The article can be read below or found online here.
I like and respect Kit Malthouse a huge amount, as a colleague, but I cannot allow his article about changing the law to license assisted suicide or, as he calls it, ‘assisted dying’ to pass without comment. Much of what he has to say is, at best, questionable – and in some instances widely adrift from the facts.
Campaigners for assisted suicide often argue that we have two choices when we are dying: to travel to a country where assistance with suicide is legal or as Kit said in his article, “to stay here and suffer a painful and terrifying death”. This is nonsense. Even the activists campaigning for legalised assisted suicide have admitted, in a document they published last month, that “the majority of people who die in the UK will not suffer pain” and that this country has been ranked number one in international surveys for the quality of end-of-life care.
In the six out of fifty US states in which assisted suicide has been legalised, pain or the fear of death comes well down the list of reasons people give for wanting to end their lives. Britain, as the founder of the modern hospice movement, is a world leader in palliative care and with access to good care of this kind, there is no reason why any death should be a painful experience. As a nurse who specialised in cancer care I can attest to this.
Many imply that legalising assisted suicide for terminally ill people in Britain would mean that those who take their own lives in Switzerland would be able to do so here. Well, let’s look at the data. In 2016, 47 Britons ended their lives at the Dignitas assisted suicide facility near Zurich. However if you transferred across the death rates in Oregon, where assisted suicide is legal, we would have been looking, not at 47 but at just under 2,000 assisted suicide deaths in England and Wales alone that year
Legalising an act doesn’t just reproduce the status quo in legal form: it changes the dynamic completely. Laws are not just regulatory instruments; they send social messages. And an ‘assisted dying’ law would send the message, however unintended on the part of legislators, that if we are terminally ill taking our own lives is a course of action to be considered.
Campaigners for assisted suicide tells us that the Supreme Court and the Crown Prosecution Service have told us repeatedly that the law is not fit for purpose. I am not aware of any statement to this effect by the Crown Prosecution Service.
The last time the Supreme Court looked at this subject it observed that the question involved “important elements of social policy and a moral value-judgment, which are inherently more suitable for decision by Parliament as the representative organ of the constitution”. Two years ago the Commons did just that. It debated Rob Marris’s Assisted Dying Bill at length – and rejected it by 330 to 118 votes.
Parliament has debated this issue repeatedly during the last ten to fifteen years, and has not been convinced either that the law is in need of change or that any “strict set of safeguards” has been put forward. What we are seeing is the same old proposals wheeled out yet again.
The argument that terminally ill people want the right to decide when and how they die is often put forward as a reason for changing the law – but those with a terminal illness have that right now. Seriously ill patients can refuse life-sustaining treatment and, if they do so, doctors have a duty of care to ensure that the process of dying is without distress. There is, quite literally, a right to die. But there is a world of difference between that and licensing doctors to supply lethal drugs to terminally ill patients for suicide.
It’s all very well quoting opinion polls, but we are not told what information was given to respondents, what questions were asked and how they were sequenced or phrased. And what about the views of those who actually deal with death and dying, week in and week out? In a 2015 survey of a thounsand GPs, only one in seven said they would be prepared to participate in an assisted suicide regime. In a 2014 survey of its members, the Association for Palliative Medicine, the branch of medicine that specialises in care of the dying, found that 82 per cent of respondents were opposed to changing the law. Yet these are the people who would find themselves in the front line of any ‘assisted dying’ law.
With many deaths now taking place in hospital, there is less first-hand familiarity than was once the case with the dying process, with its natural phases and with how it can be gently managed. Unfamiliarity can all too easily breed fear. Such fears are intensified by the creation of a false choice between assistance with suicide and an agonising death. I do not doubt the sincerity of Kit’s views in this controversial and often-emotive area, but is essential that the debate be conducted with care and proper regard for the facts.