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A Short Stay in Switzerland - Care Not Killing reviews this controversial film

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26th January 2009

Care Not Killing reviews this controversial film

A Short Stay in Switzerland

Last night viewers saw a moving drama about the late Dr Anne Turner's death at the Switzerland's suicide facility, Dignitas. It is impossible not to have sympathy with the plight of Dr Turner and her family, and Julie Walters gave a splendid performance. However, the question we have to ask ourselves isn't whether we feel for Dr Turner and her family or whether we understand this lady's wish to end her life. The answers to those questions can be taken for granted. The real question is whether, as was suggested a number of times during the drama, we ought to legalise in Britain what Dr Turner did in Switzerland - commit suicide with assistance. That means examining the facts calmly and weighing the issues carefully.

Dr Turner was portrayed in the drama as a highly individualistic and determined woman with a powerful urge to control and as someone who was experiencing great difficulty in coming to terms with the loss of mobility and independence that her advancing illness caused her. Many viewers will have watched her and commented that they themselves wouldn't want to 'linger on' in such circumstances and they would want to 'end it all'; and they may well have sympathised with the words spoken by Julie Walters, who played the part of Dr Turner, that it ought to be possible to have assistance to commit suicide in this country. "That is my right", said Dr Turner in the drama.

But what responsible law-makers have to consider is whether they can safely make laws that give 'rights' to some people without exposing others to harm. Indeed, Julie Walters herself was reported a few days ago in the Manchester Evening News as having said, in relation to her portrayal of Dr Turner:

What would worry me is protecting the vulnerable if we were to draft a law. So it's a balance, isn't it? I believe in everybody having their rights, but also that the vulnerable must be protected.

She's right! It is a question of balancing benefits against harms. While there is a minority of seriously ill people who are, like Dr Turner, self-reliant and resolute about wanting to end their lives, the great majority are not. Many of them are, however, vulnerable to depression or to perceptions, real or imagined, that they are imposing a care or a financial burden on their families and to feelings that they ought, perhaps, to 'get it over with' in order to remove such burdens on others. Some of them even raise the matter with their doctors - which they can do, safe in the knowledge that, because the law forbids assistance with suicide, they can't be taken at their word. Almost invariably, they change their minds over time and, especially if they are receiving good palliative care, they come to terms with their condition and die in due course peacefully and with dignity. It is these seriously ill people - the majority, many of whom do not have the self-confidence or articulacy of professionals like Dr Turner - whom the law is designed to protect and who could easily be put at risk of making decisions to end their lives against their better judgement.

Of course, the advocates of an assisted suicide law here say the answer lies in safeguards. But it's one thing to talk about safeguards and another thing to make them robust enough to stand up to the very real stresses of serious illness and clinical practice. None of the safeguards we have seen to date do that.

Let's also be clear that those who want to see assisted suicide legalised here in Britain aren't thinking of the Swiss model. Their template is the US State of Oregon, where for the last 12 years they have had physician-assisted suicide - the Swiss organisation Dignitas isn't a "clinic" (as it is often mislabelled in the media) or indeed any part of the Swiss health care system, it's a plain suicide facility. Campaigners here, however, are trying to place assisted suicide within the comfort zone of the National Health Service.

Well, look what has happened with that in Oregon. Very few doctors there will touch assisted suicide, so 'doctor-shopping' is happening - with prescriptions for lethal drugs in some cases being written by doctors who have little knowledge of the patients beyond their case notes. It's hardly surprising therefore to learn, from an independent survey published last October in the British Medical Journal, that as many as one in six of people who have ended their lives in recent years in Oregon with drugs supplied by their doctors were suffering from treatable depression which their doctors had failed to pick up during the assessment stage.

If physician-assisted suicide were to be legalised here as the campaigners are urging, we could expect to see the same thing. All the Medical Royal Colleges and the BMA have declared their opposition to a change in the law, and surveys of doctors in the field show that the great majority of them would not write such prescriptions. These objections reflect the long-established and widely-held view in almost every country of the world that the role of doctors is to treat illness where they can and deal with its symptoms where they can't, but never to end life deliberately. As the Hippocratic Oath puts it so eloquently, 'I will give poison to no one'.

So, while last night's drama was good television, we must beware of the danger of jumping to wider conclusions about the state of the law on the basis of a highly individual case and a moving performance. We need to think with our heads as well as feel with our hearts.

Links

BBC Press Office Report
BBC News Report
Daily Telegraph
The BBC and Ann Turner
Coroners and Justice Bill
Coroners and Justice Bill - Briefing
BBC accused of trying to influence debate
Interesting timings
Bristol Evening Post 27/01/2009 - Assisted dying is a dangerous idea

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