Vulnerable People

“I readily acknowledge that many of these cases are tragic.” says HM Advocate General for Scotland and MoJ spokesperson for the Lords The Rt Hon Lord Keen of Elie QC

Today, in an oral question relating to the Crown Prosecution Service’s (CPS) Policy for Prosecutors in Respect of Cases of Encouraging or Assisting Suicide, several members of the House of Lords, asked Lord Keen about the law prohibiting on assisted dying. Below is a transcript of the questions.

Assisted dying is legal in Belgium, Canada, Colombia , The Netherlands, Luxembourg, Switzerland and seven US states. Last week, new figures released by the UK Assisted Dying Coalition, which includes My Death, My Decision, found that more than one person a week now travel to Switzerland, each week, to end their life. Individuals such as Geoff Whaley, an 80 year motor neurone disease suffer, who traveled to Switzerland last week to end his life only last week.

Under Section 2(1) of the Suicide Act, any action to help another person to end their life is illegal, and those convicted face up to 14 years in prison.  In 2015, parliament rejected by 330 against to 118 in favour, Rob Marris’ private members bill to legalise assistance for those who were terminally ill and likely to die within 6 months.

Responding to a question from Baroness Blackstone. Lord Keen said:

“The CPS policy on assisted suicide provides guidance for prosecutors on assessing the evidential and public interest stages, in reaching decisions on cases of encouraging or assisting suicide. The policy sets out the factors, which must be applied in reaching decision in these cases, and balances the various important factors which need to be considered. There are no plans on reassess the CPS policy in such cases.”
In response, Baroness Blackstone asked: “Does the Minister really think, it is a good use of police time to interview, under caution, the wife of a dying man who wishes to choose how he dies? In light of the Whaley story, and the treating of families like criminals, does the Minister think that the law is working well?”
He replied: “It is for the CPS to apply the law, not make the law. Every case must turn on its own facts and circumstances, where matters are drawn to the attention of the police of matters relating an assisted suicide or potential assisted suicide, they will investigate. They are bound to investigate what is potentially criminal conduct in terms of Section 2 of the Suicide Act. I see no reason why they should pause those investigations given the current state of the law.”
Also asking Lord Keen about the law relating to assisted dying, Lord Pannick, who recently acted in Noel Conway’s legal case to change the law for those suffering from a terminal condition, said: “Does the Minister recall that the CPS policy was adopted after the Debby Purdy case in 2009, because of the uncertainty of the law. Does the Minister accept that there continues to be very considerable uncertainty in this area, which is causing enormous distress to those at the end of their lives and their families?”
He was told: “A consultation was prompted by a decision of the courts, that led to a consultation exercise in September 2009 to which there were more than 5000 responses, and resulted in the publication of the CPS policy document in 2010. I consider that that policy is working well at the present time.”
Next, Lord Sherbourne of Didsbury asked: Does the Minister understand that for people with a terminal illness, with no hope of recovery that are suffering great distress, that for these people the current law, which prevents them from being able to end their own life in dignity, is condemning  them to great and unnecessary suffering?
He was told: Of course we are conscious of the difficulties and challenges facing people, in the situation outlined, but again I emphasise it is for the CPS to apply the law not make the law. In doing they they follow a policy that not only addresses an evidential test but also a public interest. The consequence is that in the 140 cases referred in the last 9 years, there were prosecutions in respect of section 2 of the Suicide Act in only 4 of those cases, resulting in 1 acquittal and 3 convictions.
Lord Low if Dalston, then asked: The police are only enforcing the law, so it is really the law which is the problem, rather than the police. When will the government bring in a new law to free the police from having to treat loving families like criminals?
He was told: It is not a case of having to treat loving families like criminals, it is a matter of having to look at the facts and circumstances of every case, in which the victim may be extremely vulnerable. It is therefore, as the government has said before, a matter for Parliament because it is a matter of conscience, and it is not a matter for government to bring forward such legislation. Lord Low will be aware that such legislation was proposed in 2015 and did not succeed.
Baroness Barker, then asked: Given the statistics just quoted is that not in itself, an indication that the law is not working? She was told: No I do not think so. I say only in a small minority of cases has there been a successful prosecution. I should also add however, that there have been a number of instances, in which the case which was taken forward involved prosecution for homicide not assisted suicide.
Following this, Baroness Meacher said: Indeed, Geoff Whaley did die from a dignified death in Switzerland last Wednesday, but most people can’t afford to take their families to Switzerland for such a death, or they can’t get the medical report from their doctor to have such a civilized death. Does the Minister agree that in a civilized society, someone in Geoff Whaley’s position, should be able to avoid months of being unable to swallow, to eat, to drink, to speak, or move and totally therefore cut off from communication. Will the Minister discuss with his colleges what can be done to change the law?
Lord Keen replied: It is not the intention of the government to seek to change the law in this area. I emphasise that every case needs to be considered according to its own particular facts and circumstances. I readily acknowledge that many of these cases are tragic.
Finally Baroness Chakrabarti asked:
Whatever the conflicting views, and there are many, on public and prosecutorial policy in this area, I think we  can all agree that the current situation does present loved ones with Motor Neuron Diease and similar conditions at the end of their lives, with an emotional, ethical and legal mindfield. Is the Minister confident that these people, at a very difficult time, are getting the advice and support that they need to navigate that?
She was told: I’m not in a position to say where such people seek advice on these matters, but such advice is available. The policy of the CPS with regards to this matter is publicly available.
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MDMD Campaign Policy Director responds Dominic Lawson

