Universe Column for February 19th 2006
by David Alton
On Friday May 12th the House of Lords will once again consider an attempt by Lord Joffe to legalise “assisted dying” – and it is being vigorously opposed by those who believe that to die well you don’t need a doctor to kill you.
The new Bill seeks to legalise medical assistance with suicide for terminally ill adults who request it and who are thought to have mental capacity and to be suffering ‘unbearably’.
A new all-party Parliamentary group, called “Dying Well”, has rigorously set out the arguments against a Bill which would have profound effects for the terminally ill and for society as a whole.
The Joffe Bill is based on a number of flawed assumptions. The principal of these concerns is suffering.
You don’t need to provide assistance with suicide necessary to deal with terminal suffering. Britain is a world leader in the science of palliative care; and, given better resources still, there is no reason why anyone should be unable to receive expert care to relieve suffering from pain, breathlessness or other symptoms of terminal illness. Instead of telling someone who is suffering that they would be better off dead people need help to resolve the psychosocial and spiritual concerns which come to the fore when you face death.
Another central argument put forward by Lord Joffe is patient autonomy. Although this is a proper part of clinical practice, autonomy is about protecting patients from the imposition of unwanted treatments rather than to give them a right to demand specific forms of treatment. Like most people, I would not want to be kept alive by officious treatments and interventions but nor do I believe it right that I or anyone else can tell a doctor or nurse that they should kill me or assist in my killing.
Proponents of change constantly cite public opinion polls. These regularly show majority support for a change in the law. But these surveys consist of Yes/No or Either/Or questions, posed with little explanatory context and answered in many cases without any real understanding of the issues involved. Public opinion surveys on the reintroduction of capital punishment could be expected to give a similar result.
More important than these surveys are the attitudes of doctors who have a better understanding of the issues and who would be in the front line of implementing any new law. These surveys all show majority opinion against a change.
We should be deadly clear where a step by step change in the law will ultimately lead.
In Holland, where the law was changed in 2002, 1 in 32 deaths is attributable to either legal or illegal euthanasia or assisted suicide, In the UK this would mean one death by euthanasia every 30 minutes.
Less than four years after the legalisation of voluntary euthanasia in Holland protocols are now being drawn up to cover involuntary euthanasia of new-born infants, and Dutch pro-euthanasia organisations are pressing for further extensions in the law – for example, to include people with dementia, the ultimate objective being an ‘end-of-life pill’ on demand. Lord Joffe has himself said that he regarded his last Bill, which sought to legalise assisted suicide and euthanasia, as being just “a first stage”.
Supporters of change often allege that doctors are ending the lives of terminally ill patients, with or without their consent, out of “compassion.” But a recent study by Professor Clive Seale of Brunel University concluded, on the basis of an anonymous survey of doctors, that such action is extremely rare in Britain compared with other countries. Professor Seale’s report observes that the argument which is sometimes advanced – that there is widespread covert euthanasia in this country and that the law needs to be changed in order to regulate it – cannot be sustained. There is simply no evidence of widespread covert killing of patients in Britain.
Ironically, 30 or 40 years ago, when palliative care and the hospice movement were in their infancy and little could be done to remove the suffering of terminal illness, there was no serious mention of assisted suicide or euthanasia; while today, when such suffering can be dealt with and terminally ill people can die peacefully of natural causes, there is a succession of bills seeking to change the law.
Although there continue to be instances of people dying in pain, this is nothing to do with inadequate modern medical science. It is the failure to allocate NHS resources so that good palliative care services and hospice provision is universally available. That’s where the campaigning needs to be taking place. It is simply not necessary to end a patient’s life in order to end the suffering. Urge your MP to join the Dying Well group and urge Peers to oppose the Joffe Bill on May 12th.