Assisted Dying Bill: Is this the thin end of a very dangerous wedge?
- Credit: PA
There are some issues when I look at all the arguments and agree with both sides. I simply do not know the right answer.
The Assisted Dying Bill is difficult.
As a doctor, my aim was to save life. The idea of deliberately taking a life seemed wrong.
But I also know that, when people are dying, it would be cruel to inflict painful and distressing treatments.
Our aim must also be to comfort when no cure is possible.
Are the safeguards in this Bill enough?
The person must not be expected to live longer than six months, although giving any terminally ill patient a timescale is notoriously difficult and inaccurate.
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They must have capacity and make a clear, voluntary and settled wish to end their life.
The legal document must be signed by two doctors and there must be at least two weeks before any action is taken.
When my mother died I had the advantage of knowing her views. She had said she did not want any heroics if she’s dying. She even went further. Her father had been a GP before the war and she said: “I know you doctors speed things up. Can you arrange that?”
I do not know what her father might have done in the 1920s and 30s but in my practice I could not 'speed things up'.
When she was 90 and developed sepsis, the consultant spoke to me.
“We’ll do everything we can with powerful antibiotics but, if she’s not responding by the afternoon, do you mind if we let nature take its course.”
The situation was not easy but I knew exactly what she would say.
But allowing nature to take its course is very different from deliberately killing someone, even if they are terminally ill.
Under the current rules we have 'double effect'.
This means that any treatment must not be deliberately designed to kill but if a terminally ill patient is suffering, we might use the dose of a pain killer or tranquilliser that we would not use if they were expected to recover.
The important legal point is that we give the drug to relieve pain and suffering not to kill.
With modern palliative care most suffering can be relieved, especially with the experts at hospices such as Rowcroft.
But even with the best palliative care every year 6,400 dying people suffer severe pain.
Up to 650 terminally ill patients take their own lives while 50 British people choose to go to Switzerland for assisted dying - 84 per cent of the public back assisted dying and the BMA have moved from opposition to neutrality.
But can we be sure that there are enough safeguards? Will terminally ill people be pressurised? Will the palliative care team be used to their maximum effect?
In Oregon, where assisted dying is legalised, one doctor fills out a simple form to show that there is no coercion.
And 53 per cent of patients who died under their 'Death with Dignity' Act reported feeling a burden on their families.
Luckily, I am well but how would I feel if I was in continuous pain or facing death from a disease such as Motor Neurone Disease despite excellent palliative care?
Am I being arrogant by telling anyone facing this awful situation that they have to continue to suffer?
If passed, will the Act move from carefully controlled assisted dying to 'death on demand'?
I would love to be able to argue passionately on one side of the other but I am left with serious doubts on both sides. Even the church is split on the issue.
Baroness Meacher’s Assisted Dying Bill has cleared its second reading in the House of Lords. There is a long way to go before it has any chance of becoming law.
I am still not sure whether it is an amazing piece of legislation to relieve suffering or the thin end of a very dangerous wedge.