Subject / interviewee : Physician Assisted Suicide - Lord Joffe, Dr Rowan Williams, Baroness David, Baroness Chapman, Sophie Turner, Edward Turner, Mandy Paine, David Hart and Fergus Walsh
Prepared by : David Griffiths and Ellie Persse
Fiona Bruce: A new Bill that would allow doctors to help terminally people end their lives has been rejected in the House of Lords. After an impassioned and often emotional debate peers blocked the move as morally indefensible and completely unnecessary.
[Comment: The Lords' debate was impassioned but also a comprehensive and thorough examination of the issues. The words 'morally indefensible and completely unnecessary ' are themselves emotionally loaded and do not adequately describe the key objection to this bill. The bill was rejected primarily because it was felt that it would place vulnerable people - the sick, elderly, disabled and depressed - under pressure to request early death on the grounds that they constituted an emotional or financial burden to others, that the right to die could become a duty to die.]
The Bill proposed that doctors should be able to prescribe a lethal dose of medication for patients who are terminally ill with less than six months to live and who are suffering unbearably. There were safeguards in the Bill so patients would have to be of sound mind, not suffering from depression and two doctors would have to agree on all of this. Although doctors would prescribe the medication they wouldn't be allowed to administer it.
[Comment: The word medication is not neutral and begs the question as to whether drugs prescribed with the intention of ending a person's life could be legitimately described as therapeutic. 'Lethal drugs' would have been a better description. The 'safeguards' in the bill do not actually require that the patient see a specialised doctor, such as a psychiatrist, who might be able to assess mental capacity, coercion or depression. Again this begs the question.]
Our Medical Correspondent Fergus Walsh has this report.
[Comment: Was Fergus really the best person to front this? He arguably has a strong vested interest in this law being passed, having accompanied Dr Ann Turner on her trip to the Dignitas Clinic in Switzerland and having been described in PR Week (3 Feb, 2006) by Mark Slattery, Head of Communications at Dignity in Dying (formerly the Voluntary Euthanasia Society) as 'a journalist I could trust'.]
Anti Assisted Dying Demonstrators: Praise the Lord Jesus. Care not killing.
Fergus Walsh: Opponents of assisted dying, among them religious and disability campaigners, have proved a potent coalition. They demonstrated outside Parliament while inside the Lords debated the issue for seven hours with more than eighty speakers.
[Comment: The opposition to this bill has been led by the medical profession and disability groups along with faith groups of Christians, Muslims, Jews, Hindus, Buddhists and Sikhs. The Royal College of Physicians, Royal College of GPs, and Royal Colleges of Nursing, Psychiatry and Anaesthetics are opposed to a change in the law along with all the main disability rights groups. Popular opposition to this bill has been led by the Care not Killing Alliance, a respectable group of 32 organisations including professional groups, healthcare providers, human rights groups and faith groups including the Association for Palliative Medicine (800 medical specialists in end of life care), the British Council of Disabled People (representing over 100 groups and 300,000 disabled people), RADAR (the Royal Association for Disability and Research), The Christian Medical Fellowship (5,000 doctors), the Church of England, the Catholic Bishops Conference, the Islamic Medical Association and the Medical Ethics Alliance. I was present at the demonstration, which was an orderly quiet broad-based protest from faith groups, disabled people, doctors and carers. It was addressed by doctors, academics, politicians, leaders of CNK member organisations and faith leaders. This clip caricaturises it as a bunch of religious fanatics and disability rights campaigners. There is no mention of the fact that 100,000 people signed a petition against the bill in four weeks and that this was delivered to 10 Downing Street earlier in the day nor that Peers had received more individual letters on this issue from the public than any other in the last 30 years.]
Anonymous Lord: My Lords, I pay tribute to the noble Baroness for her speech …
FW: And heartfelt views on both sides.
Lord Joffe: As a caring society we can not sit back and complacently accept that terminally ill patients who are suffering unbearably should just continue to suffer for the good of society as a whole.
Dr Rowan Williams: Whether or not you believe that God enters in to consideration, it remains true that to specify even in the fairly broad terms of this Bill, conditions under which it would be both reasonable and legal to end your life is to say that certain kinds of human life are not worth living.
Baroness David: As a ninety two year old, and I think probably the oldest person speaking in this debate today, I think it is patronising for opponents of the Bill to suggest that elderly people are unable to make informed decisions about their lives. If I were terminally ill I believe that I would be the only person with the right to decide how I die.
Baroness Chapman: My Lords, I have lost count of the number of times I've been told by the medical profession this could be the beginning of the end. On all of these occasions it is feasible I would have been classed as terminal under the structure of this Bill. To describe my condition many people would assume unbearable suffering. I would hate to be in a situation where I could be offered physician assisted suicide as a treatment option.
[Comment: These are fair quotes from the debate but again create the impression that opposition to the bill was primarily from religious and/or disabled people.]
FW: Of course the view of Parliament will have a direct impact on society, where assisted suicide will remain illegal. These four people have found themselves on opposite sides of the argument.
Sophie Turner (Daughter in Law of Assisted Suicide Patient): Hi.
