All-Party Parliamentary Pro-life Group Briefing

Patient (Assisted Dying) Bill

2^nd Reading Date: Friday 6^th June 2003

 What will this Bill allow? 

The Patient (Assisted Dying) Bill would “enable a competent adult who is suffering unbearably as a result of a terminal or a serious and progressive physical illness to receive medical help to die at his own considered and persistent request”.

 Why are we opposed to this Bill? 

In opposing this Bill we are joined by the British Medical Association, Help the Aged, disability rights groups, the Archbishops of Canterbury and Westminster and the Chief Rabbi.

 Intentional killing, other than for the requirements of justice, is unethical. The prohibition against intentional killing is fundamental to our whole legal system.

The Patient (Assisted Dying) Bill would fatally undermine the prohibition. Allowing doctors to help their patients to die corrupts the doctor-patient relationship.

 Rules in our moral and legal codes against actively causing the death of another person are not isolated fragments. They are threads in a fabric of rules that support respect for human life. The more threads we remove, the weaker the fabric becomes.

 Why has this Bill been introduced? 

The Patient (Assisted Dying) Bill is being promoted by the Voluntary Euthanasia Society (VES). It arises out of the tragic cases of Diane Pretty and Reginald Crew and seeks to allow patients to ask for, and receive medical help to die.

 We are informed by the VES that this Bill has broad public support. This dubious assertion overlooks the fact that amongst those whom this Bill will affect the most – the elderly, the terminally ill and the disabled - there is overwhelming opposition: 

"Euthanasia is a minority interest amongst the terminally ill.  It is only those who are healthy who want Lord Joffe's Bill." - Dr Nigel Sykes, Medical Director, St Christopher’s Hospice, London.

 “This (the Patient (Assisted Dying) Bill) is not a Bill that Help the Aged would support, because we do not support changes to the law relating to euthanasia.” - Help the Aged.

 “Until we are convinced that sufficient regulation and safeguards can, and will be, put in place to ensure the right to life of disabled people, we will not support the legalisation of assisted suicide and voluntary euthanasia.” - Disability Rights Commission (DRC).

 Does the medical profession support a change in the law to legalise assisted suicide and voluntary euthanasia?

 Absolutely not. An independent survey of doctors carried out by Opinion Research Business (ORB) and published on 13^th May 2003 revealed that almost three out of four doctors (74%) would refuse to perform assisted suicide if it were legalised. A clear majority (56%) also consider that it would be impossible to set safe bounds to euthanasia.

 What if the patient is in unbearable pain and suffering?

 These are subjective concepts. Unbearable pain or suffering seems to be the hoop through which one has to jump for euthanasia to be acceptable to some. Yet, as Dr Andrew Lawson, a Consultant in Anaesthesia and Pain Management, recently pointed out in the Daily Telegraph, why is this so?

 “How much pain and of what kind do I have to have for it to be enough of a burden to be allowed to die? Surely it would be discriminatory to suggest that only in certain circumstances can euthanasia be allowed. One would in effect have to prove to someone else’s satisfaction that one’s quality of life was so bad. This would inevitably involve a subjective judgement which would diminish individual choice.”

 Euthanasia cannot be limited except by arbitrary and discriminatory regulations of the sort contained in the Patient (Assisted Dying) Bill. Euthanasia would become a symptom control choice, one option of treatment among others.

 Those who care for the terminally ill in our hospice movement maintain that with proper care, patients should not die in pain.

 Professor David Currow, Professor of Palliative and Supportive Services at Australia’s Flinders University insists that despair and depression – not pain – are the main reason why people end their lives: "If you’re not depressed or demoralized your chance of seeking euthanasia is zero".

In the Netherlands, surveys have shown that pain is very low down on the reasons for requesting euthanasia. Positive requests for euthanasia usually result from poor medical care. When good palliative care is offered there is a dramatic drop in requests. A recent independent survey of doctors revealed that two-thirds of doctors considered that the pressure for euthanasia would be lessened if there were more resources for the hospice movement.

