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By Baroness Finlay of Llandaff - 9th March 2009
Baroness Finlay of Llandaff, chairwoman of the All Party Parliamentary Group on Dying Well, writes for ePolitix.com on why the legalisation of assisted suicide is dangerous and unnecessary.
This article coincides with the publication by the all-party group of a parliamentary briefing on the Coroners and Justice Bill, warning against amendments which seek to legalise the assistance of a suicide.
In recent months there has been increasing debate on whether or not the law in this country should be changed to permit a doctor to kill his terminally ill patients or assist their suicide should they so request. As a practising doctor who has dedicated the majority of my working life to improving end of life care for my patients, I have become convinced that 'medically assisted death' has no place within healthcare.
Let's be clear - end-of-life care is very different to ending life. Good healthcare is about caring for people who are sick, not helping them to commit suicide.
It is easy to talk glibly about more choice at the end of life but 'medically-assisted death' cannot be regarded as just another end-of-life choice, like choosing to die at home rather than in hospital.
It poses very real risks to the safety of the overwhelming majority of terminally ill people. The question to be asked is whether Parliament can safely allow, for the convenience of a small minority of resolute individuals, an exception to the law on killing which flies in the face of medical ethics and which could easily create subtle and unwanted pressures on the great majority of terminally ill people to take their own lives.
This serious issue cannot be brushed aside simply by categorising 'medically-assisted death' as just another end-of-life choice.
Recently the prime minister publicly stated his opposition to a change in the law to allow 'assisted dying', saying that "it is not really for us to create any legislation which would put pressure on people to feel they had to offer themselves because they feel they were causing trouble to a relative".
And the prime minister is right. A law to allow medically assisted suicide could not protect vulnerable patients who, out of a fear of being a burden, would feel obliged to ask for an assisted death. Patients sometimes say they want to 'end it all' but when these patients are given good care and assurance of person-centred care, their request vanishes.
Those in favour of assisted suicide/euthanasia argue that a new law would include safeguards to protect vulnerable people but the so called 'safeguards' that are being suggested are nowhere near robust enough to stand up to the pressures of terminal illness or everyday clinical practice.
In the past people often died in pain or with other distressing symptoms unrelieved. But over the last 25 years medical science, and the wider discipline of palliative care, have advanced by leaps and bounds.
The government is now investing in end of life care and has many important initiatives to fill current gaps in service provision and to drive up standards of care. Terminally ill patients should no longer have to die with unrelieved pain nor with their fears and distress not addressed.
Parliament has debated this issue on three occasions in the last five years and had a select committee look at it in detail. Attempts to change the law were not 'blocked' by the House of Lords as is often reported. The last debate was eight hours long after which a large majority (of 148 to 100) decided not to approve the Bill in question.
'Assisted dying' is both unnecessary and dangerous. The current law protects patients from coercive pressures and enables doctors to focus on providing good end of life care.
The current law prohibits assistance with suicide, but allows flexibility in its interpretation – it is a law with a stern face and a kind heart. Parliament has the responsibility to protect the public by ensuring that this law is not weakened.
Baroness Finlay is a professor of palliative medicine at Cardiff University, the immediate past president of the Royal Society of Medicine and an Independent Crossbench member of the House of Lords.
Article Comments
I have leukemia and would like at some time in the future to seek medical help to end my life. Your campaign will prevent me seeking a suitable remedy and I will be forced either to go to Switzerland or throw myself in front of an oncoming train. Neither alternative is at all satisfactory so please stop your campaigning.
From my point of view it is disturbing to see that you rely on illiterate emails to support your case e.g. Ivan Martin's posted on 20 March 2010.
Professor Alan Gilbert
1st Dec 2010 at 11:32 am
Many of us are not religious and therefore do not wish to be dictated by others with faith. Had Lord Joffe's Assisted Dying for the Terminally Ill Bill not been bloked by those such as Baroness Finley and the 26 Bishops in the House of Lords in May 2006 on it's 2nd reading it might at least have reached the Commons.
The argument by the vociferous groups against such as the Christian Madical Fellowship and Care not Kill is that if such a Bill were to become law there are those who would coerce their elderly frail relations to accept assisted dying so as to benefit early from their legacy . This mantra has been picked up by both Gordon Brown and David Cameron. it is not only quite disgraceful (and unChristian) but totally false. In the assisted dying bill it states a person wishing to end their suffering by assisted dying would need to be over 18, of sound mind and with a prognosis of no more than 6 monthe to live: just being you old granny would not come into that category. A letter from the patient would be required to initiate proceedings after which a verbal repeat would be required from the attending doctor and a specialist in the condition. If necessary a psychiatrist would need to examine the patient and they must also be given advice on palliative care as an option. At the signing of the document only a solicitor and one witness could be present. No relations, friends or medical staff allowed. Only after 14 days could the request be acted on, but could be cancelled at any point. If those who wished to dispose of their elderly relations were to be allowed then Parliament would need to amend the Bill to that effect. And who would do that? In the State of Oregon assisted dying has been legal since 1997 with no reports of abuse or a 'slippery slope'. The phrase so loved to be used by those against. Now it is also legal in the States of Washington and Montana. These in 'God's own country'. Incidentally the palliative care, in which Baroness Finlay is a consultant, has improved with the introduction of assisted dying and is better than in Britain. Personel choice without interference from those who have no part in our lives must and will eventually prevail as 80% of all people, including Christians, surveyed wish for it.
