It’s a moral and ethical question that stirs up strong emotions and divides opinion. Should a terminally-ill person have the opportunity to ask their GP for medication to end their life?
According to the findings of a report by the Commission on Assisted Dying, adults who are likely to have less than a year left to live could be given the chance to determine their death.
But it says stringent safeguards must be in place to protect those who might not have the mental capacity to make such a choice, or who might be clinically depressed or experiencing pressure from friends or relatives.
The commission, chaired by former lord chancellor Lord Falconer, said that, under its proposals, a terminally-ill person would need to be able to take the medication themselves as a clear sign that their actions were voluntary.
In a majority decision, the commission called for Parliament to consider developing a new legal framework for assisted dying, saying that the ‘current legal status of assisted suicide is inadequate, incoherent and should not continue’.
One member, the Rev Canon Dr James Woodward, said he was unable to back the decision, arguing it was not the right time to consider changing the law until a greater ethical, moral and social consensus had been generated on the issue.
Since new guidelines for prosecutors in cases of assisted suicide were introduced in February 2010, anyone acting with compassion to help end somebody’s life is unlikely to face criminal charges.
But assisted suicide remains a criminal offence in England and Wales, punishable by up to 14 years in prison.
The findings of the commission, which includes Portsmouth North MP Penny Mordaunt as one of its 11 members, have angered campaigners against a change in the law. They have warned that it would risk increasing the pressure on vulnerable people to end their lives out of fear they might become a burden for others.
Prime minister David Cameron has previously signalled his opposition to changing the law on assisted suicide. But MPs would expect to be given a free vote if the issue came before Parliament.
The commission was set up by think-tank Demos. It has taken evidence from legal, medical and religious experts, and people with personal experience of this issue.
Sarah Wootton, chief executive of Dignity in Dying, which supports changing the law, said: ‘Opponents will continue to attack any efforts to find a solution to the unbearable suffering which continues daily in the absence of a compassionate assisted dying law, but they themselves cannot suggest an alternative.’
The campaign group has released an online poll of more than 2,700 people which showed three in five would be in favour of a parliamentary debate on the issue of Britons travelling abroad to Switzerland to be assisted to die.
But Dr Peter Saunders, campaign director of Care Not Killing, insisted the law does not need changing and branded the commission’s report ‘unnecessary, biased and... seriously flawed’.
Author Sir Terry Pratchett, who has campaigned for a change to the law over assisted dying since being diagnosed with Alzheimer’s disease and helped to fund the commission, said its report didn’t go far enough.
He claimed poor quality end-of life care in the UK was driving people to travel abroad to die.
Portsmouth North MP Penny Mordaunt is a member of the Commission on Assisted Dying.
She says there was a need for the report because of the state of end-of-life care in this country and the need for more legal clarification.
‘It looks at what’s wrong with the status quo. One is that we have really patchy end-of-life care and that needs to be much better and more consistent.’
Penny adds: ‘We also have a legal muddle in that it is still illegal for someone to assist someone to commit suicide, but no-one has been prosecuted.’
Penny highlights the fact that 400 people a year who are terminally ill or chronically ill in the UK commit suicide, often by suffocating themselves. Many of them are alone and terrified.
She says: ‘For me the most compelling issue we have is that there are a small number of people who are in extreme pain or terrified of death and want to be in control of the situation.’
Research for the report looked at how systems that allow people to have assisted deaths work in other countries.
Penny says: ‘Quite often people aren’t opposed to the idea of assisted death, but they don’t know how it would work.’
In the American state of Oregon, she says it was noted that many patients who received prescriptions to end their life did not use them.
Penny, who now wants the report’s findings debated in Parliament, explains: ‘It seemed to provide peace of mind, knowing that they had that option.’
THE HOSPICE CHIEF EXECUTIVE
Ruth White, chief executive of The Rowans Hospice at Purbrook, a charity dedicated to improving the lives of people with cancer and other life-limiting illnesses, says: ‘Our desire is to maintain the quality and value of life. That isn’t to say we would do things to prolong suffering, but we would support allowing people a natural process of dying with appropriate medication to enable people to feel comfortable, and give the necessary counselling, support and care to allow people to have important time together towards the end of life.’
She says the hospice places emphasis on making sure patients feel valued and important until the end of their lives. And she is concerned about the risks of prescribing medication.
‘We know from our patients that there are days when it’s very, very difficult, but not all days are really hard. People can pass through difficult stages.
‘Certainly, many of our patients come in feeling very depressed but as they start feeling valued again as individuals that depression can lift. I find the finality of suicide quite difficult.’
The Rev Canon Nick Ralph, social responsibility adviser for the Anglican diocese of Portsmouth, is strongly against a change in the law and says of the commission: ‘This is a group masquerading as an official commission when it is in fact a self-selected group of like-minded people already supporting the idea of assisted dying.
He adds: ‘The outcome was therefore a foregone conclusion and flawed. It is flawed because it does not take into account the absolute sanctity of human life. The idea of state-sanctioned and commissioned death is a massive step to take that is dangerous and frightening.’
Nick doesn’t see how people would be protected if the law was changed.
He explains: ‘How will those who worry about being a burden on their families be supported?
‘How will those who are depressed or in pain, but who, with better treatment, could have a better quality of life, not be missed or failed?
‘At a time of falling resources in health, the idea that we should be considering this is not only quite wrong, it is abhorrent.’
Dr Jon Price has been a GP at The Osborne Practice in Southsea for 20 years and is a clinical lead for end-of-life care for the Portsmouth Clinical Commissioning Group.
He says of assisted dying: ‘It’s an important issue for the time. But I have a concern that it distracts from the majority of the problem, of looking after people at the end of their life.
‘In my own practice I’ve only had one person who’s seriously asked me about it (assisted dying) because they were frightened, as a number of people are about having a bad death. But they didn’t have a bad death.‘
If the law was changed, Dr Price has concerns about protection of the vulnerable.
He explains: ‘I have significant reservations. It’s possible it may happen with safeguards, but these would need to be very careful.
‘One issue that stands out a mile is the issue of capacity.
‘Of those who die in hospital, probably about 40 to 50 per cent have extreme frailty including dementia, cancer, or organ failure. They don’t have the mental capacity to make this decision at the time.’