The issue of euthanasia, or assisted dying, is incredibly controversial and there are legitimate concerns on either side of the debate. Today I will propose a motion to the British Medical Association's annual conference in Liverpool, which states:
This meeting supports the introduction of legislation to allow people who are terminally ill but 'mentally competent', the choice of an assisted death. Further, the law should not criminalise people who accompany those who make rational decisions to end their suffering
The motion will seek to take the issue forward in a compassionate and fair way that I believe will serve the interests of the terminally ill and our society.
The starting point has to be in the law, which at present is failing, as shown by the recurrence of cases in the courts that often place relatives, already dealing with the painful loss of a loved-one, in the middle of distressing legal battles. There is clearly a desire – whether we like it or not – among a number of patients at the end of often terrible battles with debilitating, incurable diseases to end their suffering with the support of their relatives. To deny this right is to prolong the suffering for individuals and families, something that I can simply not condone.
I do accept though that this is not like any other clinical decision – and that if society is to offer this solemn choice it must also build in safeguards to its laws that not only rectify the inadequacies of the current situation, but also protect the vulnerable, the weak and all those – doctors and nurses included – who are involved in this incredibly difficult situation.
As a start we must enact legislation to decriminalise acts of euthanasia and physician-assisted suicide. Some of the reasons that are compelling enough for us to change our laws are:
Prevention of cruelty and protection of human rights
To allow a terminally ill individual to end their life is the only humane, rational and compassionate choice. The current prohibitions require a person with great physical and/or mental suffering to continue to endure their suffering against their wishes, which cannot be right. The right to life and the right to private and family life under the European convention on human rights should be interpreted broadly to include decisions about quality of life, including decisions about death if the life is no longer one of quality.
The terminally ill are travelling abroad to countries where the right to end of life in terminal cases is recognised and is lawful. We cannot regulate the laws of foreign lands. We must make provisions within our laws to regulate this issue within our boundaries under our control and supervision. We must not prosecute loved ones for "encouraging or assisting" suicide who enable or assist a terminally ill individual to travel abroad to end his or her life lawfully.
Ambiguity in the application of the current law
The current law conflicts with the law as it is being enforced. If the laws as written were being enforced, over a hundred people would have been prosecuted for accompanying their loved ones abroad to help them end their lives. This ambiguity and uncertainty leaves all concerned, including physicians, unprotected.
Discriminatory effect of the laws
The ability of the wealthy to travel to countries where it is lawful for the terminally ill to end their lives has the discriminatory impact of treating the haves and have-nots unequally.
Many people are opposed to legislation that would allow "end of life" choices. But our concerns relating to abuses and protection of the vulnerable can be addressed by ensuring that certain objective safeguard conditions are met prior to allowing a terminally ill individual from exercising his or her right to die with dignity. Some of the safeguards include the following:
• The patient must be terminally ill.
• The patient must be an adult.
• The patient must be mentally competent.
• The patient must be in severe pain.
• Two independent physicians must be satisfied that the above conditions are present.
In conclusion, the only humane choice is to allow individuals who are suffering to choose to end their suffering. Further, the discrepancies in the laws as they exist and how they are being enforced have led to uncertainty. This uncertainty leaves the doctors, their patients and patient's loved ones unprotected. If we do not address these issues openly and head-on, we will have continued uncertainty and unregulated practice of euthanasia or assisted suicide with the fear of prosecution hanging over the heads of all concerned.
The goals of the medical profession should continue to remain one of saving lives but this should not be at the expense of compassion and a terminally ill individual's right to choose to end his or her life and die with dignity.
• Dr Kailash Chand is a GP in Greater Manchester
A third of senior doctors want assisted dying to be made legal, a major survey has found.
It shows that there has been a marked shift in favour amongst the country’s leading medical professionals over the past eight years.
A survey of 8,900 members of the Royal College of Physicians found that 37 per cent were in favour of a change in legislation.
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A survey of 8,900 members of the Royal College of Physicians found that 37 per cent were in favour of a change in legislation
By comparison, when the same exercise was carried out in 2008 just 26 per cent wanted to change the law.
The College – which represents 29,000 specialist doctors – said it would remain opposed to assisted dying but had acknowledged the of doctors and would continue speaking with them in case there was a sudden groundswell of support.
Yet there appears to be growing support amongst health professionals and this Summer the British Medical Journal called for patients to have the right to ‘call time’ on their lives.
And earlier this month the deputy chair of the British Medical Association called for the law to be changed allowing euthanasia within the next two years.
A bill put forward by Labour peer Lord Falconer is currently making his way through
The survey also found that just over a fifth of doctors would personally be prepared to help a patient end their lives if the law were to change.
And 32 per cent said they supported a change in the law to permit the assisted suicide of terminally-ill patients with the help of doctors.
Dr Andrew Goddard, the RCP’s senior officer with responsibility for professional matters, said: ‘These results give us a basis for our position on assisted dying and for responding to proposed legislation, now and in the coming years.
‘Whilst there is still a majority against a change in the law, we recognise there has been a shift in opinion over the past eight years, and will continue to engage with members and fellows on this issue.’
Assisted dying could become law within the next two years and a bill put forward by Labour peer Lord Falconer is currently making its way through Parliament.
Under his proposals, terminally ill patients with less than six months to live would be allow to end their lives with a fatal dose of medicine.
They would have to get a form signed off by two doctors before the fatal dose could be administered.
It is currently being debated in the House of Lords and will subsequently voted on MPs in the Commons who will decide whether it should become law.
Assisted suicide remains a criminal offence in England and Wales, technically punishable by up to 14 years in prison.
But the practice has been legal in the Netherlands since 2002 and around 4050 patients a year end their lives in this way.
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