Assisted dying is about giving people a choice to die on their own terms, and with a sense of dignity. The term is a catch-all expression for when someone voluntarily requests medical help from another person to end their life. This should mean helping an adult who is of sound mind and either terminally ill or intolerably suffering.
A specific example of assisted dying is sometimes called ‘assisted suicide’, which is when someone who is terminally ill or intolerably suffering is given the means to bring about their own death, i.e. they are provided with a susbtance which they then self-administer. Another example is ‘euthanasia’, which is when a medical professional intentionally kills a person by the administration of drugs, at that person’s voluntary and competent request.
The right to die campaigner Tony Nicklinson is an example of someone who was intolerably suffering, but not terminally ill. Tony suffered from locked-in syndrome, which meant that he was completely paralysed from the neck down, and unable to speak or move his body. Although this meant Tony wasn’t close to death, he found that his quality of life unbearable and sought help from the courts to die.
Provided someone is in the early stages of dementia and still capable of making decisions for themselves we believe they should have the right to request assistance, as is already the case in several countries with legal assisted dying.
The ability to process and weigh information and communicate your decision is the widely accepted definition of ‘mental capacity’ under the Mental Capacity Act 2005. This test is already applied on a regular basis by medical professionals in England and Wales, and is used to judge if someone has mental capacity to refuse medical treatment or empower a lasting power of attorney.
Helping someone to end their life is a criminal offence in England and Wales, and those found guilty can face up to 14 years imprisonment.
The law isn’t clear on this point, but broadly speaking anything which directly helps or encourages someone to end their life would qualify as assistance. For example, this would include accompanying someone to Switzerland.
Assisted dying is legal in Austria, Canada, Belgium, Italy, Germany, Luxembourg, The Netherlands, Switzerland, and Spain for both the terminally ill and intolerably suffering. It is also specifically permitted for those with six months left to live in Colombia, eleven US jurisdictions, the Australian state of Victoria, and will soon become legal in Western Australia and New Zealand.
Research from the UK Assisted Dying Coalition, co-founded by My Death, My Decision, estimates that at least one British citizen per week now travels to Switzerland for an assisted death.
According to independent research from NatCen, nearly nine in ten (88%) members of the public favour changing the law on assisted dying for adults of sound mind, who are either terminally ill or incurably suffering, in at least some circumstances. This is more than double the level of support in 2014.
In one of the largest surveys of medical opinion ever, the British Medical Association found that half of doctors personally support changing the law. If the law were to change, a majority of doctors also said that people facing incurable suffering should be able to request an assisted death; whereas, a minority thought the law should be limited to helping those with six or fewer months left to live.
Although the vast majority of medical professionals support assisted dying, a minority conscientiously object to a change in the law. This is why most high profile medical groups are either neutral or don’t have a stance on assisted dying, including: The Royal College of Physicians, The Royal Society of Medicine, The Royal College of Nursing, and the Royal College of Psychiatrists.
According to independent research from Natcen, 88% of people who identify as having a long-standing condition affecting their day-to-day life support a change in the law on assisted dying, in at least some circumstances. However, the vast majority of disability organisations are either neutral or don’t have a stance on assisted dying, including: The Multiple Sclerosis Society, The Motor Neurone Disease Association, Parkinsons UK, and The Alzheimer’s Society.
Parliament last voted on assisted dying in 2015, rejecting by 330 to 118 a private member’s bill which would have legalised assisted dying for those with six or fewer months left to live. It has been more than 15 years since Parliament scrutinised the evidence on assisted dying in any detail via Lord Joffe’s Select Committee.
Successive and independent studies have found no credible evidence in countries where assisted dying is legal, that a change in the law results in pressure upon vulnerable people. For example, a study by Professor Maragret Battin et al looked at evidence from Oregon in the US and the Netherlands, and concluded: ‘Where assisted dying is already legal, there is no current evidence for the claim that legalised PAS (physician-assisted suicide) or euthanasia will have disproportionate impact on patients in vulnerable groups’.
Doctors already assess whether a patient is of sound mind and making a voluntary choice on a daily basis when someone seeks palliative sedation, or to end their life by refusing life-sustaining treatment. And, there are strong reasons to believe that our current law on assisted dying fails to protect vulnerable people.
Palliative medicine is a crucial healthcare service which is capable of reducing millions of people’s suffering throughout the world. Nevertheless, despite its best efforts, some forms of suffering cannot be adequately alleviated by palliative medicine alone. A recent study by the Office for Health Economics found that even if every dying person who needed it had access to good quality palliative care, 6,394 people would still have no effective pain relief in the final three months of their life.
We don’t think that it is helpful to view palliative medicine and legal assisted dying as mutually exclusive, and instead think that they should be seen as two choices on a spectrum of end-of-life choices. This is because two independent studies from the European Association of Palliative Care and Palliative Care Australia have both concluded that palliative care has benefitted in overseas jurisdictions which have legalised medical assisted dying. The European Association found that:‘There is evidence of advancement of palliative care in countries with legalised euthanasia, also after the legalisation of euthanasia and/or assisted suicide. The idea that legalisation of euthanasia and/or assisted suicide might obstruct or halt palliative care development thus seems unwarranted and is only expressed in commentaries rather than demonstrated by empirical evidence’. Palliative Care Australia found: ‘no evidence to suggest that the palliative care sectors were adversely impacted by the introduction of the legislation. If anything, in jurisdictions where assisted dying is available, the palliative care sector has further advanced’.