My Death, My Decision’s Campaign Policy Director, Phil Cheatle, responds to the Daily Mail’s Dominic Lawson. 

Today, the Daily Mail published an article by Dominic Lawson, criticising the Royal College of Physicians (RCP) decision to poll their members on assisted dying. His article misses some important points.

One example, is Mr Lawson’s insistence that: “assisted dying already exists in this country: it is called palliative care and takes place in hospices across the land.” Another is his claim, that: “the issue is whether doctors should be required to perform [assisted deaths] if any of their patients request it”, or that the very notion of assisted dying requires a doctor to breach their Hippocratic Oath.

Palliative care is undoubtedly an important choice for anyone at the end of life, and My Death, My Decision firmly supports its work. However, whilst MDMD recognises the importance of its benefits, we also believe it is important to recognise its limitations. Palliative medicine is ill equipped to help those who fear a loss of dignity, or loss of autonomy. Not all pain can be palliated, and worse, people are unable to say “enough is enough I just want help to die peacefully”. More significantly, it offers very limited help those who suffer from degenerative neurological conditions such as dementia (which accounts for one in eight deaths in the UK).

On the issue of “requiring” a doctor to directly participate in someone’s assisted death, MDMD firmly supports the notion of conscientious objection. Although 45% of UK doctors already believe that a form of assisted death occurs in the UK, and 55% of UK doctors already agree that the law on assisted dying should change, MDMD recognises that an important minority of doctors are opposed. As with all questions of conscience, My Death, My Decision would never “require” a doctor to assist in someone’s wish to die, and would respect their right not to participate. Similarly, when Mr Lawson suggested that the very notion of assisted dying would “breach [a doctor’s] Hippocratic Oath”, it appears that he overlooked the modern articulation of the medical profession’s practice oath which now reads: “I will respect the autonomy and dignity of my patient”. A striking statement, considering that it is unclear how refusing the peaceful death requested by a patient after careful consideration of the options, when their future quality of life for them lacks the level of dignity they would wish, “respects the autonomy and dignity” of the patient.

Amongst Mr Lawson’s other objections to changing the law on assisted dying, is a concern that many patients “can come under subtle (or not so subtle) pressures from relatives who stand to benefit from such ‘assisted suicide’”. This is an important concern, and it is right for Mr Lawson to raise it. However, as important as this concern is, there are three significant considerations to be drawn out from the issue of coercion.

Firstly, it is likely that a much larger percentage of dying people already experience a form of coercion, through the strong social pressure to “keep on fighting”. Many individuals who suffer unbearably want to die peacefully, but often feel forced to accept medical treatment to stay alive.

Secondly, as Mr Lawson himself notes, there is already an absolute right, without any recourse to scrutiny, for someone to refuse life-sustaining medical treatment. Therefore, if it were true that unscrupulous relatives are motivated by a desire to pressure their elderly relatives to end their lives, it is unclear why there is no evidence of individuals being pressured into ending their life by removing treatment. Indeed, in most cases, grieving relatives are likely to pressure their loved one into staying alive longer, as opposed to pressuring them into ending their lives.

Finally, medical professionals are well versed in identifying coercion and ensuring that individuals can make fully informed decisions. However, MDMD believes that it is important that we continue to develop and improve good practice to detect and avoid pressure and coercion relating to all end-of-life planning decisions and choices – accepting or refusing treatment, making advance decisions and statements of wishes, as well as (when legalised) requesting a medically assisted death.

