Advocates of Lord Joffe's Assisted Dying for the Terminally Ill Bill have been quick to point out the so-called 'safeguards' within it; that it is only assisted suicide and not euthanasia, only for adults and not children, only for those with less than 'six months to live', only for those with unbearable suffering and only for those who make a 'persistent and considered' request. They further emphasise the option of palliative care, the need for signed consent, assessment of mental competence, the two-week waiting period and the detailed documentation.
However they fail to point out the following:
- Assisted suicide is euthanasia by intention and often unsuccessful leading for the need for the doctor to step in with a lethal injection
- Assessments of 'competence' will extend the Act to children using the precedent of Gillick
- The prognosis in terminal illness is difficult to define and can be altered dramatically by treatment
- Suffering in the bill has been completely subjectively defined contrary to the advice of the Select Committee
- Individual cases of assisted suicide are not to be reviewed independently until after the key witness (the patient) is dead
- The evidence from Oregon and the Netherlands shows that relying on doctors' self-reporting is unreliable
- Requests for assisted suicide can be profoundly influenced by fear of being a burden which is impossible for those without personal knowledge of the patient to properly assess
- People often express a wish to die because of depression and no psychiatric screening is required in the bill
- The bill only requires advice about palliative care not experience of palliative care but many suicidal terminally ill patients change their minds completely once they receive good care
- The Bill has ignored all the House of Lords' Select Committee's recommendations that concern safeguards.[1]
This Bill also contains within it the seeds of its own extension. If we are allowing assisted dying for reasons of compassion, then why deny it to patients who are suffering unbearably but not terminally ill? If we are allowing it for reasons of autonomy, then why not grant it to anyone who wants to make the choice? Such inconsistencies will be ripe for challenges under the Human Rights Act the minute that assisted suicide is established as a therapeutic option for anyone at all.
Lord Joffe is to be commended at very least for his honesty in giving evidence to his own Select Committee:
'We are starting off, this is a first stage... I believe that this Bill initially should be limited, although I would prefer it to be of much wider application… But I can assure you that I would prefer that the law did apply to patients who were younger and who were not terminally ill but who were suffering unbearably, and if there is a move to insert this into the Bill I would support it.'[2]
Don't be fooled by the so-called 'safeguards' in this bill. It's only the beginning!
References
- HL Paper 86 Session 2004-05
- Assisted Dying for the Terminally Ill Bill [HL]. Volume 1: Report, Paragraph 92