Those of us opposed to legalised killing recognise the suffering of patients with Motor Neurone Disease and similarly debilitating diseases and acknowledge the anguish of the families who care for loved ones with these conditions. We regret that these patients are being used by the VES to perpetuate negative stereotypes of the disabled and frighten people who may be in the early stages of these diseases. Jane Campbell of the DRC articulated the concerns of many disabled people when she said in a recent article in the Independent that “the campaign to assist our so-called voluntary death is dangerous and reinforces our unequal status.”

Greater investment in our hospice movement represents the way forward, not the Patient (Assisted Dying) Bill.

What has happened in those jurisdictions where euthanasia has been legalised?

In Oregon, USA experience has shown that the longer euthanasia has been legal, the greater the percentage is of patients who think that they have become a burden to society and should be requesting euthanasia.

In the Netherlands, Drs Henk Jochemsen and John Keown reported the following:

• In one year 900 patients – 20% of the 4,500 patients whose lives the doctors had said they had actively and intentionally helped to end by euthanasia or assisted suicide – had had their lives ended without their explicit request.
• 60% of all cases of euthanasia and assisted suicide are not reported to the legally appointed authorities. More worryingly still, Professor Griffiths of the Faculty of Law, University of Groningen admitted at a recent meeting organised by the VES that it is the “more problematic” cases that are escaping the control system.

 Jochemsen’s and Keown’s findings led the Journal of Medical Ethics to conclude in an editorial:

  “Restrictions on euthanasia that legal controls in the Netherlands were supposed to have implemented are being extensively ignored and from that point of view it is surely justifiable to conclude…..that the practice of euthanasia in the Netherlands is in poor control; and in particular, that as well as voluntary euthanasia…….involuntary and non-voluntary euthanasia are also being carried out.”

 Dr Peter Hildering, President of the Netherlands Physicians League recently told a meeting in Parliament that there are Dutch patients who go to Germany for treatment since they are afraid that they might be killed in the Netherlands against their will.

 Isn’t euthanasia being practiced by doctors behind closed doors, unreported and unscrutinised?

 To suggest that our medical profession is practicing de facto euthanasia is highly misleading and a slur on the doctors and nurses working in palliative medicine who strive to give their patients a dignified death – without taking positive steps to terminate their lives.

 The ORB survey of doctors referred to earlier explodes the idea that many people are clamouring for euthanasia.  In response to a question asking how many patients had requested euthanasia during the past three years nearly half (48%) of the doctors said not one.  37% quoted less than five; 11% gave numbers between 5 and 10 patients; only 2% gave figures of more than ten. In their comments doctors said that in their experience requests for euthanasia were often “cries for help that have been resolved with good symptom control…they almost invariably want relief from distress”.

 Conclusion

 Voluntary euthanasia and assisted suicide are unethical and should remain illegal. Many organisations and bodies representing those who would be affected most by the Patient (Assisted Dying) Bill - the elderly, the terminally ill, the disabled and the medical profession – are united in their opposition to it.

 It is impossible to establish an effective regulatory framework for assisted suicide and euthanasia. By allowing a few patients to receive medical help to die we would be putting large numbers of patients at grave risk.

 Tinkering with the Patient (Assisted Dying) Bill will not save us from its disastrous effects.

Lord Walton of Detchant: “the contributions of the Palliative Care Movement have made [the Patient (Assisted Dying) Bill] unnecessary.”

 Most Rev and Rt Hon the Archbishop of Canterbury: Euthanasia is “an act of violence, an attempt to take possession of the future…..even if euthanasia were legalised in some form and pragmatic anxieties overcome, it could not be a course of action endorsed by Christians.”

 Lord Carlile of Berriew: “I shall be in the House to oppose the Bill from the noble Lord, Lord Joffe, and I shall be in the House on any other available occasion to oppose legislation that attempts to introduce euthanasia.”

 For further information please contact Martin Foley, Clerk to the All-Party Parliamentary Pro-life Group; Telephone: 0207 219 0968 or email: foleym@parliament.uk.