If you would like to add your own comments to Mr Lawson’s article, it can be found here.

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Is “Mercy Killing” ever the right thing to do?

The BBC, and a number of newspapers, (see the Ayrshire Post), report the story of Ian Gordon who smothered his wife of 46 years with a pillow as “a final act of love” to relieve her pain and suffering. Did he do the right thing?

The judge’s explanation in sentencing, though interesting, doesn’t really help. The judge may well be doing his job to the best of his ability, implementing the law within the bounds he is permitted. But cases like this are complex and, (MDMD believe), indicate a failing in the law itself, rather than its application. The original charge of murder which Mr Gordon faced was reduced to culpable homicide, on the basis of diminished responsibility, at an earlier hearing.

The court heard that Mr Gordon’s wife did not want to be treated for her health problems because she was afraid of hospitals. Her family report her suffering excruciating pain immediately prior to her death. This is the first complexity – the possibility for treatment and pain relief, and even professional diagnosis was apparently refused. This was Mrs Gordon’s right, but it makes the situation harder for everyone else when it causes desperate actions, however well intentioned.

Did she actually ask to be killed? And if she did, was it her own, well considered and persistent wish, made when she had sufficient mental capacity? No verbal or written request is recorded, though apparently the couple had a “death pact” between themselves. There were, of course, no independent professional witnesses to this.

Had all alternative options been explored? For example, could increasing levels of pain relief have been given at her home, possibly including terminal sedation? To what extent might these have provided a good death, or at least a better death, for this unfortunate lady?

Mrs Gordon’s daughter explained that her mother had a history of suffering from anxiety and depression. To what extent did this exacerbate the situation? Was it resistant to all possible treatments?

In cases like this, without the possibility of legal medically assisted dying, these questions cannot be satisfactorily answered. In the most important sense, it is too late to ask after the person concerned – and primary witness – has been killed, or has taken their own life. It is only when a formal legal process for assisted dying is available,and someone has requested this, that proper investigations can be made before the death, and the secrecy and anguish of well-meaning but possibly misdirected illegal actions can be avoided.

MDMD Coordinator, Phil Cheatle, says, “I have been in a similar, very difficult situation to Mr Gordon, so I have every sympathy with him and his actions. On balance, I decided to refuse my mother’s requests to help end her life when I had a similar opportunity, but perhaps my mother’s suffering was not as great as Mrs Gordon’s. However, seeing my mother in pain, and her personality slowly disintegrating due to dementia, was dreadful, both for her and for those who knew the person she had been. We need a change in the law to prevent tragedies like this – whichever decision people like Mr Gordon, or me, take.”

What sort of assisted dying legislation would have avoided the Gordon’s tragedy and others like them? Fundamentally a law which respects a dying person’s well informed and well considered wishes, and which gives them some control over the timing of their death. However, for the protection of vulnerable people and the wider society, such a law needs to place strong requirements on the person seeking assistance to die. For someone to take advantage of such a law, they would have to agree to many examinations and consultations with multiple trained professionals. At the very least these professionals would need to ensure:

  • that the requestor was incurably and unacceptably suffering from a condition that was highly unlikely to improve;
  • that the requestor considered an assisted death to be the best option available for them, having carefully considered all other available options, and the likely future quality of life they could expect;
  • that the requestor had sufficient mental capacity to take a life-ending decision;
  • that the requestor’s decision was consistent over a period of time;
  • that the requestor had instigated the request themselves and had not been coerced into their decision.

It is not clear whether Mrs Gordon would have agreed to the process, or would have met conditions like these, had the option been available. This makes this case particularly difficult. It surely cannot be correct for others, (in particular those who are emotionally involved, and not medically qualified), to make a life ending choice on behalf of another, however well-intentioned and compassionate their motives. The only exception is in the situation of doctors making a best-interests decision to stop further treatment in cases they deem hopeless, or following a patient’s advance decision to refuse treatment. Our sympathy with the actions of Mr Gordon is precisely because there didn’t appear to be better alternatives available to him and his wife. With better alternatives, his actions would have been unacceptable.

An appropriate law would make the situation much clearer to those who wanted to do their best to help their loved ones to have a good death. If someone like Mrs Gordon had sought professional help – knowing that help to die would be available when needed… If she had put on record, many years before hand, her desire for the option of an assisted death if she ever reached a point in later life where she deemed it necessary… Then there would be no excuse for people to take drastic, illegal and dangerous action themselves, and as a result society, (and in particular, vulnerable people), would be safer.

