What are the key current issues, what do you need to know, and what can you do?
On 6 January 2017, it was announced that Noel Conway, a 67-year old man with Motor Neurone Disease, would, supported by Dignity in Dying (formerly the Voluntary Euthanasia Society), challenge the Suicide Act in the courts. Mr Conway's case is similar to that of Tony Nicklinson; the difference, it is argued, is that Mr Conway's conditional is terminal. Three High Court judges heard contributions on behalf of the claimant (Mr Conway), the defendant (the Secretary of State for Justice) and three interveners (CNK, Not Dead Yet UK and Humanists UK) from Monday 17 - Thursday 20 July; they dismissed the application on 5 October 2017, but an appeal was heard at the Court of Appeal Tuesday 1 - Thursday 3 May 2018. CNK again intervened, with counsel for the Secretary of State making extensive reference to our expert evidence; the appeal was dismissed, and the Divisional Court ruling upheld, on 27 June 2018. On 27 November 2018, the Supreme Court declined to hear a further appeal, bringing the case to an end.
A second, separate case, that of 54 year old Omid, who was diagnosed with Multiple System Atrophy (MSA) in 2014, 'seeks a declaration that the Suicide Act 1961 and the Coroners and Justice Act 2009 are incompatible with the Human Rights Act.' Omid ended his life at an assisted suicide facility in Switzerland on 5 October 2018.
CNK intervened at the Supreme Court in 'Y', concerning the necessity of court approval for withdrawal of Clinically Assisted Nutrition and Hydration (CANH) in cases of prolonged disorders of consciousness (PDOC) when five justices heard the appeal 26 - 27 February. Again, extensive reference was made by lead counsels to CNK's expert witness evidence.
Despite a clear rejection in May 2015 of the bill Patrick Harvie inherited from Margo MacDonald, many advocates of legalised assisted suicide (and euthanasia) claim that the new Parliament elected since (in 2016) would be more receptive to legal change, and the threat of a new bill, supported by better established campaigners on the ground, is expected.
Immediately on the heels of three successive sets of 'assisted dying' proposals being put before the House of Lords - where they have failed to make headway - Labour MP Rob Marris, having won the 2015 Commons Private Members' Bills ballot in the Commons, brought Lord Falconer's proposals before MPs. Following the first legislative debate on assisted suicide in the lower house for 18 years, MPs rejected the Assisted Dying (No. 2) Bill by a massive 330-118 on 11 September and Mr Marris retired at the 2017 General Election.
Senior physician Baroness Finlay's Access to Palliative Care Bill was drawn 31st in the Lords 2017-9 bill ballot. Lord Hayward's Assisted Dying Bill was drawn 26th, but the Bill does not appear among bills before Parliament. No MP drawn in the equivalent Commons ballot chose to present an 'assisted dying' bill.
Healthcare professionals have consistently been opposed to legalising practices which their experiences tell them are uncontrollable, unethical and unnecessary. None of the major medical bodies have contradicted this view and a change in the law is formally opposed by the British Medical Association, the Association for Palliative Medicine, the British Geriatric Society, the World Medical Association and the Royal Colleges of Physicians, General Practitioners and Surgeons of England. Only the Royal College of Nursing is officially neutral, while the Royal Colleges of Psychiatrists and Physicians of Edinburgh have specifically declined to state a position.
Medical opposition has been frequently reaffirmed as the threats to vulnerable people and the medical profession which serves them loom larger. Recent examples include the RCP in 2010, the BMA in 2012 and 2016 and the RCGP in 2011 and 2014, when 77% of respondents to "one of the most comprehensive consultations the College has ever undertaken" favoured maintaining collegiate opposition. Such opposition must be maintained.
Requests for euthanasia and assisted suicide are extremely rare when patients' needs, including physical, social, psychological and spiritual needs, are properly met. Building on the excellent tradition of palliative care that we have in this country and making palliative care more readily accessible to all who need it are of the greatest importance, and poor practice must be identified and improved.
Concerns relating to to a current care issue are often best put through your GP, who will best understand the personal and local factors in the case, and who is best placed to make contact with the necessary individuals or bodies. Complaints regarding poor care should, according to the seriousness and circumstances of the case in hand, be directed to the relevant employer or health trust, to the General Medical Council (regarding doctors), to the Nursing and Midwifery Council (regarding nurses and midwives) or to the Care Quality Commission. You can also seek to bring further attention to instances of poor care by contacting the Department of Health, your MP or Members of the House of Lords.
Media outlets have access to people's homes and lives on a daily basis, and have a responsibility to portray serious issues such as these with impartiality and caution. Yet all too often, publishers and broadcasters happily give a free platform to campaigners for legal change (for example...) and high-profile advocates within the media use their abuse their position (for example...), while contempt shown for guidelines laid down by major health bodies like the World Health Organisation and the Samaritans to guard against suicide contagion - the 'Werther effect' - extends to drama and fiction (for example...). Some do better than others, as with ITV's treatment of the issue in 2011; they were strongly advised to aim for a similar balance in a January 2014 Coronation Street storyline. The BBC, on the other hand, has consistently failed to present euthanasia and assisted suicide with the objectivity required of a national broadcaster. From news anddocumentaries to soap, drama and comedy, the Corporation has justifiably been called a 'cheerleader for assisted suicide'.
If you consider a portrayal or report about assisted suicide, euthanasia or other end of life issues to be biased or in breach of media guidelines, you can complain to the broadcaster (e.g. BBC) or newspaper; to regulators like Ofcom; or to your MP or Members of the House of Lords (especially where the bias concerns the license fee payer-funded BBC). Social media is a useful way of engaging with others during or shortly after a broadcast or as soon as a media story has been published. On Twitter, be sure to include our handle: @CNKAlliance.