The principle aim of MDMD is to see a change in the UK law to allow medical help to die for people who request it of their own free will, provided they are mentally competent and the request is because incurable medical conditions have reduced their quality of life below the level they are able to tolerate, and this situation is highly unlikely to improve significantly.
Such a law would require careful safeguards and strict procedures. The exact nature of these is the subject of current discussion and public debate.
As input to that debate, MDMD advocates:
- As a first step for someone requesting assistance to die, the individual should receive professional counselling about available options for continued treatment, palliative care, supported living etc.
- Two doctors should independently certify that the individual:
- has mental capacity to make autonomous medical decisions relating to rationally ending their life, (a referral to a psychiatrist would be essential if there is any doubt/concern about someone’s mental capacity);
- is not suffering from a curable medical depression which might be impairing their judgement;
- has incurable medical conditions which permanently reduce their quality of life below the level the individual can accept; and
- the person has carefully considered all possible options, including palliative care and has allowed time to adapt to changed circumstances resulting from injury or illness.
- Every person requesting a doctor-assisted death being interviewed by an official, independent legal witness, experienced in family matters, to ensure that the person is acting on their own free will and is not being pressured by relatives or friends. (A similar proposal for this to be done by a tribunal was made by Claudia Carr, Senior Lecturer in Law, University of Hertfordshire in 2013.)
To assist in this, MDMD propose for discussion the idea that individuals who would like the option of assistance to die at some point in the future, be encouraged to make a clear statement to that effect, repeatedly signed and witnessed, while they are still healthy and fully mentally competent. We refer to this as an Extended Advance Decision. Such statements would ease the judgement of independence of the individual’s wishes, and could be a requirement for anyone deemed significantly “vulnerable”. This idea may play a significant part in overcoming objections based on the risk to vulnerable people.
- Detailed reporting to a central government office, by all those involved.
MDMD strongly rejects any requirement for the individual to be “terminally ill”, and in particular, there should be no requirement on doctors to predict any life expectancy. MDMD see three reasons why such a “safeguard” is inappropriate:
- Doctors have argued that it is frequently impossible for them to make life expectancy predictions with sufficient accuracy.
- Some people have to suffer an intolerable quality of life for much longer than a 6 months time limit.
- People suffering from dementia, will typically no longer have mental capacity by the time their condition has worsened such that their life expectancy is predicted to be less than 6 months.