Mr Gordon told his daughter “I don’t have a single regret.” His whole family and many character referees, appear to back his decision to kill his wife out of compassion. A law that makes people feel they have to take the law into their own hands to “do the right thing”, due to lack of appropriate legal choices, is fundamentally a bad law and needs to be changed. This failure of the current law to provide a more compassionate option, is made worse, in this case, by compounding the tragedy of the violent death of a much loved wife and mother, with another tragedy of a jail sentence imposed on a caring husband, driven to break the law due to lack of an acceptable alternative.

The case is not an isolated incident. For example, earlier this year a man who attempted to kill his wife to end her suffering was given a suspended manslaughter sentence. How many more cases of successful or attempted mercy killings, assisted suicides, and people taking their own life do we have to endure before we get more compassionate laws – throughout the UK? How many more tragic events like these go undetected, or under reported?

Update 19th March 2018:

Scottish Legal News reports that the custodial sentence of Ian Gordon has been quashed on appeal – leaving Mr Gordon with an admonition. The full ruling is here. It appears that the appeal court decided that the original  sentence was inappropriate as insufficient weight had been given to psychiatric reports on Mr Gordon which indicate that he “was suffering an abnormality of mind” which rendered him “unable by reason of mental disorder to appreciate the nature or wrongfulness of any conduct”. Good news for Mr Gordon and his family, but it further emphasises the need for a change in the law to avoid these dreadful, unsafe situations in the first place. We need to allow the option for a medically assisted death under carefully controlled circumstances, in order to remove the need for desperate actions by apparently compassionate, well-meaning, people who are “suffering an abnormality of mind” which leaves them “unable … to appreciate the nature or wrongfulness of any conduct”. Where are the safeguards in that? Where is the careful, objective, consideration from impartial experts – before the (possibly vulnerable) person has died?

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Suspended sentence for failed mercy killer

The BBC and the Guardian report the particularly tragic story of 95 year old Denver Beddows who admitted battering his 88-year-old wife Olive with a pan and a hammer at their home in Warrington. Mrs Beddows survived the attempted murder. Mr Beddows received a two year suspended sentence.

Apparently Mrs Beddows had pleaded with her husband to end her life so that she would not die in a care home. This is given credibility by the fact that Mrs Beddows has now forgiven her husband and wished to be reunited with him.

The story is complicated by the fact that according to psychiatric reports Mr Beddows had a history of depression dating back to 1962 and was “clearly under a great degree of mental strain and was not thinking straight”.

Without a compassionate right-to-die law, it is hard to see how tragedies like this can be avoided. With an appropriate law, Mrs Beddows would be able to formally request medical assistance to die. Before being granted, the request would be assessed by multiple independent professionals who would evaluate, amongst other things:

  • Did Mrs Beddow have the mental capacity to make a life ending decision?
  • The medical situation leading to Mrs Beddows request – presumably an 88 year-old, in need of a care home had a serious illness. What were the prospects of a recovery that Mrs Beddows would find meaningful?
  • Whether Mrs Beddows was being coerced into making her request. Was there evidence of a long held view that she would want an assisted death if she was so ill as to require permanently living in a care home – something that she foresaw that she would find intolerable. In its best form such a view would be documented in a signed and witnessed advance statement. This would help doctors and others assessing the case to be confident that it was her own choice. MDMD advocate such advance statements to be made at the same time as an Advance Decision.
  • Whether all other possible solutions have been properly examined.
  • Was she suffering from a curable depression?
  • Might she adapt, given time, to a changed situation following some life-changing change in circumstances.

If, following careful evaluation by multiple independent professionals, the conclusion was that her wish to end her life was safe and persistent, then with appropriate medical assistance, she could have the good death she wished for. If the request was found to be unsafe and rejected it would not be defensible for someone to attempt murder or assist suicide – so vulnerable people would be better protected than at present.

For some people, even the best nursing or palliative care is not the type of end of life they want. Instead of fighting on against inevitably worsening illness, they would prefer to peacefully go to sleep and not wake up, often in their own home, possibly in the company of those closest to them. Why should they be denied this rational choice?

