The Assisted Dying Bill

Rob Marris MP recently announced his intention to introduce a new Assisted Dying Bill, which will receive its second reading in the House of Commons on Friday 11 September 2015.

The text of the Bill has not yet been published, so it is still too early to say how it will be viewed by Members of Parliament.

I met with four constituents at my surgery on Saturday to discuss this important issue. As I said to these constituents, my own experience of my father’s long drawn out death from Lewy Body Dementia has inevitably coloured my view of whether it would ever be right to assist a seriously ill person to die – my father went from being a strong and dynamic worker for the UN to being tormented by visions, distressed and disorientated, and then through a downward spiral of physical and mental deterioration before he finally passed away.

I was very sad for him that he had had to go through all this – and I would not want the same thing to happen to me. So I would like to think that there might at some point be an option for those afflicted with a dreadful condition like this to make a positive choice to end their own life, and I would like to see that debate on this issue continuing.

However, there are huge challenges in trying to legislate for situations like this – if the Assisted Dying Bill is similar to Charlie Faulkner’s (which made some progress in the Lords) its application will be extremely limited. It would not have been of any assistance to my father. (There was no stage in his illness at which he was both terminally ill and of sound mind).

And, of course, the Bills we have seen so far would have been unlikely to assist the suffers of locked-in syndrome and motor neurone disease who have brought high profile cases through the court – these brave individuals have put their own suffering on the line in the cause of changing the law, but they would not have been helped by a Bill focussing on assisting those patients whose death could be expected within the next six months.

These cases and the public debate over the issue have resulted in very helpful guidance from the Director of Public Prosecutions on when it would be right not to prosecute family members and carers for assisting a suicide. However, this guidance does not provide a blanket exemption from prosecution for doctors who actively assist a suicide, and I understand that the proposed Bill, focussing on medically assisted dying, aims to introduce a new set of rules which would give a key role to doctors in assisting those who wish to die.

It is clear that although there is public support for the concept of assisted dying for the terminally ill, there is considerable concern amongst doctors over what such a change in the law would mean for the medical profession. The British Medical Association’s policy is to oppose physician-assisted suicide, and to stress the importance of improvements in palliative care to ensure that patients in their final weeks and days get the care and support they need to enable them to die with dignity.

I share my constituents’ concern and that of many doctors that legislation to permit assisted dying in specific circumstances could be the start of a slippery slope, leading to further changes in the law. There is the risk that vulnerable people might feel pressured to choose dying if they felt they were being a burden on family and carers, and I understand that many doctors also feel that a change in the law to enable them to assist suicide would be contrary to the code of ethics of clinical practice.

Much will depend on the text of the Bill when it is published. I would like to be able to allow the suffering of those who are dying and wish to die at the time of their choosing to be eased, but I have serious concerns about safeguards – we would need to have a safe and effective framework before making any change to the law. I do, however, consider that the UK should continue to look at developments across the world in this area of law, and we should continue to monitor the effectiveness of the DPP’s guidance.

In my view, the key issue for the UK now should be to make sure that the palliative care and support we provide for those with incurable and terminal conditions is of the best possible quality, and so we need to make sure that we do everything we can to ensure that our National Health Service is in a position to deliver this care. We need to move forward on joining up healthcare and social care, and we need to recognise and celebrate the contribution made by family members and carers.

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