Ivan Martin
20th Mar 2010 at 3:21 am
The gift of life is God given and as such sacred. As a Christian my belief is that God has a plan for everyone of His creation. His desire is to have a relationship with each of His children. The Bible teachings on healing are still relevant, they did not die with the apostles. God's last word on length of life was not three score and ten but 120 years, if we are satisfied. God can and does intervene in terminal illness, He sees and weeps over illness and is moved by faith in His power. All things are possible to those who will believe.
David Holding
14th Mar 2010 at 12:47 am
I have followed your work which I respect. As a cradle christian I value life. I fear the slippery slide with poor legislation.
However there is something seriously wrong in Britain that so many more FEAR the process of chronic illness and the process of death. I am now one, with a husband suffering from S-P.Multiple sclerosis and at 72 years 'well' in other respects and so may have years of distress ahead compounded by the care available within the NHS and Residential nursing/care Homes.Cost of care and my own vulnerability as his 24/7 carer albeit with visiting help .
The vision you presented on TV this week of palliative is simply not available even to the aware who are able to ask and seek.
It is with the greatest sadness that if my husband sought my assistance (as a stoical former Army officer this is unlikely) when little or no support or palliative care was vailable I would support his wishes and take the consequences in this world and the next. This I never thought to even countenance.
Sue Treseder
18th Feb 2010 at 6:42 am
I want to be able to choose the time that I die (with reasonable precautions) because as I get older what I fear most is an extended period with a debilitating condition being "cared for". I fear it more than anything else and in the absence of a choice to die I fear that I may be tempted to end my life before I need to and in a way which is far from comfortable and causes great distress to my loved ones. I believe that I should be allowed the choice, particularly while I am of sound mind. I have no wish to die yet but life would be more worth living if I knoew that I could end it when I reached a condition I find unbearable. Neither you or anyone else can tell me what that condition is because you cannot live my life, yet you seem to wish to impose on me an possibility of an appaling end. I cannot understand or accept your arguments.
Martin Gillie
2nd Feb 2010 at 10:45 pm
I have had Motor Neurone Disease for more than five years now. I cannot do anything for myself any more. I still have the use of one arm, but when I lose the ability to use that one remaining arm. I will do all that I can to commit suicide. I am in sound mind and i will not become a vegetable. It is my life and nobody else's. In the five years that i have had MND, I have had very little help, in fact it is almost non-existent. I go to The Hospice In The Weald once every two weeks, although the nurses and volunteers are all very nice, i see others with MND and I certainly do not want pipes and tubes coming out of me as they do the others with MND. With the non-existent help that my wife and I have, I do not have a choice. Every piece of equipment that i have I had to purchase it myself. Nothing has come from Social Services or the NHS. My wife does not get any allowance from anywhere, Yet I worked for 45 years and WAS hardly ever ill, paid my taxes and NHS insurance and get no help. If I was a immigrant I and not paid no NHS insurance I would be better looked after, but I am not, I am only a Englishman, a real one. CARE AND SUPPORT DOES NOT EXIST. If this is what you call palliative care then I will be better off dead.
D. Kingsnorth
D. Kingsnorth
2nd Feb 2010 at 10:08 am
I believe that Parliament has the responsibility of ensuring that every single private care home in the UK and every GP has the necessary training, funds and incentive to implement the sort of palliative care advocated. In my experience this only exists in the better hospitals and expensive establishments for the elderly. All the rest are afraid to offer the amounts of painkillers necessary to many of their patients for fear of being prosecuted or deaths. For myself I believe in choice and so long as an adult understands the consequences of their actions a system of electing suicide in given circumstances whilst still hale and hearty should give that choice. A declaration sworn before a judge with no friends or relatives present should be respected when the circumstances specified are encountered. I have no fear of death itself only the manner of my going and frankly that terrifies me. The thought of being brought back from near death to endure humilation at the hands of our care home staff as well as pain and suffering until I finally manage to expire is horrific. The world is very over populated and those of us wanting assisted suicide are doing the rest of mankind a favour. Now I feel my only choice is to to keep the means of suicide by my own hand near me so that I can avoid such a fate. I want the right to die in peace!
Carolyn Finbow
23rd Sep 2009 at 4:22 pm
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