In the absence of an appropriate right-to-die law, cases like this will persist. Untrained, emotionally involved people will take the law into their own hands. They will try to assist in suicide, or even attempt murder. It may go horribly wrong, as in this case. It could be very traumatic. The person may not die but be left with serious injuries. Worse, once the life has been ended there is no way of knowing whether the action really was at the deceased’s request. Where are the safeguards in that? Yet that is what parliament decided was a “safer” option than really tackling the issue of what right-to-die legislation this country should have. The result: people who would like an assisted death have to continue to suffer, against their will, and be denied the good death they seek. And in addition, people, like Olive Beddows, have to beg apparently well-meaning people to assist suicide or murder. They risk themselves ending up in a worse situation. The person assisting them will be subjected to, at best, a police interrogation, and at worst, criminal charges and a custodial sentence. The parallel with backstreet abortions before abortion was legalised is chilling.

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House Of Lords Debate on Assisted Dying

On 6th March 2017 the House of Lords held a short debate on Assisted Dying “To ask Her Majesty’s Government what assessment they have made of recent legislation on assisted dying in North America; and whether those laws provide an appropriate basis for legislation in England and Wales.”

The transcript reveals the continuing debate along well-worn lines. Those in favour of a change in the law in the UK describe the recent changes in legislation in Canada, California and Colorado as indicating a “tide of history” which will sooner or later reach the UK.  Those opposed were concerned about inadequate safeguards and the possibility of future extensions of an initial law permitting assisted dying.

In his summing up, the Advocate-General for Scotland (Lord Keen of Elie) makes some helpful observations. Importantly he points out something that is often overlooked in media headlines: the two sides of the debate have much in common. We all want to ensure people have access to high quality compassionate care at the end of their lives. Further, we all want to protect those who are vulnerable from coercion. He identifies the central question as “whether a blanket ban on assisting suicide is a necessary and proportionate way of achieving this.” MDMD clearly think not. True compassion, for some people, in some situations, means medical assistance to end their life at a time of their choosing, when their quality of life is incurably below the level they can accept. To deny people this opportunity is a cruelty that vulnerable people should be protected from as much as from any coercion to request it.

Regarding a change in the law, Lord Keen cautions that there are cultural differences between countries which mean that we cannot simply adopt a law from elsewhere. He also echoes concerns about the possibility of laws being modified in future. He points out the need for very carefully crafted safeguards, while accepting that no safeguards could eliminate risk completely. “The real question is: how much risk to the vulnerable is acceptable in order not to deny those who would genuinely wish to be assisted to commit suicide the opportunity of an assisted death?”

How do we move the debate forward? MDMD believes that some new thinking and proposals are necessary. Some important suggestions we offer are:

  • The six month criterion has serious problems both of diagnosis, but also for people with incurable, often slowly degenerative, diseases who suffer intolerable conditions for much longer. Dementia is an important example. It is now the most common cause of death in England and Wales. People with a dementia diagnosis are faced with horrible alternatives before they lose their mental capacity: ending their life in Switzerland like Ron Hall; ending their life themselves like senior judge Sir Nicholas Wall, the former President of the Family Division; or being subjected, like Joan Cheatle, to the living nightmare of one’s self withering away uncontrollably with loss of all shreds of dignity, even though she had excellent specialist care.Despite these concerns, the six-month criterion may turn out to be an important initial safeguard – but it should be recognised for what it is, the first step in a cautious, incremental approach towards more compassionate, but still safe, solutions. Many changes in law have been introduced step-by-step – our right to the vote being the most obvious example.
  • Currently proposed safeguards are not considered adequate by many opponents. We should work actively to improve this. MDMD’s suggestion of extending the concept of an advance decision could be an important contribution here. Under our proposal, vulnerable people who had not previously made a formal statement of their wish for the option of an assisted death, made at a time when there were no questions about their “vulnerability”, would have precisely the same protection as at present. Yet those who could point to evidence of their long held wish, or who were very clearly not vulnerable even if they had recently changed their mind (like Lord Rix), would be allowed assistance to have the good death they desire.
  • More detailed proposals are needed of how exactly doctors and courts could establish that someone was making their request freely. There are already many healthcare professionals experienced in interviewing people, especially vulnerable people, to ascertain their wishes, to test the reasons for those wishes, and their consistency. Perhaps such an expert interview should be compulsory and recorded on video for consideration by others involved in the authorisation process.
  • The question of “how much risk to the vulnerable is acceptable” needs to be balanced by the question “how much suffering should be inflicted on the incurably ill by refusing their well considered requests for an assisted death?”. The best estimates, from those jurisdictions where assisted dying is legal, suggest that the risk to vulnerable people is very small indeed – there is very little evidence of coercion – though admittedly it could be hard to trace. We should perhaps do more work to quantify the amount of incurable suffering being experienced by those who are refused the life ending assistance they desire – but it is very difficult to do so. We have estimates of how many people choose to end their life in Switzerland (47 people went to Dignitas in 2016 from Great Britain). We can only estimate how many people take their own lives due to incurable suffering. Dignity in Dying estimate 300 per year. This is a helpful statistic, but it is likely to be a significant underestimate as they only include those suicides where “terminal illness” is mentioned, and their data will exclude many situations where someone has voluntarily stopped eating and drinking to hasten their death, as this is unlikely to be recorded as suicide. Anecdotally we hear of many more cases of people suffering against their will at the end of life, where death eventually comes as a relief.

