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By British Association for Nutrition and Lifestyle Medicine (BANT)

British law should neither encourage or assist anyone’s suicide

4 min read

Writing on Lord Falconer's Assisted Dying Bill, Lord Carlile of Berriew says Parliament cannot decide whether it is safe to change the law unless it has approved a safeguarding system. 

The law that we have accords completely with social attitudes to suicide - that, while it may be understandable in individual cases and should be treated with understanding and compassion, suicide itself is not something to be encouraged or assisted. An 'assisted dying' law flies in the face of this.  It says that there are some suicides which as a society we should facilitate.  And it drives a coach and horses through a fundamental principle of medicine - the principle, which underlies all clinical practice, that a doctor should, above all, 'do no harm'.

We can all empathise with someone who breaks the law in highly exceptional circumstances and for the best of motives.  The law recognises that: it gives the Director of Public Prosecutions discretion not to prosecute where it is clear from careful examination of all the facts that assistance with suicide was given reluctantly, after serious soul-searching and for wholly compassionate reasons.  But there is a world of difference between that and creating an advance licencing system for assisting suicide.

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Laws are not just regulatory instruments.  They send social messages and they confer social approval.  An 'assisted dying' law sends the message that, if you are terminally ill, suicide is perhaps something you might wish to consider.  For a minority of strong-willed people that may make little difference.  But most terminally ill people aren't like that.  They are often anxious about what lies ahead, in turmoil about what is happening to them and struggling to come to terms with their mortality.  It can make even the strongest of us become vulnerable.

And where are the safeguards in Lord Falconer's Assisted Dying Bill?  It lists various conditions for assisting suicides - such as a settled wish and freedom from coercion - but it requires no more than that a doctor who is willing to consider a request believes that these conditions exist.  It does not require any inquiries or investigations to be made.  The development of concrete safeguards has been kicked into the long grass of codes of practice, to be drawn up by Whitehall and others after Parliament has agreed to change the law. 

Yet how can Parliament decide whether it is safe to change the law unless and until it has seen and approved the safeguarding system.  Codes of practice are there to deal with the detail of legislation.  But safeguards for a regime of assisted suicide are hardly detail.  They are of the essence of any such legislation, and Parliament needs to see them before, not after, it decides whether the law should be changed.  Lord Falconer's Assisted Dying Bill is, in effect, asking Parliament to sign a blank cheque.

Dignity in Dying says that terminally ill people are ending their lives 'in the shadows with no scrutiny'.  The debate here is about whether the law should be changed to legalise assistance with suicide - whether we should be licensing doctors to involve themselves in deliberately bringing about the deaths of some of their patients.  And what sort of scrutiny does Lord Falconer's Bill offer?  In a recent survey of GPs, six out of seven said they would not be prepared to conduct a full assessment of a request for assisted suicide.  The net result of that would be to place those seeking lethal drugs in the hands of a small number of referral doctors who had no prior knowledge of them as patients.  What sort of scrutiny is that?

The law is not perfect - no law is that.  But it does the job it was designed to do.  It makes anyone minded to encourage or assist another person's suicide think very carefully indeed before proceeding and it has the discretion to deal sensitively with genuinely compassionate cases while at the same time having penalties in reserve to deter and, if necessary to deal with the malicious or manipulative.  The experience of the handful of jurisdictions that have chosen to go down the 'assisted dying' road is far from reassuring.  We should look before we leap.

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