FW: This was Sophie and Edward Turner minutes after their mother's suicide.
Edward Turner (Son of Assisted Suicide Patient): My mother's just died, she died about twenty five to, to two and she took the, the final dose at about five past one, within five minutes she was asleep.
FW: Ann Turner had swallowed a lethal drug prescribed by a doctor in Switzerland.
ET: And so these are, these are just some of the letters we've had.
FW: This was the first time we'd met since her death. The Turners have received letters of support from all over the world. Ann Turner had wanted to die because she knew her incurable brain disease would gradually rob her of speech and movement.
ET: She'd have been unable to move any muscle in her body, probably for the last six months to a year of her life and not even able to open her eyes, blink, swallow, speak, communicate. And, and so for her we saw that she had a very peaceful death, it was ordered and we were able to say everything we wanted to, there was no pain, there was no suffering and our mother actually looked forward to the day she died.
[Comment: Was it appropriate to give such coverage to the Ann Turner case here given that Ann Turner probably had 5-7 years at least to live and would not have qualified for assisted suicide under Lord Joffe's bill? This case, in which Fergus Walsh has been intimately involved, as he led the BBC team to Switzerland to film her death, has been widely criticised and is the subject of an early day motion in parliament which has already been signed by over 80 MPs. Ann Turner was a VES member and the trip was timed to coincide with the Voluntary Euthanasia Society changing its name to Dignity in Dying. The above emotive and subjective account is also medically inaccurate, and yet no medical input has been included. Rather the family's words are left to stand. None of this came out in this interview, or has actually emerged in BBC reports at any point.
The EDM (No 1494A1) reads as follows:
"That this House is saddened by the death of Dr Ann Turner and regrets the manner in which her assisted suicide in Switzerland was politicised by the euthanasia lobby to promote the legalisation of euthanasia; notes that what was described in The Times as as a 'grisly travelling theatre of death' for which a television team and other journalists were present throughout has been used relentlessly by the Voluntary Euthanasia Society to promote Lord Joffe's Bill to legalise assisted suicide; notes however that Dr Turner was not terminally ill and would not have qualified under the proposed legislation which requires a prognosis of death within six months whereas Dr Turner had six to eight years to live; further notes that she was diagnosed as having progressive supranuclear palsy (PSP) in 2004 for which the average survival is 10 years; further notes that the clinical course of PSP is not unlike Parkinson's disease and, although not curable, treatment is available that considerably improves the quality of life; hopes the authorities treated Dr Turner's son and daughters who accompanied her with compassion; nonetheless reminds the Government that every Disability Rights group in the UK is opposed to the Joffe Bill and any form of euthanasia because they consider it would totally undermine the basic rights of disabled people; and calls on the Government to invest extensively in research into PSP and similar diseases, to finance major extensions to the hospice movement and to oppose euthanasia."]
Mandy Paine (Terminally Ill Patient): That's the watch tower yeah.
FW: But Mandy Paine and David Hart say the law must not change. David has liver cancer, the doctors say he has less than six months to live. Mandy is just forty four and has a terminal lung condition. She needs oxygen twenty four hours a day and morphine to control the pain.
MP: It's, it's wrong …
FW: They told me life has value no matter how ill you get.
MP: Well from the day you're born you start dying so we're all in the same boat no matter what speed we go and it's written in the Ten Commandments, though shalt not kill and it's wrong to ask others to end your life.
[Comment: This example again caricaturises opposition as being mainly religious.]
David Hart (Terminally Ill Patient): Death is terminal and you can't reverse your decision once you've made it. I think it's fairly natural, when you're initially told by somebody you're going to, you know you're terminally ill you're going to be depressed and you'll depress your family and people say well, well maybe you should look in to this, that and the other and I think that's putting pressure on people at that stage.
[Comment: This is fair and puts the case.]
FW: Although the Lords rejected a change in the law, campaigners on both sides know this crucial issue simply won't go away.
Fiona Bruce: So Fergus, where does this leave people who are seriously ill and concerned that they won't be able to die at a time of their choosing?
FW: Well some of them are going to feel pretty desperate tonight Fiona. Some will go to Zurich to the Swiss group Dignitas which has helped more than forty Britons to die in the last three years. But having been there in January with Ann Turner and her children I can tell you that it's not straight forward planning your suicide in another country. And first of all you have to be well enough to get there, having said there is a lot of good palliative care and hospice support which opponents of this Bill say can help people who are in pain to die with dignity.
