and burned, but most are attributable to the work of the campaign group Care Not Killing, which pulled out a fascinating fact from under each and every stone it overturned. For example, the report made much of the one disabled member of the Commission, Stephen Duckworth, chief executive of Disability Matters Ltd. However, the five main UK disability rights groups all oppose change, because 70 per cent of disabled people believe that such a change would “lead to pressure being placed on them to end their lives prematurely”, and over half that it would be “detrimental to the way that disabled people are viewed by society as a whole”.
Care Not Killing discovered that Disability Matters Ltd is a private company that, according to the Companies House website, was dissolved in the summer of 2010. This raises questions as to the extent of the representation of disabled people on the Commission.
Over the last three years, two British Parliaments have refused to change the law for – among others – two very simple reasons. Firstly, to protect the vulnerable, and secondly, in acknowledgment of the fact that doctors often get it wrong. Look at Stephen Hawking: he was given a few months to live when first diagnosed with Motor Neurone Disease, and has now just passed his 70th birthday, having contributed vast amounts to the total knowledge of mankind in his lifetime.
Sentiment is growing around the concept of a loving family member assisting in the final act on behalf of a loved one. Whereas it’s true that many people are surrounded in death by loved ones, for far too many others the next-of-kin is the state. The elderly, disabled and terminally ill are today protected by the law, but in an age when the call upon the state budget to care for the elderly is high, and at a trying time in the economic cycle, how safe would people feel if that law were to change?
No matter how you try to dress up assisted suicide, it will always be the first step towards making it possible for those with a vested interest to hasten the end of others. It’s not beyond the imagination to envisage a doctor having a quiet chat with a depressed elderly man, devoid of relatives and dependent upon the state, who is blocking a care bed. And what about the patient suffering from undiagnosed early dementia or depression, who is incapable of making a rational judgement and yet has not-so-loving relatives who may gain materially from an adverse decision?
Lord Falconer himself was clearly aware of these arguments against his proposals. He went to great efforts to emphasise the ‘safeguards’ that would be in place to protect the vulnerable. However, he also admitted that these could never be foolproof. He was thereby admitting that his proposed change in the law would put at risk the lives of those least able to stand up for themselves and say ‘no’.
As it is today, the vulnerable are protected. Three times in the last five years Parliament has refused to bow to pressure to alter the law. On each occasion, it has recognised its most important duty: to protect the weak and vulnerable. I hope and believe that this will always be the case.
Nadine Dorries is the Conservative MP for Mid Bedfordshire