Do doctors have the right to assist suicide?

The time has come for legalising assisted suicide and I want to be a test case for a euthanasia tribunal, declared Sir Terry Pratchett. I want pop-in euthanasia booths, added Martin Amis. We support terminally ill people’s right to die, cried 80% of the British public. (Figures by the National Centre for Social Research 2010.) It seems that support for assisted suicide is sweeping the nation.

Terry Pratchett is ready to be a test case for a euthanasia tribunal

Image: Robin Zebr0wski @ Flickr

This week Dr Michael Irwin, dubbed “Dr Death”, hit the headlines once again; he avoided prosecution after accompanying a cancer sufferer to Dignitas where he later ended his life.

Many argue that the current legal situation surrounding assisted suicide offers no safeguards; it does not protect those who do not wish to die, or provide any guidance to doctors and family members who have been asked to assist in voluntary suicide. It also results in many ending their life prematurely, while they are still capable of doing so.

Yet the fear that legalising assisted suicide will put pressure on a very vulnerable group of people, many of whom already feel like a burden, is a very real concern. Simply by making assisted suicide legal and therefore socially acceptable could be enough to make some people feel duty bound to take their own life, this is an issue that cannot be ignored.

Simon Stevens, an active campaigner for disability rights, speaks out against assisted suicide

Image: Simon Stevens

Simon Stevens is a leading independent disability consultant and trainer with vast experience in disability equality. He is an active campaigner for disability rights and over the last 15 years has worked for organisations including Scope, Warwick University, the BBC and the Council of Europe to help improve the situation for disabled people.

Born in 1974, Simon has cerebral palsy. He says it affects his speech, balance, hand control, and even his sense of humour – in a good way. Despite his difficulties and the everyday discrimination he faces because of his disability, Simon is rightly proud of his achievements; winner of a 2004 Enterprising Young Brit award and a 2008 UK Catalyst Award, he proves that cerebral palsy doesn’t have to get in the way of running a successful business or two.

Although Simon says that he’s tried to stay open minded about assisted suicide he has decided to speak out. He’s worried that recent support for euthanasia, that’s been extensively covered by the media, has already made it socially acceptable. “I realised that increasingly the media would portray the death of disabled people in ‘mercy killings’ as acceptable”, he said. “It appears that when a parent kills a non disabled person they are deemed evil while when a parent kills a disabled child they are presented as a hero.” Simon believes that this is because disabled people are treated as second-rate citizens, as though their lives are not worth as much.

“When a parent kills a disabled child they are presented as a hero”

By legalising assisted suicide it will make people with disabilities and terminal illnesses feel like a burden and there will be increased pressure, however indirect, to commit suicide out of a sense of duty, says Simon. “Society will increase the pressure until it becomes a duty imposed upon the family. I worry that a situation will occur whereby society will assume that terminal illness should lead to suicide.”

“Society will assume that terminal illness should lead to suicide”

Speaking from his own experience, Simon is fearful of the impact that legalising assisted suicide could have on those who are struggling to cope. Last March, at the peak of his paralysis, Simon wanted to end his own life. “There was a point when I did want to die, and indeed it was not the first time I considered suicide”, he explained. “But both times it was because I was unhappy with my environment and the lack of certainty. Once I knew what was happening and regained control I became happy; it was never about the illness. People may argue that it is different for me because I knew I would get better, but that was not the case. The hospital had written me off and sent me home; I had no desire to improve my situation and I didn’t believe it would improve.”

This is why Simon is adamant that improvements in the health service and social services would reduce the number of people thinking about assisted suicide. “If people have good quality support and healthcare they can manage their conditions better”, he said. “I would like to see a legal guarantee to appropriate and responsive rehab in a speedy, coordinated, and informed manner.”

Failing to work closely together to provide effective healthcare for chronic or terminal conditions is a criticism that the NHS and social services often faces. This is an issue that both pro and anti euthanasia campaigners seem to agree on. Jo Cartwright, campaigns officer for Dignity in Dying, said, “We believe assisted dying should be a choice for people who are terminally ill and mentally competent. For this to be a real choice the individual should have had full access to palliative care. At the moment not all people have access to good quality palliative care, so this needs to be addressed.”

Yet, Dignity in Dying state that even the highest quality of palliative care cannot alleviate all suffering, and it’s for these people that they campaign for assisted suicide legislation.  Jo said.

“At the moment assisted dying is going on, either by people travelling abroad to die or being helped to die here in the UK, with or without success. There are currently no safeguards, and retrospective prosecutions don’t help the individual who has died if there was coercion.”

Jo argued that assisted suicide legislation with upfront safeguards would protect people who do not want to die. While also protecting those who want that choice; they would not longer have to travel abroad to die earlier than they would want, while they physically can.

Former chairman of Dignity in Dying, Dr Irwin, hit the headlines this week as he avoided prosecution after taking a cancer sufferer to the euthanasia group Dignitas in Switzerland where he later ended his life. His was the first assisted suicide case not involving family members or friends to be considered by the Crown Prosecution Service since the landmark guidelines were set out by the director of public prosecutions (DPP) in February, and has prompted fresh claims that the crime is being effectively legalised by the back door.

Yet an interview I conducted in March with Baroness Ilora Finlay, a world authority on the care of terminally ill cancer patients, saw her defend the guidelines. Ilora, a consultant doctor at the cancer centre in Cardiff, Wales, shares her own story of sickness and suffering and reveals her passionate views on assisted suicide.

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(Note: This interview was conducted in March 2010 and is therefore not a reaction to Dr Irwin avoiding prosecution)

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An environmental journalist and communications trainer, Bethan specialises in nature conservation and social justice

Posted in Health
2 comments on “Do doctors have the right to assist suicide?
  1. Do doctors have the right to assist suicide?…

    I found your entry interesting do I’ve added a Trackback to it on my weblog :)…

  2. Very much liking the blog, Bethan. Strong stories convincingly argued. (And I’m not just saying this because I’ve been one of them).

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