MDMD encourages and participates in constructive discussion between all parties. There is clearly much more work to be done to produce a more acceptable proposal for how the law should change in this country.

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Dementia sufferers ending their lives in Switzerland

Today the Mail on Sunday published an article about the father of an MDMD supporter who ended his life at Dignitas. Penny’s father Ron Hall suffered from early stage dementia. The psychiatric assessment to ensure he still had mental capacity to make the life ending decision was done by MDMD’s associate coordinator, Colin Brewer. Interestingly, the article goes on to point out that Colin regularly has to refuse an assessment of adequate mental capacity when, in his professional opinion, the person is no longer lucid enough to make the decision to take their life.

Dementia is a particular concern for MDMD. It is now the leading cause of death in England and Wales. Many more people die with dementia rather than of it. The issue of dementia highlights the reason why MDMD does not want assisted dying to be restricted to those who are expected to die within six months. By this stage, terminally ill dementia sufferers are very unlikely to have sufficient mental capacity to safely make the decision, and they will have already suffered for far too long.

Opponents to a change in the law warn that dementia sufferers who choose to end their lives while they still have mental capacity may be shortening their lives unnecessarily, as they may die of something else first. This is true, but some of us would prefer to sacrifice a period of diminishing life quality rather than run the risk of having to suffer the living nightmare that the later stages of dementia can become. It is a difficult choice for anyone – but one that we should be allowed to make for ourselves, provided we are well informed, but before it is too late, we no longer have capacity, and we end up like Joan Cheatle.

A spokesman for the group Care Not Killing commented that “a lot of people fear that when there is a care crisis within the NHS there will be more pressure on people who are elderly and frail to think about ending their lives.” MDMD understands this concern. We propose the idea of an extended advance decision – which allows people to record their wish for the option of a medically assisted death, long before they are elderly and frail. Such an advance statement would ensure that their choice was not the result of pressure, should they be considered vulnerable at the time they make their choice.

MDMD are pleased that articles like the one in today’s Mail on Sunday keep the issues in the public eye. We call on those with concerns over the safety of assisted dying legislation to work with us constructively to find a safe proposal to allow people a “good death” when, for them, that requires medical assistance to die.

UPDATE 24th January 2017

Following the Mail on Sunday article, Radio 5 live contacted MDMD. This resulted in the radio interview with Penny Hall. A reduced podcast of the interview is available here. For the next few weeks the original full interview is here.

Penny’s interview was followed an hour later by an interview with Baroness Ilora Finlay, chair of National Council for Palliative Care and co-chair of Living and Dying Well. MDMD agrees with Baroness Finlay’s comments that everything possible should be done to enhance the final phase of people’s lives. Where we differ is how to deal with the the situation when a person’s quality of life falls permanently below the level the person is able to tolerate, despite having the best care available. Only the person themselves can judge where that point is for them.

The knowledge that medically assisted suicide is available when things get unbearable can help people enjoy that final phase of life for as long as possible. Without it some people feel that the better option is to end their lives themselves, one way or another, while they still can. The irony is that a carefully designed assisted suicide law, working in partnership with the best palliative care, could actually prolong people’s lives and increase it’s quality by removing the fear that the dying process may at some stage become intolerable and they will be trapped.

Until the palliative care community work with groups like MDMD to find a safe, workable way forward which includes the possibility of a medically assisted death in this country, there will be far too many bad deaths, and people like Penny Hall’s father, who decide that the best death possible for them is an assisted one in Switzerland.

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Protecting Vulnerable People

We were interested to see an article on the Christian Institute website about MDMD, claiming that we “lobby for legal protections to be removed from vulnerable people”. Nothing could be further from the truth. MDMD is concerned that any right-to-die legislation should fully protect vulnerable people.

We suggest that the author read our proposals for extending advanced decisions which would allow assisted dying for those who wish it, but still provide vulnerable people with the same protection as they have today. This is much stronger protection for vulnerable people than previous proposals for right-to-die legislation and deserves to be seriously considered.

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