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Assisted Dying Bill offers transparency, choice and dignity

Assisted Dying Bill offers transparency, choice and dignity
5 min read

Labour MP Rob Marris sets out the detail of his Private Members' Bill on Assisted Dying which was drawn top of the ballot in Parliament last month

I have two main reasons for introducing the Assisted Dying Billin the House of Commons.  

Firstly, it’s a straightforward question of choice and dignity: with appropriate, strong safeguards, terminally ill adults of sound mind should be legally allowed to have assistance to end their own lives.    

Secondly, the current state of the law is a mess.  The Director of Public Prosecutions has done her best, issuing guidelines as to when it is, or is not, in the public interest to prosecute.  The DPP’s guidance on assisted suicide sets out the factors that weigh for and against prosecution, and broadly confirms that compassionately motivated assistance by an amateur will not be prosecuted. I do not blame her personally. 

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Lord Farmer: Evidence for physician-assisted suicide 'is far from reassuring'

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Some, such as Lord Carlile, writing recently on this site, argue that the law’s threat of prosecution, combined with the DPP’s discretion, works well.  Yet the status quo does not prevent assisted deaths, nor does it offer protection to dying people considering ending their lives.  

That approach is an unacceptable compromise. The DPP is doing the best she can.  However, in a democracy it is elected representatives who should make the laws, not an unelected civil servant.

Last summer the Supreme Court issued Parliament with a final warning, to address the problems with the current law.  In his decision on the Nicklinson case, Lord Neuberger, President of the Supreme Court, provided this compelling analysis: “…A system whereby a judge or other independent assessor is satisfied in advance that someone has a voluntary, clear, settled, and informed wish to die and for his suicide then to be organised in an open and professional way, would, … provide greater and more satisfactory protection for the weak and vulnerable, than a system which involves a lawyer from the DPP’s office inquiring, after the event, whether the person who had killed himself had such a wish, and also to investigate the actions and motives of any assister….”.

Contrast that to what is currently happening, which is usually hidden.  Terminally ill patients are ending their own lives, often in undignified and desperate ways.  Anecdotally, for compassionate reasons, some doctors are complicit in hastening patients’ deaths.  Some relatives and loved ones are doing likewise.  Some richer patients are going to Switzerland.  

About 300 suicides in England each year are by a person with a terminal illness. It is estimated that about 1,000 deaths in the UK each year are the result of direct help to die by the doctor, at the patient’s request. British citizens are travelling to Dignitas in Switzerland for assistance to die at a rate of one a fortnight.

The law currently denies dying people the choice of a safe, legal assisted death, whilst turning a blind eye to home suicides, technically illegal actions by doctors, and Dignitas deaths. A recent editorial in The Economist summed up the situation well: “It is hypocritical because society is pretending to shun doctor-assisted dying while tacitly condoning it without safeguards.”

As an MP, as a lawyer, and as an individual, I am convinced that we can do better for dying people. At present, it is illegal to assist or encourage a suicide, and the law makes no distinction between the suicide of a vulnerable person, due to depression or problems in their personal life; and the choice of a well-informed, competent, adult who is already dying, to control the manner and timing of their death.  

Let’s be clear about what the Bill does and does not allow. It does allow a patient to self-administer medication to end their own life.  It does not allow euthanasia. It does allow a terminally ill patient who is of sound mind to seek assistance.  It does not allow a person with a painful disability which is not terminal to seek assistance.  It does allow a mentally competent patient to seek assistance.  It does not allow a patient with dementia to be “put to death”, as some have suggested, because dementia is not a terminal illness, and a patient with late stage dementia would not pass the “of sound mind” test.

The law is not working and it clearly does not have the confidence of the public or the courts.  Lord Carlile has argued that the law accords with social attitudes. I do not know the evidence, if any, upon which he relies for that assertion. What I do know is that opinion polls indicate that 82% of the public believe there should be a change in the law on to permit assisted dying for terminally ill, mentally competent adults.

Up-front safeguards would provide far greater protection than the currently sporadic, retrospective investigations offered by the law. If the Assisted Dying Bill were enacted, decisions around assisted dying would be subject to intense scrutiny before a patient could die.  Under my Bill, two doctors and a High Court judge would have to be satisfied of the requesting patient’s eligibility, and that he or she had made a fully informed decision, before assisted dying would be allowed.  Only terminally ill adults with a prognosis of six months or less who were mentally competent and who had considered all of their alternatives, would be eligible. That’s transparency.  That’s choice. That’s dignity.

Full text of the Assisted Dying Bill& explanatory noteson the Bill as introduced in the House of Commons on 22 June 2015.

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