Volume 2

Assisted Dying for the Terminally Ill Bill (HL) / Select Committee on the Assisted Dying for the Terminally Ill Bill.

  • Great Britain. Parliament. House of Lords. Select Committee on the Assisted Dying for the Terminally Ill Bill.
Date:
2005
Catalogue details

Licence: Open Government Licence

Credit: Assisted Dying for the Terminally Ill Bill (HL) / Select Committee on the Assisted Dying for the Terminally Ill Bill. Source: Wellcome Collection.

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    3.5 In some instances, a terminally ill patient may ask a loved one for help to die. Relatives can feel compelled to help even though they may be prosecuted. The psychological and emotional impact of helping a loved one to die in secret can be immense. Perhaps even worse, when that help has not been successful, the patient can be left in even greater distress and in a worse physical condition?!. 3.6 To end their suffering, dying patients may take their own life, in some cases violently”. Seven per cent of doctors in a Medix-UK survey (2004) reported that at least one of their terminally ill patients had committed or attempted to commit suicide in the last two years”?. 3.7 Others like Reg Crew and John Close, both of whom suffered from MND, may, as a last resort, travel to Dignitas for help to die—an organisation in Switzerland without proper regulation or safeguards”. 3.8 The use of the Suicide Act 1961 and the law of murder to regulate a terminally ill person’s wishes at the end of life is deeply inhumane. Further it: — Does not stop assisted dying. It simply drives it underground where it takes place without transparency or accountability (Meier 2003; Magnusson, 2002; Emanuel 1998; Kohwles 2001; Ward and Tate 1994); — Prevents an open discussion between a doctor and a terminally ill patient about the end of that patient’s life, causing further anguish (Ryan 1998; Bascom and Tolle 2002)°; — Denies terminally ill patients the choice of medical help to die thereby causing great distress; (Quill and Cassel 2003; Quill 1996)’; — Compassionate doctors who, at the request of a patient, help him to die, have to do so secretly for fear of prosecution. This adds to the doctor’s burden and criminalises his compassionate behaviour (Kohwles 2001; Back 2002); — The lack of transparency puts vulnerable people at risk (Lee 2003; Emanuel 2002; Brock 2000)’. 3.9 A law which is not respected, even at great risk to those who break it, is a law that needs changing. 4. PALLIATIVE CARE AND MEDICALLY ASSISTED DYING 4.1 VES is committed to the improvement of all palliative care, both in terms of resources and access, and supports the recent House of Commons Health Select Committee’s recommendations”. 4.2 Palliative care should be standard care for all terminally ill patients. However, medically assisted dying should not be seen in opposition to palliative care. Rather, we should adopt a patient centred approach, which provides all options to dying patients, including access to excellent palliative care and a medically assisted death as a last resort?!. 4.3 Some commentators have argued that legalisation would undermine palliative care service provision and its future development*”. However the evidence from both Oregon*? and the Netherlands*4 demonstrates that palliative care can successfully work alongside the option of help to die. The vast majority of patients who choose assisted dying under the Oregon Death with Dignity Act 1997 (ODDA) are enrolled in hospice programmes**. Oregon hospices continue to care for those who are considering this option*®. In the Netherlands, better palliative care has been a core goal of medical policy since the mid 1990’s and has improved substantially since that time>’. 4.4 In Belgium, legislation providing all patients with the right to palliative care was passed in parallel with assisted dying legislation*®. 4.5 Research from both the UK (Seale and Addington-Hall) and abroad shows that even with good palliative care, some dying patients still suffer unbearably and want help to die*’. The BMA * the National Council for Hospice and Specialist Palliative Care Services*! and Macmillan Cancer Relief’, have all recognised that good quality palliative care will not meet every patient’s needs. 4.6 No amount of palliative care can address some patients’ concerns regarding their loss of autonomy, loss of control of bodily functions and loss of dignity. An inability to meet these needs arises not because of a failure of palliative care, but because these are person-centred issues. These issues most frequently lie at the heart of a request for help to die*?.