[Comment: This is very unbalanced. The question from Fiona Bruce is emotionally loaded and employs the misleading phrase 'choosing to die at the time of their choosing' which is a euphemism for 'receive a lethal prescription of drugs at the time of their choosing'. It is true that some dying patients do at tjmes feel desperate and may contemplate suicide but Walsh's statement will simply further fuel public anxiety and makes a number of false assumptions. Dignitas is mentioned uncritically without any indication that their work is extremely controversial - eg. Minelli's 16 April Sunday Times interview in which he suggested extending his 'services' to anyone who wanted it whether terminally ill or not, and also to people suffering from Alzheimer's dementia during lucid moments. Walsh's reference to palliative care by contrast is weakened by the use of the phrase 'opponents of the bill say' which implies that it is only a matter of opinion that palliative care can help relieve pain or help people die in dignity. This is an appalling distortion of the facts. The fact is that whilst a small minority of patients may entertain suicidal thoughts in the context of terminal illness, persisting requests for euthanasia or assisted suicide are actually extremely rare when patients' physical, psychosocial and spiritual needs are properly met. One palliative care doctor in our group talks of 10 persistent requests in 20,000 terminally ill patients. People change their minds once they are properly cared for and even euthanasia supporters do not now argue that pain cannot be relieved with high quality palliative care. It is disingenuous of Walsh to do so. In the Association for Palliative Medicine, 95% of members are opposed to any change in the law.]
FB: So is that for this legislation now or is it going to come back to Parliament in, in another guise?
FW: No, supporters of the Bill told me tonight they will be redrafting it and they will reintroduce it in the autumn, the fourth time in as many years and they point to opinion polls, around ten over the last decade which show consistent support, in fact eighty per cent for assisted dying. And with more and more of us Fiona, living longer, this is an issue that more and more of us are going to have to address and I think that society and Parliament are just going to keep on debating it.
[Comment: This is also unbalanced and inaccurate. First, did Fergus Walsh make any attempt to talk to opponents of the bill? It is not apparent that he did. The implication that this vote was only a temporary setback trivialises parliamentary procedure and the margin of the bill's defeat in the Lords by 148-100. This bill has already been introduced three times and been subject to the scrutiny and two 7-9 hour full debates in the Lords last October and on 12 May. The fact that it has failed to proceed on these three occasions and had such a heavy defeat now despite intensive lobbying by the pro-euthanasia movement is testimony to the amount of feeling against it in the Lords.
When Joffe said he was intending to reintroduce it there were howls of derision from the Lords' benches and Lord Carlile in proposing his wrecking amendment said that he had learnt not to be intimidated by threats. Many regard Joffe's persistent as an abuse of parliamentary time, resources and procedure but none of this comes out in Fergus Walsh's comments - rather he simply functions as a conduit for VES spin. There is no way a Bill can be brought back immediately after a heavy defeat and it was quite simply political nonsense to suggest this.
The reference to opinion polls is another example of VES propaganda. The Lords' Select Committee itself said that public opinion polls are notoriously unreliable as they are usually based on simple yes/no questions with no explanatory context and no understanding of alternatives like palliative care. This was borne out by the Dignity in Dying (VES) survey, which BBC News 24 uncritically played across our screens all day on 12 May saying that 76% of people supported Lord Joffe's bill. The YouGov question (submitted by Dignity in Dying/VES) on which this was based, which was incidentally not published until after 12 May, read as follows: 'These days people in the latter stages of terminal illnesses such as cancer (for example, people diagnosed as having 6 months left to live) can receive excellent palliative and hospice care to manage their symptoms; allowing them a useful and peaceful conclusion to their life. Knowing this, do you think the law should be changed to allow such patients to receive a prescription from their doctor to end their suffering, subject to a range of safeguards?' There is no mention of Lord Joffe's Bill and the ambiguous phrase 'end their suffering' is used when what is really meant is 'end their lives'. I suspect that many people voting yes thought they were in fact asking not for lethal drugs, but rather for the law to be changed so that good palliative care was more widely accessible.
To bring home the point a Communicate Research poll commissioned by ourselves and reported on in the Sunday Telegraph on 7 May showed that: 65 per cent of people agreed that a law to allow assisted suicide or euthanasia would mean that, 'vulnerable people could feel under pressure to opt for suicide'; 72 per cent agreed that 'doctors and other healthcare workers with ethical objections might feel under pressure to comply'; 75 per cent of people agreed that 'people with treatable illness such as depression might opt prematurely for suicide' and 73 per cent felt that it would 'make it more difficult to detect rogue doctors such as Dr Harold Shipman'.
There is no mention either of the many polls that have been carried out on doctors in the last few years. The Royal College of General Practitioners (RCGP) last September voted overwhelmingly that no change in the law to allow assisted suicide was necessary. The Royal College of Physician's (RCP) poll reported on the front page of the Times on 10 May showed 73% opposed a change to the law, using the same question the GPs had used. Further, 98% of RCP respondents in palliative medicine opposed the proposed legislation, and the Association for Palliative Medicine's own survey (mentioned above) had a 72% response rate and returned a similar figure of 94%. 75% of maxillofacial surgeons, 76% of clinical oncologists and a similar proportion from the Royal College of Psychiatrists oppose changing the law. In all these groups it is only 18% who would be prepared to have an active involvement should the law change. But amongst those dealing daily with dying patients - only 3% in palliative medicine would be prepared to be actively involved.]
FB: Okay, Fergus, thanks very much.
[Comment: Why is it that Fergus Walsh's comments are apparently accepted at face value? Why is he not cross-examined given that he is seen as a safe pair of hands by the pro-euthanasia lobby?]