It does look as if most people now at last want to enable suffering persons of a sound mind and with less than six months to live to be helped to achieve their wish—death, to relieve suffering. And, after the House of Lords voted recently to accept amendments to the Assisted Dying Bill, a change in the law is one step closer.
Many antagonists of the bill do not seem to understand that a person has to be mentally competent, and this means that the new law will not apply to patients with dementia. Many also are not aware that very similar laws are in place in Switzerland; Holland; Belgium; and the states of Oregon, Washington, and Vermont in the United States. The number of assisted deaths in those jurisdictions is very small indeed, and very careful monitoring shows no sign of the “slippery slope” that some prophesy will happen in UK.
Lord Pannick’s addition to the Assisted Dying Bill, which requires a judge to decide on each individual case, will reduce the anxiety of many people and make the bill more likely to succeed.
Several years ago, I refused to continue nutrition for a young patient in a persistent vegetative state. Within three days I had to appear before a judge to justify my decision. The patient was represented by the official solicitor. The speed with which this took place, the exemplary balance and clear thinking of the family court judge, and the way the system worked impressed me mightily. From the doctor’s point of view, I found the whole legal process reassuring and helpful. An appeal was sent to the Master of the Rolls in London who approved the judge’s decision extremely quickly. This showed that the law can work very fast if necessary, and I am sure the law could do so for consideration of a patient’s request for assisted dying.
It is amazing to me that so many doctors’ organisations have been so negative about a law that has one purpose, and one purpose only: to relieve suffering at the considered request of patients of a sound mind. I think it is a disgrace that UK doctors have failed to push for this bill years ago. Is relieving suffering not one of our great aims and opportunities? Why have we obstructed this or, at the least, waited? What has been wrong with us as individuals and with our medical organisations? I suspect fear is the problem.
Many UK institutions regard maintaining themselves with their ponderous traditions as being an end in itself. Some are worried about change, and their fellows and members often differ in their opinions. It takes courage to change, and the fear of getting it wrong inhibits the necessary processes for changes in practice.
But individual doctors upholding principles that do not allow them to assist dying could easily be exempted from this function, in the same way as some gynaecologists refuse to carry out abortions. There can be no question of coercion, assuming there will still be doctors who will want to relieve suffering by enabling assisted death.
Another factor that has delayed assisted dying here is that the UK was a world leader in developing palliative care. This has created a problem because some people with official positions in the palliative care world have been upset, fearing that ordinary doctors have invaded their territory. Some have failed to see the Assisted Dying Bill as a great adjunct to current palliative care services—and not as an antagonising change.
When in doubt, as doctors, if we put the patient’s wishes first we should be moving in the right direction.
Christopher Burns-Cox is a retired consultant physician.
Competing interests: I’m a member of Healthcare Professionals for Assisted Dying (HPAD).