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Assisted Dying

The Minister must be asked the same question, then. Is it a good thing that people are apparently breaking the law but not being imprisoned, and perhaps not even prosecuted? Either way, we ought to have a law that says what it means and means what it says, rather than making people feel that they have to take a chance. Some think that they cannot take that chance, so they are unable to give or receive assistance. There is not a choice between palliative care and assisted dying. Everyone recognises that palliative care is an important part of end-of-life care, and the suggestions for legislation on assisted dying have included palliative care. However, it is a form of treatment, and at some point a person is entitled to say that they are fully palliated as far as medical and nursing care can provide for, and that they do not wish to have any further palliation as an alternative to a dignified death. It is not for us to impose on them our view that they must be satisfied with the palliative care that they get. In jurisdictions where there is assisted dying, there has been an increase in the provision of palliative care, and rightly so. In Oregon there is no perceived conflict between the two. I shall give some examples of the difficulties that people face in knowing what will happen to them if they assist someone with death. As we know, Dignitas helps people with incurable illnesses to die, and it regularly features in the British media. We understand that 650 British citizens are members of Dignitas, and more than 100 have travelled to Switzerland to have an assisted death since October 2002. I wish to mention the case of Reg Crew, who had motor neurone disease. His wife Win Crew and their daughter Jan Healey accompanied him to Dignitas when he died in January 2003. His wife Win has written:"““Although I am a Roman Catholic, like many others in my position, when Reg said he wanted medical assistance to die, to avoid a long and painful death, I felt this was the right thing to do. I agreed with him that the disease should not rob him of the ability to choose the manner of his inevitable death…For several months after my return, I had the threat of legal action hanging over me but what alternative was there?””" The problem with the current state of the law for people in that situation is that they fear legal consequences for their loved ones on return to the UK. That is cruel. A lack of legal certainty about prosecuting those who accompany loved ones to Dignitas leads some terminally ill people to travel to Switzerland all by themselves, and as a consequence to go earlier than they would have liked. It forces people to make that decision while they are still able to make it themselves and do not need assistance. They are forced to die in a foreign country, away from familiar surroundings and in some cases without their loved ones. The second example is mercy killing. Under current law, anyone who ends the life of another can be convicted of murder and receive a life sentence, even if the act is a compassionate response to a dying person’s request for help to die—a so-called mercy killing. Despite the risk of a murder conviction, a number of people who resort to mercy killing regard it as the final act of love towards a loved one who is dying and requests help to die. Home Office records show that in the past 15 years, a total of 57 suspects in homicide cases could be described as being involved in mercy killings. Again, that probably represents a small fraction of the true number. The impact of that is, again, very negative. There is obviously a risk of imprisonment, long drawn-out trials and public labelling. People who have committed an act of mercy killing often also suffer long-term effects on their mental health, which can lead to self-harm or even suicide. A Home Office report states that of the 57 suspects of the act of mercy killing, 21 have committed suicide. With no clear policy in place, people may claim to have committed a mercy killing or assisted a suicide for compassionate reasons, when in fact their motives were more sinister or selfish. We do not have a law that provides safeguards. Mercy killing is clearly not the answer, nor is the status quo, so we have to recognise what is happening and consider what can be done to avoid the all-round negative consequences. Violent or botched suicides are another consequence of the current law. People take the act into their own hands and attempt suicide, which can lead to long drawn-out and painful deaths. It is impossible to calculate the number of such cases, but examples are known. My final example is Sue, who has said about her terminally ill father’s attempt to commit suicide:"““My father had prostate cancer. At some point there was nothing more doctors could do. My Dad sadly experienced how the laws in this country operate. He threw himself down the stairs in an attempt to kill himself. It didn’t work, but the doctor left him there as long as he could, waiting to see if he might die. This is how the law forces doctors to abandon their patients. My father was left at the bottom of the stairs for two hours with a cut on his head. Eventually he died a week later at home.””" As a consequence of the law, people are sometimes forced to die a lonely death in the absence of their loved ones, out of fear of the legal consequences for anyone they ask to be present at the time of their death. As it is illegal for anyone to help another person to die, some people choose to commit suicide while they are still able to do so. Again, that may mean that they die earlier than they would wish. Authorities in Oregon are aware of 94 terminally ill people who were prevented from committing violent suicide because the option of assisted dying was available to them, and 50 of them went on to die a natural death. I do not have time to go into the case of people who refuse food and water, but again it means a more protracted death than the painless one that is available through assisted dying.